A Nurse’s Role in Detecting and Reporting Elder Abuse

• Due to mental and physical declines that occur with aging, elderly adults are one of the most susceptible age groups for abuse. Studies have shown that most often the abuse is perpetrated by a family member or other loved one. 
• The nursing staff play an important role in being able to detect elderly abuse. 
• One of the most important duties of a nurse is to keep the patients they care for safe and free from harm. As a nurse it is important to be vigilant of the warning signs of abuse. As mandatory reporters, nurses are to report any suspicion of abuse, including that of vulnerable adults.  Failure to report elderly abuse can result in criminal charges and loss of professional license. 

What Is Elder Abuse?

Due to mental and physical declines that occur with aging, elderly adults are one of the most susceptible age groups for abuse. Studies have shown that most often abuse is perpetrated by a family member or other loved one.  

A 2017 study concluded that 1 in 6 adults over 60 experienced some type of abuse in a community setting. 

Many elderly adults are cared for by nursing staff to some degree, whether they are receiving care in their homes or in a long-term care facility. The nursing staff play an important role in being able to detect elderly abuse.  

A thorough familiarity of each patient’s past and current health conditions is vital when identifying health changes that may signal abuse.  

Different Types of Elder Abuse

Physical Abuse: When elderly patients experience pain, illness, injury, functional impairment, distress or death as a result of the intentional use of physical force. Examples of this are hitting, kicking, pushing, slapping, and even burning.  

Emotional Abuse: Verbal or non-verbal behaviors that intimidate, cause distress, fear, humiliation, or isolation.  

Neglect: Failure to meet an older adult’s basic needs. Examples are food, water, clothing, shelter, hygiene, and medical care. 

Financial Exploitation: Illegal and unauthorized use of an elderly adult’s money, benefits or belongings for the benefit of someone else other than the elderly adult.  

Sexual Assault: Forced or unwanted sexual interaction of any kind with an older adult. Examples are unwanted sexual contact or sexual harassment. 

How Can Nurses Identify Elder Abuse?

Of the different abuse types, physical abuse can be the most obvious.  

Nurses can assist in identifying physical abuse by completing regular and thorough skin assessments of the elderly adult. If the adult presents with new injuries, it is helpful to ask them questions to determine the cause.  

It is important that the elderly adult is alone so they can speak freely. The skin assessment should include the entire body and genital areas. Bruises, fractures, and other injuries at various healing stages are warning signs of physical abuse.  

Emotional abuse is often perpetrated by family members during their visits to see the elderly adult. A warning sign of emotional abuse is an elderly adult being consistently upset after a certain person visits them. Other changes in mood or demeanor can occur as well. They may also start refusing visits from certain family members or other loved ones. As a nurse, one may also witness verbally abusive statements to the elderly adult. 

Signs of neglect may come in many forms. Examples are malnutrition, not having access to medical care, poor dental health, and soiled or unkept clothing.  

Financial exploitation can be tricky to prove but some warning signs may be missing belongings or property, large bank withdrawals or transfers to other accounts, and checks or bank statements going to the perpetrator.  

Sexual Assault can be detected during the skin assessment and may be reported by the elderly adult themselves

What Is the Nursing Role in Reporting Elder Abuse?

When reporting suspected elderly abuse, refer to your state and employer procedures. The most important thing to ensure first is patient safety.  

Next, it is vital to document the patient’s statements without offering your opinion. It is important to be as detailed as possible in your documentation. Depending on the facility you work for you may be asked to photograph any injuries.  

Nurses are considered mandated reporters which means as licensed healthcare professionals, nurses are required to report any suspicion of abuse, including that of vulnerable adults.  Failure to report elderly abuse can result in criminal charges and loss of professional license.  

The Bottom Line

In conclusion, elder abuse is unfortunately a frequent occurrence of this vulnerable age group. One of the most important duties of a nurse is to keep the patients they care for safe and free from harm. As a nurse it is important to be vigilant of the warning signs of abuse.  

Nursing intuition can play an important role in detecting elderly abuse as nurses can often sense when something just isn’t right with one of the patients they care for. Trust your intuition as it is always better to over report a concern than to under report. It is vital to protect those who cannot protect themselves.  

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