Abuse and neglect have become a growing concern that is affecting many in various vulnerable populations. The vulnerable population of focus for this paper is the elderly. Research shows that as many as 5,000,000 elders are abused in the United States each year. Unfortunately, the abuse and neglect occur anywhere and by anyone. It can occur in their own homes or skilled nursing facilities. Abuse can come from caregivers whether they are health care professionals or family members. There are many contributing factors that may lead to abuse to include a lack of knowledge regarding signs, symptoms, and different forms of abuse, improper protocol for reporting, and caregiver burnout.
This paper not only discusses the learning barriers that lead to elder abuse but the solutions and techniques to properly educate family and staff in order to reduce the occurrences of abuse. Although the elder population is considered a vulnerable population, they are still human beings and their rights should never be compromised regardless of their physical capabilities or cognitive status. It is imperative that those providing care receive mediation and proper education to not only decrease abuse but ensure patients are respected, maintain their dignity, and remain safe while receiving quality, holistic care.
The nursing home staff to include registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs) are the target population while addressing learning barriers to elder abuse. Education for these health care professionals includes an associate degree for an RN, an associate degree or diploma for an LPN, and a certificate or diploma for CNAs (Certified Nursing Assistant Degree or Certification?). Healthcare professionals include individuals from various races, ages, educational, religions, socioeconomic backgrounds, and cultural beliefs.
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Learning barriers in the targeted population is comprised of a lack of knowledge in being able to recognize signs and symptoms of abuse, improper protocol for reporting abuse, and inability of the caregiver to effectively manage stress leading to burnout (Barriers in Detecting Elder Abuse Among Emergency Medical Technicians, 2016). In order to overcome these learning barriers education will be provided in the form of a lecture with the use of PowerPoints, videos demonstrating examples of abuse, and a pretest/posttest to determine if learning has occurred.
For many healthcare professionals a lack of knowledge regarding signs and symptoms of abuse can make it very difficult to detect when abuse is occurring. According to MedlinePlus, there are various forms of elder abuse that can transpire. This includes physical, emotional, sexual, or financial abuse. Neglect and abandonment are other forms of abuse as well and happens when there is failure to fulfill a caretaking obligation. Physical abuse can be detected by unexplained bruises or markings, injuries, pressure ulcers, and poor hygiene habits (Elder Abuse, 2018).
Emotional abuse occurs when an elder suffers from psychological or emotional distress and pain. Intimidation by yelling or terrorizing, scapegoating, humiliation and ridicule, isolating elders from their loved ones and friends, and ignoring the elderly person can all cause emotional distress and pain. Sexual abuse involves physical contact with the elderly person without their consent. It can also occur when the elderly person is forced to watch sexual acts, shown pornographic material, and being forced to undress.
Elders are financially abused when there is unauthorized use of their funds or property to include forging their signature, stealing cash, checks, or goods, and misusing checks, credit cards, or bank accounts (Elder Abuse and Neglect, 2019). Being informed about the different types of abuse, signs, and symptoms are critical in identifying when a patient might be suffering from abuse.
Although a healthcare professional may be able to identify the different types and signs of abuse, improper protocol may prevent a nurse from taking further action. Many facilities do have screening tools and referral protocols in place for staff to utilize, however, these tools and protocols tend to lack certain needed qualities. Tools and protocols are ineffective when they lack distinction as to type, signs, and risk factors, inclusion of domestic violence in late life, and delineation of appropriate state laws and community services for effective intervention (Elder Abuse Identification and Referral: The Importance of Screening Tools and Referral Protocols, 2008).
In order to properly address cases of elder abuse you must first ensure the elder is in a safe environment and proceed with an assessment of the situation and evaluate the need for protective services. It is imperative that the elderly patient is involved in the assessment process while identifying whether abuse is occurring and what kind. If abuse is suspected then it must be reported to the appropriate authorities, such as Adult Protective Services (Adult Protective Services).
According to Elder Abuse and Neglect, there are many responsibilities and demands that can lead to caregiver burnout, especially in situations where a patient’s condition is quickly deteriorating. The author of What is Caregiver Burnout, defined the term burnout as, “a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude-from positive and caring to negative and unconcerned.” When experiencing burnout, one might experience feelings of irritability and agitation, changes in appetite and weight, changes in sleep patterns, loss of interest in regular activities, emotional and physical exhaustion, and withdrawal from friends and family (What is Caregiver Burnout?).
In institutional settings nurses can be prone to burnout because of lack of training, too many responsibilities, poor working conditions, or the healthcare professional may be unsuited to caregiving. It is imperative that proper education and support from staff are available to manage stress. Nursing home staff should never be afraid to ask for help from their coworkers or superiors. Regular breaks should be taken to ensure the staff’s needs are attended to. Eating a well-balanced diet is a valuable way to provide the body with fuel and energy. A well-balanced diet can include fresh fruit, vegetables, lean protein, and healthy fats such as fish, nuts, and olive oil.
Exercising for at least 30 minutes a day will alleviate stress, improve overall mood, as well as increase energy in order to combat fatigue. Choose activities that are completely unrelated to work or stressors; like a fun activity or resuming a favorite hobby. Staff members can seek therapy or try stress-relieving techniques such as yoga, meditation, or deep breathing exercises to keep their anger and stress under control (Barriers in Detecting Elder Abuse Among Emergency Medical Technicians, 2016). The biggest step in preventing elder abuse and getting help is realizing that burnout is occurring.
In conclusion, there are a variety learning barriers that interfere with how the nursing home staff, to include RNs, LPNs, and CNAs, report elderly abuse. The staff needs to be educated on how to properly identify objective and subjective signs of any kind of abuse such as physical, emotional, sexual, financial, neglect, and abandonment. Protocol should be improved for the nursing staff to be aware of exactly what to do and in what order when encountering a patient who is suffering from abuse. Finally, it is important to remember that before taking care of other people, staff must ensure their own needs are met as well to prevent the occurrence of care giver burnout. With proper education all the outcomes can be properly addressed, and instances of elder abuse can be reduced.
References
- Adult Protective Services. (n.d.). Retrieved February 21, 2019, from https://www.ncdhhs.gov/assistance/adult-services/adult-protective-services
- Barriers in Detecting Elder Abuse Among Emergency Medical Technicians. (2016, September 2). Retrieved February 18, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5010700/
- Certified Nursing Assistant Degree or Certification? (n.d.). Retrieved February 17, 2019, from https://www.allnursingschools.com/certified-nursing-assistant/degrees/
- Elder Abuse. (2018, December 21). Retrieved February 17, 2019, from https://medlineplus.gov/elderabuse.html
- Elder Abuse and Neglect. (2019, February 13). Retrieved February 17, 2019, from https://www.helpguide.org/articles/abuse/elder-abuse-and-neglect.htm
- Elder Abuse Identification and Referral: The Importance of Screening Tools and Referral Protocols. (2008, October 24). Retrieved February 21, 2019, from https://www.tandfonline.com/doi/abs/10.1300/J084v13n02_02?journalCode=wean20
- Statistics on Nursing Home Abuse – Get the Facts You Need. (n.d.). Retrieved February 26, 2019, from https://www.nursinghomeabuse.org/nursing-home-abuse/statistics/
- What Is Caregiver Burnout? (n.d.). Retrieved February 21, 2019, from https://www.webmd.com/healthy-aging/caregiver-recognizing-burnout#1
