Dr Darcy's Ethical Issues

Choosing a long-term care facility can be very difficult because of incidents of abuse and/or neglect reported against care facilities can be overwhelming. For example in “Ending Elder Abuse: A family guide”, Diane Sandell lists many elder abuse incidents from her files such as: neglect of decubitis ulcers led to infection, sepsis, gangrene, and death. Facility failed to provide necessary diabetic diet; improper insulin administration, insulin overdose; dehydration and death. Resident left alone in chair in shower room fell, became paralyzed from neck down. Many reports of pinching, rough handling, slapping, yelling, threats (2000). It is believed that abuse is most likely to occur if the caregiver not only finds the work difficult but also (1) works full time, (2) cares for young children, (3) is poor, (4) feels little affection for the older person, (5) finds the elderly person very difficult, and (6) gets no support or help from others (Macionis, 2005). Although there is no excuse for abusing elderly Americans, it is still very prominent in today’s society. Diane Sandell explains in Ending Elder Abuse, that her 91 year old mother was beaten by a long-term care facility employee in the middle of the night for reasons unknown. It is stated that her mother died 6 weeks after the incident, unable to recover mentally from the abuse (2000).

Elder abuse includes physical, emotional, and sexual abuse as well as neglect, exploitation and abandonment of our older generation (Falk, 2012). The people that cause these injuries include the elderly person’s own family and staff members of nursing homes, assisted living facilities, medical rehabilitation facilities and hospitals (NCOA, 2017). There is approximately 1 in 10 older adults that have experienced some type of elder abuse in the United States (NCOA, 2017). Within these staggering numbers, only 1

Every elderly deserved the right to be treated with respect and protect from all type of abuse (American Psychological Association, 2006; Lee, 2007). Significant progress have been made in the past five years toward eliminating violence against older adults. However, the lack of knowledge and clinical skills in health care provider

A current ethical issue is elder abuse. The World Health Organization (WHO, 2015) defines mistreatment of the elderly, as “any single or repeated act or lack of appropriate action, occurring in any relationship where there is an expectation of trust, which causes harm or discomfort to an older person.” A distinction of elder abuse compared to domestic violence, sexual assault or fraud is that “elder mistreatment implies that the recipient of the mistreatment is in a situation or condition in which the ability to protect oneself is limited in some way” (Touchy & Jett, 2012, p. 401). Elder abuse represents a serious social problem, which is only on the rise because of the longevity and increased dependence of some elders (Martins, Neto, Andradea, & Albuquerquea, 2014).

Everyday thousands of senior citizens and people with Alzheimer’s disease or dementia suffer from abuse by a caregiver. Most of the abuse is in the form of emotional or physical abuse, but there are also a number of different types of abuse including financial abuse. The abuse can either take place in a medical setting such as a nursing home or hospital, or it can also be done by the victim’s own family members. These senior citizens are mostly targeted due to the fact that they are mentally incapacitated; they do not have a very strong short term memory, and sometimes they do not have the ability to talk to another individual about how their caregiver has been abusing them.

Although it does not usually make news headlines and is rarely discussed, nursing home residents and the elderly experience abuse sometimes on a daily basis. Medical errors, physical abuse, or stealing from them could all be classified as abuse. All around the world today, a population that is not able to help itself is being harmed, whether it is physical or sexual abuse, exploitation, or not being properly supervised; the elderly and nursing home residents are being abused.

Too often seniors refuse to report abuse, neglect, or crime against them out of fear of losing independence. It is a common misconception that being victimized will deem you unfit to live independently and will result in being placed in a facility of some sort. It is important that seniors feel they can turn to those around them with concerns and incidents that occur. In the event that a senior is not forthcoming with information there are a number of avenues that may involve reporting of suspected incidents. Hospitals, doctors, community service organizations, and long term care facilities can report suspected crimes to authorities or Department of Social Services in an effort to protect the individual. If a senior cannot properly protect themselves then health care professionals from all areas should have the ability to act on behalf of the individual to seek help but not dictate the overall outcome as a result. For example: simply finding that a person has been a victim of exploitation should not mean that a person be moved immediately into a facility forfeiting their right to care for themselves. All facilities acting to protect a senior should aim to preserve senior

The definition of patient abuse is the mistreatment or neglect of individuals who are under the care of a health care organization (Pozgar, 2013). In the United States, the vulnerable populations for this abuse are the elderly and children. Patient abuse is not only in an institutional setting, but also at home. The rise of elderly patients has increased in recent years due to the aging of the baby boomers. Currently, 13% of the population is over the age of 65 (NCEA, 2014). Many cases of elder abuse is caused by their own family (NCEA, 2014), this in turn reflects underreporting and insufficient data. The elderly also experience higher levels of physical and mental disability, which impair their abilities to report (CDC, 2014). Children are at high risk as well due to their vulnerability because of age and mental age (CDC, 2014). Health care workers are required by law to report suspected abuse (Pozgar, 2013). There is a strong ethical duty to acknowledge abuse of any patient. There are also legal ramifications compelling health care workers to be aware of suspected abuse. Each state has enacted laws to report abused patients as well as protect and at times penalize the reporter.

Abuse can happen to anyone, but elderly adults residing in nursing homes are more vulnerable and have a higher risk for abuse (Rasansky Law Firm, 2006, para. 1). Elders are among the fastest growing in the population, and because of this many more elderly

Professional people have to deal with senior adults as a special population and intervene to prevent and protect them from getting abused. Furthermore, the researchers discuss the ways to recognize the abusers by absorbing how complex or flexible the relationship between the caregivers and the victims and by knowing the caregivers’ personal issues as stress, which may lead to the abuse (Gorbien & Eisenstein, 2005). People who take care of elderly have to provide great attention to these vulnerable people and being aware of all the circumstances that around them whether relationship problems, illness problem as identifying dementia at an early stage, and promoting home service Monod (2013). All of these examples may prevent elder abuse.

One way elder abuse or elder mistreatment can be defined is, “intentional actions that cause harm or create a serious risk of harm, whether or not intended, to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder” (Bonnie & Wallace). There are seven main forms of elder abuse which include emotional, physical, psychological, sexual, financial, neglect, abandonment, and self-neglect (Cohen, Levin, Gagin & Friedman, 2007; Fulmer, 2008; Thompson & Priest, 2005). Even though only 6.2% of victims are abused in long-term care settings, my experience of witnessing neglect and abandonment are very serious (Teaster et al., 2006).

The elderly population is faced with many challenges as they age. One of the challenges is elder abuse. Globally, elderly abuse is a major social problem that has worsened over time. Physical, sexual, emotional or psychological and financial abuses are some of the forms of abuse the elderly population are subject to. Has memory problems such as dementia, lack of support and physical disabilities are some causes or risk factors of elderly abuse. The consequences of such abuse going unresolved is have health issues, such as depressions, anxiety, stress, long term-psychological issues and even death. Moreover, “elderly abuse is often defined as a repeated or single act, or lack of appropriate action, that happens in any relationship where there is an expectation of trust, which causes distress, injury, or suffering to an older person” (Kilvik et. al., 2015). The prevalence of Elder abuse is that of a world-wide issue caused by perpetrators, such as family members, friends, healthcare professionals, relatives and strangers. Interventions and prevention measures are put into place to help older adults suffering from the after math of abuse. As the elderly population grow, elder abuse increases. what are the different forms of elderly abuse? What are the various risk factors of elder abuse?

To better understand the scope of the problem, it is crucial that society knows what is considered as elder abuse and why it is important to resolve this issue. Elder abuse refers to any intentional or negligent act by a caregiver or any other person that causes harm or a risk of harm to a vulnerable adult. There are many forms in which an elder can be abused, “Elder Abuse and Neglect” Journal of Psychosocial Nursing & Mental Health Services distinguishes between the five most common types of elder abuse as well as their effects and/or common signs and symptoms for each. These types of abuse include physical abuse,

Elder Abuse is defined as any activity performed by an individual whereby these actions cause suffering of the older adult, intentionally or not (Touhy, Jett, Boscart & McCleary, 2012, p. 378). Unfortunately, the incidents of elder abuse continue to rise with the increasing number of people entering older adulthood. It is interesting to note that although elder abuse is highly under reported its occurrence increased three fold over a ten-year period (Friese & Collopy, 2010, p. 61). Certainly, it is a nurse’s duty to provide holistic care to his or her patients, which must include protection from abuse. Elder abuse can take on many forms including physical, emotional, sexual, neglect and financial. It is important to note that for the

It is also stated that family members and caregivers tended to be the responsible parties for most victims of elderly abuse and neglect (EAN). This form of EAN often fails to be reported to the relevant authorities as they maybe physically or psychologically unfit to make a complaint; or they may fear vital services necessary to their survival could be removed or denied by their tormentor as a form of punishment, however despite their fears, there has been a thirty per cent rise in reports of EAN in the last ten years. (Teaster, Lawrence and Cecil, 2007; Sepler, F.