BOOK
Medical Implications of Elder Abuse and Neglect, An Issue of Clinics in Geriatric Medicine, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Clinics in Geriatric Medicine, devoted to Medical Implications of Elder Abuse and Neglect, is edited by Drs. Lisa Gibbs and Laura Mosqueda. Articles in this issue include: Physiology of Aging; Understanding the Medical Markers of Elder Abuse and Neglect: Physical Exam Findings; Medical Markers of Elder Abuse and Neglect: Laboratory Findings; Common Presentations of Elder Abuse in Healthcare Settings; Physical Abuse; Elder Abuse and Neglect by Others; Geriatric Sexual Abuse; Emotional Abuse in Geriatrics; Self- Neglect in Geriatrics; Capacity Assessment in Elder Abuse and Neglect; Geriatric Dementia and Abuse; Mental Health/ Psychiatric Issues in Elder Abuse and Neglect; Care of the Victim in Elder Abuse and Neglect; Prevention and Early Identification of Elder Abuse and Neglect; and Doctors Roles and Relationships with other Agencies in Elder Abuse and Neglect.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Medical Implicationsof Elder Abuse andNeglect | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Clinics In Geriatric Medicine\r | xi | ||
| Erratum | xiii | ||
| Preface\r\r | xv | ||
| Aging | 671 | ||
| Key points | 671 | ||
| Overview of aging physiology | 673 | ||
| Body Composition | 673 | ||
| Skin | 673 | ||
| Bone | 673 | ||
| Eyes | 675 | ||
| Ears | 675 | ||
| Cardiovascular | 675 | ||
| Pulmonary | 676 | ||
| Muscle | 676 | ||
| Renal | 676 | ||
| Gastrointestinal | 676 | ||
| Neurologic | 677 | ||
| Reproductive | 677 | ||
| Overview of common conditions of aging (geriatric syndromes) | 677 | ||
| Delirium | 677 | ||
| Dementia/Neurocognitive Disorder | 678 | ||
| Depression | 679 | ||
| Urinary Incontinence | 679 | ||
| Falls | 680 | ||
| Osteoporosis | 680 | ||
| Conditions That Affect Sensory Systems | 680 | ||
| Substance Abuse | 681 | ||
| Polypharmacy | 681 | ||
| Frailty | 681 | ||
| Conditions That Affect Physical Function | 682 | ||
| Social Issues Affecting Older Adults | 682 | ||
| Elder mistreatment: difficulty in diagnosis and recovery | 683 | ||
| References | 684 | ||
| Understanding the Medical Markers of Elder Abuse and Neglect | 687 | ||
| Key points | 687 | ||
| Introduction | 687 | ||
| Physical findings associated with elder abuse | 688 | ||
| Trauma Involving Skin | 688 | ||
| Bruising Characteristics | 688 | ||
| Other Skin Injuries | 691 | ||
| Burns | 692 | ||
| Skin findings associated with neglect and self-neglect | 695 | ||
| Rashes | 695 | ||
| Ulcers | 698 | ||
| Head, Face, and Neck Findings | 702 | ||
| Strangulation | 703 | ||
| Head and Face Findings | 705 | ||
| Falls and Fractures | 706 | ||
| Placing physical examination findings into context | 707 | ||
| Documentation | 708 | ||
| Summary | 709 | ||
| References | 709 | ||
| Medical and Laboratory Indicators of Elder Abuse and Neglect | 713 | ||
| Key points | 713 | ||
| Introduction and overview | 713 | ||
| Medical and laboratory indicators of elder abuse and neglect | 714 | ||
| Malnutrition | 714 | ||
| Laboratory findings suggestive of malnutrition | 717 | ||
| Dehydration | 717 | ||
| Laboratory findings suggestive of dehydration | 718 | ||
| Chronic Illness Management | 718 | ||
| Medication misuse | 719 | ||
| Laboratory findings suggestive of mismanagement of chronic illness | 719 | ||
| Hypothermia and hyperthermia | 719 | ||
| Rhabdomyolysis | 721 | ||
| Infection | 721 | ||
| Toxicology | 722 | ||
| Postmortem biochemistry | 723 | ||
| Summary | 723 | ||
| References | 724 | ||
| Common Presentations of Elder Abuse in Health Care Settings | 729 | ||
| Key points | 729 | ||
| Introduction | 729 | ||
| Presentations of elder abuse in community living | 731 | ||
| Home Environment | 731 | ||
| Nursing Homes | 732 | ||
| Findings associated with elder abuse | 733 | ||
| Factors associated with elder abuse in different settings | 735 | ||
| Health care settings | 736 | ||
| Addressing elder abuse in different settings | 737 | ||
| References | 739 | ||
| Prevention and Early Identification of Elder Abuse | 743 | ||
| Key points | 743 | ||
| Introduction | 743 | ||
| Definition | 744 | ||
| Types of elder abuse | 744 | ||
| Incidence and prevalence | 745 | ||
| Morbidity and mortality | 745 | ||
| Risk factors | 745 | ||
| Early identification and prevention: state of the literature | 745 | ||
| Ageism | 746 | ||
| Increasing Awareness and Elder Abuse Indicators | 747 | ||
| Bruising and Fall-Related Injuries | 748 | ||
| Burns and Lacerations | 748 | ||
| Screening and monitoring for elder abuse risk factors | 749 | ||
| Comprehensive Geriatric Assessments | 749 | ||
| Referrals for Comprehensive Geriatric Assessments | 749 | ||
| Periodic Assessment of Elder Abuse Risk Factors | 749 | ||
| Social history and qualitative interviews | 750 | ||
| Elder abuse clinical assessments | 750 | ||
| Elder Assessment Instrument | 752 | ||
| Brief Abuse Screen for the Elderly | 752 | ||
| Hwalek-Sengestock Elder Abuse Screening Test | 752 | ||
| Elder Abuse Suspicion Index | 752 | ||
| American Medical Association Abuse Screen | 752 | ||
| Vulnerability to Abuse Screening Scale | 753 | ||
| Geriatric Mistreatment Scale | 753 | ||
| In-Home Assessments | 753 | ||
| Feasibility of clinical screening | 753 | ||
| Reporting and responding to elder abuse | 754 | ||
| A clinician’s pocket guide to early detection and prevention of elder abuse | 755 | ||
| Summary | 757 | ||
| References | 757 | ||
| Elder Physical Abuse | 761 | ||
| Key points | 761 | ||
| Introduction | 761 | ||
| Definition and prevalence | 762 | ||
| Risk factors associated with elder abuse | 762 | ||
| Types of physical abuse | 762 | ||
| Signs and symptoms of elder physical abuse | 763 | ||
| Reporting elder abuse | 763 | ||
| Case studies | 764 | ||
| Case 1 | 764 | ||
| Case 1 discussion | 764 | ||
| Case 2 | 764 | ||
| Case 2 discussion | 765 | ||
| Case 3 | 765 | ||
| Case 3 discussion | 766 | ||
| Case 4 | 766 | ||
| Case 4 discussion | 766 | ||
| Summary | 767 | ||
| References | 767 | ||
| Elder Neglect | 769 | ||
| Key points | 769 | ||
| Introduction | 769 | ||
| Definition and prevalence | 770 | ||
| Signs and symptoms | 770 | ||
| Approaches to screening | 771 | ||
| Clinical evaluation | 771 | ||
| Intervention | 772 | ||
| Reporting | 772 | ||
| Case 1 | 772 | ||
| Discussion | 773 | ||
| Case 2 | 773 | ||
| Discussion | 774 | ||
| Case 3 | 774 | ||
| Discussion | 775 | ||
| Summary | 775 | ||
| References | 775 | ||
| Case Series of Sexual Assault in Older Persons | 779 | ||
| Key points | 779 | ||
| Introduction and literature review | 779 | ||
| Interviews | 781 | ||
| Genital Structures | 782 | ||
| Offenders | 783 | ||
| Case Studies | 783 | ||
| Institutional dwellers (hospitals, skilled nursing homes, supervised group homes, and assisted-living facilities) | 784 | ||
| Case 1: A Hospitalized 84-Year-Old Woman Complaining of Rape | 784 | ||
| Analysis of evidence | 785 | ||
| Discussion | 785 | ||
| Treatment | 785 | ||
| Case outcome | 785 | ||
| Case 2: An Unconscious 65-Year-Old Woman in a Skilled Nursing Home | 785 | ||
| Analysis of evidence | 786 | ||
| Discussion | 787 | ||
| Treatment | 787 | ||
| Case outcome | 787 | ||
| Case 3: A 68-Year-Old Man Living in a Supervised Group Home | 788 | ||
| Analysis of evidence | 789 | ||
| Discussion | 789 | ||
| Treatment | 789 | ||
| Case outcome | 789 | ||
| Case 4: A 70-Year-Old Woman Residing in an Assisted-Living Facility | 789 | ||
| Analysis of evidence | 791 | ||
| Discussion | 793 | ||
| Treatment | 793 | ||
| Case outcome | 793 | ||
| Domestic community dwellers | 794 | ||
| Case 5: An 88-Year-Old Woman Residing in the Home of Her Daughter | 794 | ||
| Analysis of evidence | 794 | ||
| Discussion | 795 | ||
| Treatment | 796 | ||
| Case outcome | 796 | ||
| Case 6: A 65-Year-Old Woman with Spastic Cerebral Palsy Living with Her Sister in the Community on Weekends | 796 | ||
| Analysis of evidence | 796 | ||
| Discussion | 796 | ||
| Treatment | 797 | ||
| Case outcome | 797 | ||
| Case 7: A 78-Year-Old Woman Residing Alone | 797 | ||
| Analysis of evidence | 798 | ||
| Discussion | 799 | ||
| Treatment | 799 | ||
| Case outcome | 799 | ||
| Case 8: Mary Is a 72-Year-Old Woman Who Lives Alone in a Federally Subsidized Apartment | 799 | ||
| Analysis of evidence | 799 | ||
| Description of findings | 800 | ||
| Treatment | 800 | ||
| Discussion of case | 800 | ||
| Outcome of the case | 801 | ||
| Case 9: A 70-Year-Old Vietnam Veteran Residing in an Unsupervised Group Home | 801 | ||
| Analysis of evidence | 801 | ||
| Discussion | 802 | ||
| Treatment | 802 | ||
| Case outcome | 802 | ||
| References | 803 | ||
| Medical Implications of Elder Abuse: Self-Neglect | 807 | ||
| Key points | 807 | ||
| Case study: “the possum house” | 807 | ||
| Home Environment | 808 | ||
| Social Support | 808 | ||
| Clinical Impressions and Capacity Assessment | 808 | ||
| Recommendations and Outcome | 809 | ||
| Background | 809 | ||
| Definitions | 809 | ||
| Clinical Findings | 810 | ||
| Outcomes | 810 | ||
| Model | 811 | ||
| Etiology of Elder Self-Neglect | 811 | ||
| Assessment | 812 | ||
| Approach | 812 | ||
| Capacity Assessment | 813 | ||
| Interventions | 813 | ||
| Adult Protective Services | 813 | ||
| Clinical Interventions Teams | 815 | ||
| Medical Interventions | 818 | ||
| Future implications for policy | 818 | ||
| References | 819 | ||
| Evaluating Abuse in the Patient with Dementia | 825 | ||
| Key points | 825 | ||
| Historical perspective | 825 | ||
| Dementia and risk of abuse | 826 | ||
| Special Issues | 826 | ||
| Dementia in the Setting of Domestic Violence | 827 | ||
| Dementia in the Setting of Prejudice | 827 | ||
| Defending the Caregiver | 827 | ||
| Stages of dementia and types of abuse | 827 | ||
| Mild Cognitive Impairment (MCI) | 828 | ||
| Financial exploitation | 828 | ||
| Physical abuse | 828 | ||
| Psychological/emotional abuse | 828 | ||
| Neglect/abandonment | 829 | ||
| Sexual abuse/abusive sexual contact | 829 | ||
| Mild Dementia | 829 | ||
| Moderate Dementia | 830 | ||
| Severe Dementia | 831 | ||
| Types of Elder Abuse That a Person with Severe Dementia May Face | 832 | ||
| Financial abuse | 832 | ||
| Physical abuse | 832 | ||
| Psychological abuse | 832 | ||
| Neglect/abandonment | 832 | ||
| Sexual abuse | 832 | ||
| Interviewing techniques | 833 | ||
| Documentation | 834 | ||
| Summary | 834 | ||
| References | 834 | ||
| Mental Health/Psychiatric Issues in Elder Abuse and Neglect | 839 | ||
| Key points | 839 | ||
| Psychiatric risk factors for abuse | 839 | ||
| Dementia | 839 | ||
| Family carers reporting abuse | 840 | ||
| Professional carers reporting abuse | 840 | ||
| Objective Measures of Abuse | 841 | ||
| Depression and Anxiety | 841 | ||
| Alcohol Use Disorders | 842 | ||
| Psychiatric morbidity in perpetrators | 842 | ||
| Family Carers of People with Dementia | 843 | ||
| Detecting and managing abuse in people with psychiatric and cognitive illness | 843 | ||
| Detection | 843 | ||
| Detecting abuse in a person with dementia and challenging behavior | 844 | ||
| Assessing Capacity | 844 | ||
| Treating Psychiatric Symptoms | 845 | ||
| Supporting Carers | 845 | ||
| Respite Care | 846 | ||
| Improving Detection of Abuse in Psychiatric Services | 846 | ||
| Psychiatric consequences of abuse and neglect | 847 | ||
| Summary | 847 | ||
| References | 848 | ||
| The Role of Capacity Assessments in Elder Abuse Investigations and Guardianships | 851 | ||
| Key points | 851 | ||
| Introduction | 851 | ||
| Case example | 852 | ||
| Capacity: definitions and key concepts | 853 | ||
| How is capacity assessed? | 855 | ||
| Role of capacity assessments in elder abuse investigations | 862 | ||
| Role of capacity assessment in guardianships | 863 | ||
| Summary | 866 | ||
| References | 867 | ||
| Care of the Victim | 869 | ||
| Key points | 869 | ||
| Introduction | 869 | ||
| Definition | 869 | ||
| Victims of Elder Abuse | 870 | ||
| Health Care Response: Reporting | 870 | ||
| Health Care Response: Working with Other Disciplines | 871 | ||
| Clinical Response | 872 | ||
| Elder abuse shelters | 873 | ||
| Caring for the victim: legal system | 874 | ||
| Guardianship and other legal issues | 875 | ||
| Financial abuse | 876 | ||
| Medical consequences of abuse | 876 | ||
| Additional services and resources for elder abuse victims | 877 | ||
| Multidisciplinary Teams | 877 | ||
| Legal Intervention Teams | 877 | ||
| Criminal Justice System | 877 | ||
| Civil Justice System | 877 | ||
| Fiduciary Abuse Specialist Teams | 877 | ||
| Elder Fatality Review Teams | 877 | ||
| Agencies on Aging | 878 | ||
| National Center for Elder Abuse | 878 | ||
| Clearinghouse for the Abuse Neglect of the Elderly | 878 | ||
| The American Bar Association Commission of Law and Aging | 878 | ||
| Summary | 878 | ||
| References | 878 | ||
| Health Professionals’ Roles and Relationships with Other Agencies | 881 | ||
| Key points | 881 | ||
| Introduction | 881 | ||
| Responding to elder abuse: an interdisciplinary approach is crucial | 882 | ||
| Sheriff | 883 | ||
| Adult Protective Services | 883 | ||
| Who’s who in elder abuse | 883 | ||
| Intervening in the elder abuse case: important terminology | 887 | ||
| Index | 897 |