Safeguarding Vulnerable Elderly from Physical Abuse - Essay Example

Safeguarding Vulnerable Elderly from Physical Abuse Introduction Vulnerability denotes the inability of persons to endure the rigors of a hostile environment. It can also be defined as the inability of persons to guard them against being wounded or hurt, physically and emotionally. Vulnerability is both a subjective and an objective subject. The old, elderly people become more vulnerable with time. Social factors have a direct correlation with the health of the elderly persons. Social vulnerabilities tend to increase with the progression of time (Decalmer, 1997). Often times the elderly people suffer from frailty; a condition that renders them physically weak. It is at such a stage of life that these people need tender loving care. Elder abuse is serious in westernized societies. Community nurse that frequent the home where the elderly live serve as chief agents for detection of elderly abuse. Such nurses have an obligation to report any abuse to the relevant authorities (Carel, 2009). This essay aims at identifying the reasons why the elderly are vulnerable, and the factors related to the vulnerability that might negatively impact on their health. This essay focuses on the elderly old because of the neglect that this target group continues to suffer. Elderly abuse is either understudied or underreported. According to Action on Elderly Abuse (2005), elderly abuse is formally defined as “a repeated action or lack of desired action, occurring in a relationship where trust is expected, which results in harm to an elderly old or infringes on his human rights”. At an old age, a person is considered fragile should, therefore, be accorded the right treatment. It is expected that such people should be afforded tender loving care by the society as a whole. Contrary to this expectation, the elderly old are exposed to abuses that may take the form of physical abuse (White, 2000). The scope of this essay is, however, restricted to discussing physical abuse. The elderly and physical abuse The elderly old are prone to physical abuse and physical neglect. Physical abuse is defined as any act of violence that may lead to injury, pain, disease or impairment. This kind of abuse may take the form of: pushing, pinching, slapping, force feeding, improper administration of medication, incorrect positioning, etc. Signs of physical abuse may include rope marks, lacerations, bruises, fracture and burns. Physical neglect, on the other hand, is typified by a failure by the caregiver to prevent harm or provide desired living condition for an elderly old. This form of abuse encompasses acts such as failure to provide physical aids e.g. hearing aids and eye glasses, and denying health maintenance care to an elderly person (White, 2000). Reasons why the elderly are vulnerable Vulnerable elderly old may faces abuse from their relatives, family members or paid care givers. The reasons for their vulnerability are quite varied. Physical abuse of elderly people can happen once or may happen repeatedly. Sudden outburst by the elderly person might lead the care giver to slap the elderly, an act that is considered abusive. Sometimes the care giver might not know how to handle or support an elderly person. This lack of proper training can lead to injuries (Acierno et al, 2010). Most elderly old are slow in conversation and movement. This may frustrate the care giver resulting in rough handling and annoyance. Hot temper from the care giver might result into actual physical harm on the elderly person. In a family setup, abuse may occur due to long-standing hostilities between the elderly person and the family members. Family members may find it cumbersome and stressful to care for the elderly relative. Some of these families may leave the elderly person unattended to, exposing him to suffering. Abuse of the elderly old can also take place in a hospital or a nursing home. These places may be poorly managed, and their staff may not take reasonable care of the elderly old (Acierno et al, 2010). Poor staff motivation in nursing homes often leads to shoddy work output from the staff. In addition to these reasons, certain factors may lead the caregivers to abuse the elderly old. These include: living continually with a dependant elderly; the caregiver’s inexperience or unwillingness to care for the elderly person; lack of social support and isolation; poor health of the caregiver; history of depression, drug abuse, family violence etc (Lowenstein, 2010). The Role of a Nurse in Safeguarding and Protecting the Elderly Persons All medical practitioners and agencies that interact with the elderly persons have a duty of care to make certain that the elderly well treated and protected. A nurse plays a pivotal role in safeguarding and protecting an elderly person from physical abuse. Community nurses who are in close contact with the elderly are expected to monitor and evaluate how these people are faring. The nurses have an obligation to report any abuse they detect to relevant authorities (Baker et al, 2009). The community nurse can assess the older person’s home environment to determine whether he/she is being abused. The nurse must employ all measures to ensure that the elderly is not abused. Targeted preventive measures can go a long way in tackling circumstance where abuse might arise. The community nurse is also a significant secondary care provider. To successfully execute this role, the nurse must create a favorable rapport with the elderly person. Having created such a rapport, the elderly person will be able to trust the nurse, and can confide in him without fear. Disclosure made by the elderly person can help the nurse determine whether the person is being abused or not. The community nurse must be extremely careful when creating an atmosphere of mutual trust between him and the old elderly. Such a relationship is vital for full disclosure on the part of the elderly person. When victims of abuse are presented to the emergency department (ED), the forensic nurse employs protocols to establish the severity of abuse that has been meted on the elderly person (White, 2000). Nurses may be faced with challenges in safeguarding and protecting the elderly. Some of these may include: the reluctance of the elderly to expose the perpetrator and the elderly may fear that disclosure may expose him to further abuse. In all these circumstances, the nurse should assure the elderly of his safety. The community nurse must be particularly keen as he interacts with the elderly person. The suspected elder abuse cases should be investigated both objectively and subjectively. In his role as a secondary care giver, community nurse should focus on early identification of abuse. Any case of elder abuse spotted by them should be forwarded to the relevant authorities for action. The community nurse also serves as a tertiary care giver. In this role, the nurse commits to provide long term ongoing intervention to the elderly old. He may monitor the living condition of the elderly and ensure that the appropriate resources are available. In the long run, the community nurse is actually an advocate for the rights of the elderly (Gemeay & Kayal, 2011). Agencies that protects the elderly against physical abuse The National Health Services (NHS) and the Local authorities work hand in hand in safeguarding the right of the elderly old. In addition to these agencies, there are many non governmental organizations (NGOs) and community based organization (CBOs) that engage in policy formulation and advocacy for the elderly. In 1989, the Declaration of Hong Kong on the Abuse of the Elderly was adopted by the World Medical Association. According to this declaration, the elderly people have same rights to medical care as other people in the society. The declaration also empowered the elderly with the right to find their own primary care providers. Inter-agency cooperation that entails, Social service, supported housing providers, police, private and voluntary agencies aims at protecting the elderly old. Such cooperation is regulated by policies that propose collaborations at all levels of operations. Often time, multi-agency elderly protection committees are formed with its membership drawn from all the collaborating agencies and organizations (Mandelstam, 2009). Such committees make information sharing easy and policies formulated can then be enforced by all the agencies represented. The agencies intervene collectively to stop and prevent abuse. This they achieve by ensuring that right policies are formulated and enforced. Any perpetrator of elder abuse is subjected to the full force of the law. How agencies intervene to reduce vulnerability of the elderly The underlying causes of elder abuse are addressed by the health and social services. These agencies aim at stopping elderly abuse, and eliminating the possibility of recurrence. The victims of physical abuse are afforded with counseling services, legal assistance, case management, and support services. Counseling helps the victims to overcome trauma and resolve conflicts. Attorneys offer legal service to the victims of abuse (Payne, B. K. 2005). The legal process equips the victims with interventions that include: restraining orders to bar the perpetrator from contacting the victim, lawsuits and prosecution of offenders. The police protect the vulnerable elderly by arresting the perpetrators, and enforcing the restraining orders issued against them. Care management entails the provision of services to persons which needs that are ever changing. Support services are offered to ease the burden on the care givers. Respite programs allow the care giver to rest from their work. These programs are tailored to allow volunteers to visit with the elderly and care for them occasionally, taking the burden off the regular care giver’s shoulders. What to do to identify if an elderly person is at a risk of abuse and needs safeguarding Generally all elderly persons need safeguarding and protection. Everyone deserves to live stress free lives free from violent and maltreatment. Elderly adults need protection because they are frail and cannot protect themselves. As a nurse, it is my obligation to recognize abuse, respond to the reports filled by the victims, record them, and report abuse to my line manager. Recognition of an elderly who has suffered physical abuse is facilitated by signs of injuries on the body of the victim. In response to this signs, I would then go forward to investigate the likelihood that this injury resulted from physical abuse. My investigations will involve separately interviewing the victim and the perpetrator. During my interview with the victim, I will ensure that I create an atmosphere where mutual trust can be established and nurtured (Andrew, Mitnitski, and Rockwood, 2008)This would enable the victim opens up fully, and discloses what he has gone through. I would then record this information and keep it in safe custody away from the perpetrator. Further, I would tactfully question and interview the alleged perpetrator to establish the veracity of the victim’s account. If my investigation proves that the elder was indeed abused, I would then intervene by reporting the perpetrator to my line manager for further action. Conclusion All persons have equal rights of safeguarding. Nobody should be exposed to abuse on the status of their age. The consequence of abuse on the elderly person may be severe. Mistreatment of the elderly should be discouraged, and none of them should be exposed to physical violence. The elderly old might be slow in many aspects, but this does not make them lesser people. Physical abuse should not be meted on the old people. Instead, they should be treated with tender loving care. Care givers should not consider the elderly a burden; they should try and understand that they too will one day grow old and will need to be cared for (Bovbjerg, et al., 2006). Community nurses should accelerate the speed at which they respond to elder abuse cases. All cases should be thoroughly investigated, and perpetrators dealt with accordingly. Prevention of elderly abuse should be advocated for by all the relevant stakeholders. All the agencies and organizations that lobby for the rights of the elderly should continue doing so with vigor to ensure that relevant policies are not only formulated, but also implemented to ensure that the elderly old are protected, safeguarded and treated with the dignity due them. Reference List Acierno, R. et al., 2010. Prevalence and Correlates of Emotional, Physical, Sexual, and Financial Abuse and Potential Neglect in the United States: The National Elder Mistreatment Study. American Journal of Public Health, Vol. 100, Issue 2; pp.292 -7. Action on Elderly Abuse. 2005. Action on Elder abuse Bulletin 1. (Online). Available at: http://www.elderabuse.org.uk (Accessed 21 March 2012). Andrew M.K., Mitnitski, A.B., Rockwood, K., 2008. Social Vulnerability, Frailty and Mortality in Elderly People. PLoS ONE Journal, 3(5). Baker, M., et al. 2009. Mortality risk associated with physical and verbal abuse in women aged 50 to 79. 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Elder abuse: critical care nurse role in detection. Critical Care Nursing Quarterly, 23(2); 20-25. Read More