Elder mistreatment is a common phenomenon that has serious medical and social consequences. It is dramatically under-recognized by clinicians and often not reported to the appropriate authorities.
Mistreatment affects one in 10 community-dwelling, older adults and includes physical abuse, sexual abuse, psychological/emotional abuse, neglect and financial exploitation. Although some presentations of elder mistreatment are seen on the initial evaluation, many types of mistreatment require a high index of suspicion and careful assessment. Implementing formal screening protocols may be valuable.
Clinical assessment should include observing patient caregiver interactions, obtaining history from the patient alone, and performing a head-to-toe physical examination. laboratory and imaging results may be helpful.
When concerned about elder mistreatment, clinicians should ensure a patient’s immediate safety, document findings in detail and report to the appropriate authorities. clinicians should know how to access and be familiar with the role and duties of Adult Protective Services and the long-term care ombudsman in their local area.
Intimate partner violence is also an important type of elder mistreatment. With the recent COVID-19 pandemic, social isolation is emerging as a risk factor for mistreatment of older adults. It is also important to remember that financial exploitation is also a type of elder mistreatment.
Some of the common physical signs of physical abuse are bruising in atypical locations, patterned injuries, cigarette pattern burns, different types of bruises of different ages, red eye and severe malnutrition.
When a clinician notices that an older adult is being physically abused, Adult Protective Services must be informed. The state Departments of Public Health will be responsible for investigating cases of abuse and neglect especially when it comes to the nursing homes. Adult Protective Services typically has up to 72 hours before being obligated to initiate an investigation.
Anyone who would like to ask me a medical question relating to the health of older adults can email me at questions@apexmedicalgroup.org. I hope to provide a helpful answer in a future issue of this newspaper.
Disclaimer: The information shared in this column is based on current practice guidelines but is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your healthcare provider with any questions regarding a medical condition.”
Dr. Arvindselvan Mohanaselvan, M.D., is a physician board certified in internal medicine, with a subspecialty in geriatrics. He currently works at Apex Medical Group as a primary care and geriatric medicine provider. Email questions for Paging the Doctor on Call to questions@apexmedicalgroup.org.
