Willfully inflicting pain or injury to an elderly person is considered physical abuse. This includes slapping, kicking, restraining against one’s will, inappropriate use of drugs/medication, force feeding or the use of force.
Case #1
Marie is a 76 year old who presented to the Emergency Department with a broken arm. Her daughter accompanied her. They both state that Marie fell, landing on her arm. Marie continually looks at her daughter as she’s telling the story. Marie’s daughter does not leave Marie’s bedside the entire six hours she is in the ER. The nurse notices multiple bruises in various stages of healing on Marie’s wrists and upper arms. When asked if she falls a lot, Marie’s daughter answers “No”. In response to questioning about how she got all the bruises, Marie starts to cry.
Awareness of physical abuse is key to identifying and intervening on behalf of any elderly patient. Naturally Marie loves her daughter and doesn’t want her to get into trouble. Maybe her silence is because she fears for her safety. Or maybe she does have frequent falls and her daughter isn’t aware of it. It is common to see bruising on elderly people. Having a keen awareness of the situation the person is in can help clarify what’s going on in their environment. If your instinct tells you something is wrong follow it.
Signs of physical abuse can be blatant or very subtle. No one sign can be evidence of elder abuse. Because bruising and other injuries are common in the elderly, it is prudent and justifiable to question the person about how their injuries occurred. Inconsistent stories or explanations should alert you that the possibility of abuse exists.
Other signs of elderly abuse include:
Bruises, black eyes, lacerations, punctures, rope marks
Bone fractures, skull fractures
Open wounds, cuts
Untreated injuries in various stages of healing
Sprains, dislocations, internal injuries
Broken glasses
Signs of being restrained
Medicine overdose or underutilization
Sudden change in behavior
Caregiver refuses to allow visitors to see elderly person alone