Elder Abuse

An older adult may present with a fall, dehydration, a missed prescription, a pressure injury, or an unexplained financial problem. The nurse’s task is not to label the situation prematurely; it is to determine whether the finding fits the history, the patient’s condition, and the caregiving relationship. Elder abuse is an intentional act, or failure to act, by a caregiver or another person in a relationship of trust that causes harm or creates a serious risk of harm to an older adult. The relationship-of-trust element distinguishes elder abuse from a crime committed by a stranger, although a stranger’s assault still requires immediate safety measures and possible law-enforcement involvement. Abuse may be physical, sexual, emotional, financial, neglectful, or involve abandonment, and more than one form often occurs at the same time. A report requires reasonable suspicion, not proof. Begin with safety, obtain the older adult’s account privately when safe, compare the account with objective findings, and document what was seen and said. In the United States, the applicable reporting duty depends on state law; do not assume that one national deadline...