Elder Abuse

Elder abuse is any act or omission within a relationship of trust that harms an older adult or places the person at risk of harm. The harm may be physical, emotional or psychological, sexual, financial, or related to neglect. Abuse is often not a single dramatic event. It may appear as a changing pattern: repeated injuries, increasing fear, isolation, unmet basic needs, or unexplained loss of money. The clinical task is not to prove who is responsible. It is to recognize that the older adult may be unsafe, address immediate health needs, preserve an objective record, and activate the required reporting process. A practical nurse remains accountable for these actions within their scope. Reporting is not delegated simply because the nurse informs a manager, registered nurse, or prescriber. Older adults may have dementia, delirium, depression, sensory impairment, frailty, or multiple chronic conditions. These conditions can make the presentation less clear, but they do not make a concerning change acceptable or explain away an unsafe situation without assessment. Cognitive impairment may also increase dependence on a caregiver, creating greater opportunity for...