What are the 6 main categories of elder abuse?
- Physical abuse
- Sexual abuse
- Neglect
- Psychological abuse
- Racial/cultural abuse
- Financial abuse
What are risk factors for elder abuse?
- Factors relating to the older (abused) person
- Cognitive impairment
- Shared living
- Functional dependency
- Low income - Factors relating to the perpertrator
- Psychiatric illness (including dementia)
- Drug/alcohol dependency
- Caregiver burden and stres - Relationship factors
- Family disharmony
- Conflicted relationships - Environmental factors
- Low social support
- Shared living
What should be initially done regarding a patient’s home environment and concerns raised for their safety?
Inform the hospital safeguarding team
First duty is to recognise abuse and report it: discuss with a senior colleague and ensure it is referred onwards
When should referrals to a safeguarding team be reviewed?
Within 24 hours
What is NHS continuing healthcare?
NHS continuing healthcare is free care outside of hospital, arranged and funded by the NHS.
It is only available for patients requiring ongoing healthcare and meet the eligibility criteria
How is eligibility assessed for NHS continuing care?
- The local team caring for the patient complete a checklist to see if a person may be eligible.
If a patient meets enough criteria a full continuing healthcare meeting is held.
What is the continuing care checklist?
The checklist contains 11 domains. Each domain is assessed as:
A - high need
B - medium need
C - low need
A score is calculated, and a meeting is held if:
- 2+ domains are A
- 5+ domains are B
- 1 in A and 4 in B
- 1 in A in one of the boxes with an asterisk.
What are pressure ulcers?
Large cavities/sores in areas caused by being lying or sat for long periods of time, occurring in places where there are bony prominences
- Red
- Inflamed
- Very painful
Can see muscle, bone or tendon
May bleed or weep
May be foul smelling
Very serious, fatal consequences.
What are the risk factors for pressure ulcers?
- Significant loss of sensation
- Inability to position oneself
- Nutritional deficiency
- Significant cognitive impairment
- Significantly limited mobility
- Previous or current pressure ulcer
What is a grade 4 pressure ulcer?
A grade 4 pressure ulcer has full thickness skin loss down to underlying tissues. There is exposed muscle
What does SSKIN stand for?
- Support surface
- Skin inspection
- Keep moving
- Incontinence
- Nutrition
As a junior doctor you should:
- Encourage early mobilisation
- Ensure adequate nutrition and hydration
- Look for an manage incontinence
What are the three main types of care home in the UK?
- A care home without nursing:
Provides assistance with personal care on a 24 hour bases (residential home) - A care home with nursing:
Provides the above, but with 24-hour nursing staff available - A specialist care home for dementia:
Specialist units are usually for patients with prominent behavioural/psychological disorders associated with their dementia
Dementia is very common amongst care home residents and most do not require specialist homes
What is a grade 2 pressure ulcer?
A grade 2 pressure ulcer involves the dermis and epidermis but NOT the subcutaneous tissue
What factors are considered when screening a patient for continuing care assessment?
- Behaviour
- Continence
- Mobility
- Skin integrity
What are some risk factors foe elder abuse?
- Caregiver stress
- Cognitive impairment
- Physical dependency
- Social isolation
