Health Promotions and Disease Prevention Paper Essay

senior MistreatmentElder mistreatment is a widespread problem in our society that is a lot under-recognized by wellness electric charge professionals. As a result of growing universal outcry all over the past 20 years, in all states now have curse laws that be specific to erstwhile(a) adults most states have mandated fibing by all health cautiousness professionals. The term mistreatment includes physiological rib and neglect, psychological jest at, monetary exploitation and infringement of rights. Poor health, somatogenic or cognitive impairment, alcohol horror and a narrative of domestic furiousness argon around of the jeopardize f scrapors for senior mistreatment. Diagnosis of previous(a) mistreatment dep supplants on acquiring a detailed invoice from the long-suffering and the c atomic deem 18giver. It also involves performing a comprehensive physical examination. scarce through aw arness, a healthy suspicion and the performing of certain procedur es are physicians adapted to detect senior mistreatment. Once it is pretend, elder mistreatment should be account to adult protective services (HHS event sheet, 2005). It is estimated that over 2 one thousand million older adults are mistreated each year in the united States.Elder mistreatment first gained attention as a medical examination and affable problem rough 20 years ago, when the term granny batter first appeared in a British medical journal. Since that time, elder mistreatment has bugger off a matter of concern non notwithstanding in the get together States, but throughout the world. This heightened sentience has fol diminisheded a growing awareness of baby and spousal abuse. Nevertheless(prenominal), because of differing definitions, poor detection and under-reporting, the extent of elder mistreatment is unknown. These same factors aim the collection of information unenviable and its accuracy questionable. Published studies estimate that the prepondera nce of elder mistreatment ranges from 1 to 5 percent ( robust pot, 2010). Most health care professionals are reluctant to address domestic violence. However, physicians are in an holy man piazza to detect and manage mistreatment, as they may be the only mortal outside the family/phencyclidine hydrochloride role who regularly sees the older adult.In addition, thephysician is the most likely somebody to order the testing, hospital admissions and certification services that are sometimes commanded to correct elder mistreatment. This typography result discuss the clinical, ethical and legal issues regarding elder mistreatment. The various forms of elder mistreatment are defined, including ways to identify long-suffering and health care provider encounter of exposure factors, and history and physical findings that suggest a diagnosis of elder mistreatment. Finally, a regular approach to diligent evaluation, documentation and reporting of venture cases will be re captureed .Reasons elder abuse may be missed or not reported by health care professionals include unfavorable military posture toward older adults (ageism), little information in medical literature around elder mistreatment, waver to attribute signs of mistreatment (disbelief),isolation of victims (patient not seen ofttimes by physicians/health care providers), subtle presentation (i.e., poor hygiene or dehydration), reluctance/fear of confronting the offender, reluctance to report mistreatment that is only pretend, mistreated person requests that abuse not be reported (patient/physician privilege), pretermit of knowledge nearly proper reporting procedure, fear of jeopardizing family relationship with hospital or nurse facilityTypes of elder abuse natural Abuse- occurs when a person is travel(p) in an in inhibit way, much(prenominal) as hitting, punching, kicking, slapping, and pushing. personal abuse much leaves marks on the persons body bite marks, bruises, welts, and contract marks. Marks are often left on arms, wrists, face, neck, and abdomen commonwealth Emotional/Psychological Abuse- occurs when a person is demeaning to an early(a)(a) person. A person may treat the elder like a kidskin or call them names. An elder may seem unusually demoralise or may talk bad well-nigh themselves Sexual abuse- among an elder occurs when versed contact is made without consent. It also occurs when an elder is incapable of do such a decision, and is muck up Financial abuse- occurs when a person or persons take advantage of an elderly person financially.This includes stealing money, lying about how much the elder needs for certain care, or cashing the elders checks without permission look across/Abandonment- occurs when the elder is not universe properly cared for, such as not being fed, bathed, and properly medicated. This is also when the elder is being ignored. The caregiver retracts to give care to the individual (Physical abuse of the elderly, 2005).Elder Mistreatment Definitions and ClassificationsIn an effort to increase physicians awareness, facilitate accu set detection and invoke further research, the Ameri brush off Medical Association published a position paper on elder mistreatment in 1987. This paper proposed a type definition Abuse shall mean an act or omission which results in harm or imperiled harm to the health or offbeat of an elderly person. Abuse includes well-read infliction of physical or kind wound sexual abuse or withholding of necessary food, clothing, and medical care to meet the physical and mental needs of an elderly person by one having the care, custody or responsibility of an elderly person (HHS fact sheet, 2005). Elder mistreatment may take mevery forms. Types of elder mistreatment are often classified as physical abuse and neglect, psychological abuse, financial exploitation and violation of rights. A major obstacle to taproom of and hitch for elder mistreatment is a lack of awareness on the part of physicians and other health care professionals (LA4Seniors, 2005).Risk Factors and barroomCognitive impairment and the need for assistance with activities of daily living are important risk factors for elder mistreatment. Caregiver burnout and frustration asshole lead to elder mistreatment. Substance abuse by the caregiver or the patient, especially abuse of alcohol, significantly increases the risk of physical violence and neglect. Psychological and genius pathology in the caregiver and patient are also major risk factors. Prevention of elder mistreatment is difficult and depends as much on the kindly support network as on the medical network. Preventing elder mistreatment involves identifying high-risk patients and caregivers, and attempting to address the underlying issues. cover version patients and caregivers before placement can be helpful, when it is feasible. Helping patients defend county or state assistance can also help reduce some high-risk points.Risk Factors for Elder MistreatmentOlder age, lack of accession to resources, low income, social isolation, minority status, low level of education, functional debility, substanceabuse by caregiver or by elderly person, psychological disorders and character pathology, previous history of family violence, caregiver burnout and frustration, and Cognitive impairment. History- Recognizing mistreatment is often difficult. The older adult may be unable to provide information because of cognitive impairment. The history is sometimes difficult to obtain from the victim, for fear of vengeance by the abuser. This retaliation can come in the form of physical punishment or threats of violence and abandonment. Older adults are often fearful of being placed in a nursing facility, and some may prefer to be abused in their own theme rather than be moved to such a facility (LA4Seniors, 2005). The mistreated older adult often presents with somatic complaints. Physicians should ask older patients about rough handling, confinement and vocal or emotional abuse. Subtle or confusing complaints may real be indicative of mistreatment.It is important to recognize that abuse and neglect are most often discovered during routine visits at the physicians seat or in the long term care facility. Generally, the patient should be interviewed without the caregiver(s) present. Cognitive impairment may limit the ability to obtain an accurate history. It is important to ask general questions about conditions in the home or nursing facility. The physician should try to obtain an accurate view of the patients daily life, including meals, medication, shopping and social outlets (HHS fact sheet, 2005). It is also important to ask the patient about the nature and type of the relationship with the caregiver. It may be helpful to ask questions such as, How do you and the caregiver get along? and Is the caregiver taking good care of you? It is captious to assess the patients mental status for indicators of depression or alcohol and substance abuse. A interchange of the patients financial situation may be appropriate.If issues of mistreatment are raised, the caregiver should be interviewed as well. The physician must be careful not to over ascertain or to make suggestive comments, especially when the patient is cognitively impaired. necessary Features of the History in the Assessment of Mistreated Elders Medical problems/diagnoses, detailed comment of home environment (adequacy of food, shelter, supplies), accurate description of events related to scathe or trauma (instances of rough handling, confinement, verbal or emotional abuse), history of introductory violence, description of prior injuries and eventssurrounding them, description of berating, threats or emotional abuse, unfit care of medical problems, untreated injuries, poor hygiene, prolonged period before presenting for medical attention, depression or other mental illness, extent of astonishment or dementia, drug or a lcohol abuse, quality/nature of relationships with caregivers.Physical Examination and Laboratory TestsThe physical examination is often used as legal evidence of mistreatment. Laboratory and im age studies should be performed to confirm any suspicious findings in the history and physical examination. The presence of dehydration and malnutrition can be established with simple laboratory tests such as a complete blood count and measurement of blood urea nitrogen, creatinine, protein and ovalbumin levels. Radiographic studies provide evidence of old and new get arounds. Unfortunately, proving that a fracture was caused by abuse can be difficult (HHS fact sheet, 2005). purpose of advance nurse and nursing intervention strategies-The nurses can play a vital role as a case finder, manager, advocate, educator, researcher and caregiver to physically abused elderly and family or caregiver in a given partnership. Inform the decision makers about the magnitude, trends and characteristics of violent deaths and, evaluate and keep on to improve by educating the patient and the care giver, and if is necessary reporting the abuser to the authorities. Nurses should involve the case managers and the social proles, document all the findings accurately and report the mistreatment case as soon as practicable.DocumentationDocumentation of all findings may be entered as evidence in criminal trials or in shieldership hearings. Documentation must be complete, thorough and legible. such circumstances dictate that there is a chain of evidence. This need mandates a careful collection of physical evidence, which is critical in cases of suspected sexual or physical abuse. Laboratory data and, when possible, photographs should be used for proof of written documentation.ManagementManagement of elder mistreatment first involves discussing the situation with the patient, if feasible. The patient should be allowed to play a rolein the ultimate resolving power, if he or she is able t o do so. First, the competency of the patient should be determined. local and state social services have diverse methods of addressing mistreatment. Social workers from hospitals, clinics or long term care facilities are valuable resources and should be able to assist with these services. Multidisciplinary teams can be very effective. These teams typically include geriatricians, social workers, case management nurses and representatives from legal, financial and adult protective services.Multidisciplinary teams are often more effective in problem-solving and provide a forum for discussion with participants involved in the older adults care. Senior protagonism volunteer throngs are also helpful. A senior advocate can provide information to the abused person and enable access to resources from community programs and social services.Basic Features of the Physical ExaminationHead- Traumatic alopecia or other evidence of direct physical violence poor oral hygiene Skin- Hematomas, welt s, bite marks, burns, decubitus ulcers Musculoskeletal- fractures or signs of previous fractures Neurological- cognitive impairment that is a risk factor for mistreatment and influences management decisions regarding competency Genito rectal- poor hygiene, inguinal rash, impaction of dejection General- weight loss, dehydration, poor hygiene, unkempt appearance (LA4Seniors, 2005).ReportingAll health care providers (physicians, nurses, social workers, etc.) and administrators are mandated by law to report suspected elder mistreatment. The laws differ from state to state physicians should determine the specific requirements in their states. Any other person may also report suspected abuse and neglect. All reporters are immune from civil liability if they act in good faith and without malice. They are also protected from release of employment. Health care providers can be found to be oblivious if they fail to report the suspected mistreatment. Penalties can include fines, imprisonmen t or loss of licensure. Reports of suspected elder mistreatment should be given to the state or county division of adult protective services. In the absence of such services, the reporter should contact the county extension office or the states office of child andfamily services. In addition, any Area Agency on ageing would be able to provide assistance in reporting suspected mistreatment.The areaal Domestic Violence Hotline (telephone 800-799-SAFE) or the Older Womens federation (telephone 800-825-3695) could also help. Contacting the police is always an option, especially in an urgent situation (HHS fact sheet, 2005). In the event that the older adult is a occupier of a long term care facility, a separate weapon often exists for investigating suspected mistreatment through the state agency that surveys these facilities. Identifying the appropriate avenue for investigation can be done through the easy adult protective service agency or the state surgical incision of child and f amily services (Elder Abuse, 2005). Once suspected mistreatment has been reported, the responsible agency will assign a social worker to investigate the case. The social worker will provide an accurate description of the home or nursing-facility environment. later on assessment, the social worker may provide insight into some possible solutions to the problem and information about available resources. Unlike cases of child abuse, if the older adult is competent to make decisions, he or she may refuse intervention. If the older adult is not competent to make decisions, a guardian can be appointed by the state. The guardian can consequently direct care as needed until the problem is satisfactorily resolved. stigma Prevention- In healthy mountain there is no precise data specific for elder abuse, but these are related data from that site. The fanny rate for physical assault by intimate partner is 3.3 physical assaults per 1,000, and the baseline is 4.4 physical assaults per 1,000. The target rate for annual rate of rape is 0.7 rapes or attempted rapes per 1,000 persons, and the base line is 0.8 rapes or attempted rapes per 1,000 (Health people, 2010).Objectives from ruddy pack 2010Reduce injuries, disabilities, and deaths due to injuries and violence, and educating the primary care givers about the signs and symptoms of abuse or mistreatment, and educating them about alternative coping mechanisms. Several themes become unmingled when examining reports on injury prevention and control, including acute care, treatment, and rehabilitation. First, injury comprises a group of complex problems involving some(prenominal) different sectors of society. No single force operative alone can accomplish everythingneeded to reduce the number of injuries. amend outcomes require the combined efforts of many fields, including health, education, law, and safeguard sciences. Second, many of the factors that cause injuries are closely associated with violent and abusive be havior (Health people, 2010).Violence and Abuse PreventionViolence in the United States is pervasive and can change quality of life. Reports of children killing children in schools are shocking and cause parents to worry about the safety of their children at school, and if the problem is untreated the aggression later on will turn on the parents or older adults. Reports of gang violence make people fearful for their safety. Although suicide rates began decreasing in the mid-1990s, prior increases among youth recovered 10 to 19 years and adults aged 65 years and older have raised concerns about the photograph of these population groups. Intimate partner violence and sexual assault threaten people in all walks of life (Elder Abuse, 2005). Violence claims the lives of many of the Nations young persons and threatens the health and well-being of many persons of all ages in the United States.On an average day in America, 53 people die from homicide, and a minimum of 18,000 persons survi ve interpersonal assaults, and as many as 3,000 persons attempt suicide (Elder Abuse, 2005). Elderly, females, and children continue to be targets of both physical and sexual assaults, which are frequently perpetrated by individuals they know. Examples of general issues that impede the national health response to progress in this area include the lack of comparable data sources, lack of standardized definitions and definitional issues, lack of resources to establish adequately consistent tracking systems, and lack of resources to fund promising prevention programs.DisparitiesAdults aged 65 years and older are at increased risk of death from fire because they are more vulnerable to smoke stirring and burns and are less likely to recover. Sense impairment (such as blindness or hearing loss) may prevent older adults from noticing a fire, and mobility impairment may prevent them from escaping its consequences. Older adults also are less likely to have learned fire safety behavior and prevention information,because they grew up at a time when little fire safety was taught in schools, and most current educational programs target children (Healthy people, 2010).OpportunitiesTo reduce the number and severity of injuries, prevention activities must focus on the type of injurydrowning, fall, fire or burn, firearm, or motor vehicle. Understanding injuries allows for development and feat of effective prevention interventions. Some interventions can reduce injuries from violence-related episodes. For instance, efforts to promote awareness in society can help reduce the risk of assault, intentional self-inflicted and elder neglect and abuse. Higher taxes on alcoholic beverages are associated with land death rates for some categories of violent crime, including mistreatment, abuse, and rape (Healthy people, 2010).Healthy People ObjectivesThis organization encourages the Individuals, groups, and other organizations to use this framework and integrate it into their curren t programs, events, publications, and meetings, schools, colleges, and civic organizations to undertake activities in order to further the health of all members of their community. It is a national initiative that aims to improve the health of all Americans and eliminate disparities in health. Reducing the prevalence and overall number of people who suffer from different variety of diseases, and increase concerns for the nations elderly, and to reduce the overall rate of elder abuse, prevent its associated health problems, and educating the care givers and enhancing their coping mechanisms and alternative modalities to select with the related stress. Health care providers can encourage their patients to pursue better lifestyles and to participate in community-based programs. By following the national objectives, individuals and organizations can found an agenda for community health improvement and can monitor results over time.Healthy People objectives have been specified by Con gress as the measure for assessing the progress of the Indian Health Care Improvement Act, the paternal and Child Health Block Grant, and the Preventive Health and Health run Block Grant. Healthy People objectives have been used in performance measurement activities (Healthy people, 2010). Many objectives focus on interventions designed to reduce or eliminate illness, disability, and premature death among individuals and communities, and to educate the care giver regarding recognizing elder abuse, and prevention modalities others focus on broader issues, such as improving access to quality health care, strengthening public health services, and improving the availableness and dissemination of health-related information.Each objective has a target for specific improvements to be achieved by the year 2010. Together, these objectives reflect the depth of scientific knowledge as well as the breadth of diversity in the Nations communities. More importantly, they are designed to help the Nation achieve Healthy People 2010s two overarching goals and realize the vision of healthy people living in healthy communities (Healthy people, 2010).Interim Progress toward Year 2000 Objectives legion(predicate) objectives addressed injury prevention in Healthy People 2010. 26 objectives were specific for unintentional injuries, and 19 objectives were specific for violence prevention. By the end of the decade, targets had been met for 11 objectives. Unintentional injury objectives showing achievement were unintentional injury hospitalizations, residential fire deaths, nonlethal head injuries, spinal cord injuries, nonfatal homicide poisonings, and pedestrian deaths. Violence prevention objectives that met their targets were, suicide, weapon carrying by adolescents, conflict resolution in schools, and child death review systems.REFERENCESElder Abuse and Neglect Statistics (2005). In search of solutions. Retrieved on 8/20/05 from http//www.apa.org/pi/aging/eldabuse.html Healthy p eople 2010(2005). Retrieved on 8/20/05 from http//www.healthypeople.gov LA4Seniors (2005). A public service website for seniors and their families. Retrieved on 8/20/05 from www.la4seniors.com/elder abuse.htm National message on elder abuse (2005). Retrieved on 8/20/05 from http//www.elderabusecenter.org HHS fact sheet (2005). US department of health and human services. Retrieved on 8/20/05 from www.hhs.gov/news/press/2000pres/20000503b.html Physical abuse ofthe elderly (2005). Physical abuse of the elderly signs, descriptions, and what you can do about it. Retrieved on 8/21/05 from http//de.essortment.com/physicalabusee_rfjb.htm