Elder Abuse in the United States- A Teaching Strategy for Nurses

Elder Abuse in the United States: A Teaching Strategy for Nurses

More the two million older adults are abused in the United States each year according to the National Center on Elder Abuse. It is estimated that 90% of the abusers are family members or caregivers. With a growing aging population, the need for student nurses and nurse to correctly identify abused older adults is significant. Forms of abuse include: physical abuse, sexual abuse, emotional abuse, neglect, abandonment, and financial abuse. This teaching strategy can be used to enhance the learning of students in beginning pre-licensure nursing courses. Student will recognize and discuss the various forms of abuse in older adults, and identify resources that could potentially assist older adults in this situation. In addition, students will use the ACE.S to identify vulnerable older adults at risk for abuse. Lastly, this teaching strategy can be utilized in a variety of teaching/learning situations: didactic lectures; clinical settings such as post-clinical conference/debriefings; simulation scenario debriefings; or small seminar discussions. In addition, the teaching strategy can be used with practicing nurses as a professional development activity, as well as when orienting new graduate nurses.

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Elder Abuse in the United States: A Teaching Strategy for Nurses

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Learning Objectives
Students will:
- Assess and recognize the various forms of abuse in older adults.
- Assess the older adult's understanding of the various forms of abuse.
- Identify factors that contribute to elder abuse.
- Discuss available resources to assist older adults affected by abuse.
- Describe the role of the nurse when providing care to the older adult in an abusive situation.
- Describe the complexities involved in making care decisions for older adults suffering from abuse.
- Identify the legal rights of an older adult who is victim of abuse.
Learner Pre-Work

This teaching strategy focuses on assessing the risk factors related to abuse of older adults, coordinating and managing care of abused older adults, and making situational decisions with older adults. The strategy enhances the student’s human flourishing and nursing judgment.

Have students watch the video An Age for Justice: Confronting Elder Abuse in America. This activity can take place in lecture, seminar, or in pre or post conference for clinical, if internet access is available.
Suggested Learning Activities
- Using the ACE.S framework, ask the learners to discuss a situation where they suspected abuse in an older adult but weren’t sure how to address it.
- Review the ANA’s Code of Ethics for Nurses with Interpretive Statements with the students. The Code of Ethics for Nurses was developed as a guide for carrying out nursing responsibilities in a manner consistent with quality in nursing care and the ethical obligations of the profession. Use the document to discuss the ethical responsibilities of nurses when providing care to older adults.
- Discuss the various forms of elder abuse with the students. The National Committee for the Prevention of Elder Abuse (NCPEA) is an association of researchers, practitioners, educators, and advocates dedicated to protecting the safety, security, and dignity of America’s most vulnerable citizens. It was established in 1988 to achieve a clearer understanding of abuse and provide direction and leadership to prevent it. Since 1998. NCPEA has been a partner or participant in the National Center on Elder Abuse, funded by Congress to serve as the nation’s clearinghouse and resource for abuse and neglect.
- Discussion Questions: Use the following to facilitate a discussion with your students related to the video and case study presented:
- Identify and describe the form(s) of elder abuse experienced in the video. Give examples from the video to support your information.
- What risk factors for elder abuse and/or neglect were evident in the video for the individuals presented?
- What are the nurse’s ethical responsibilities for a client who is a victim of abuse/neglect viewed in the video?
- What do you think the patient is experiencing?
- Consider the possible outcomes of implementing falls precautions or not. What are the risks and benefits to the patient? To the nurse?
- Play or read the Red Yoder unfolding case monologue. This activity can take place in lecture, seminar, or in pre or post conference for clinical.
  
  Discussion Questions: Use the following to facilitate a discussion with your students related to the video and case study presented:
  - What are your concerns for Red? Give examples from the video to support your information.
  - What is the cause of the concern?
  - What else do you need to know about Red?
  - What are you going to do about it?
  - What do you think Red is experiencing?
  - Consider the possible outcome if the nurse does nothing in this situation.
  - Consider the possible outcomes if the nurse takes action. What are the risks and benefits to Red? To the nurse?
  - What steps should be taken to resolve this ethical dilemma?
  - Discuss how nurses can determine if a patient is cognitively intact in making care decisions.
Students should be encouraged to explore websites such as the Try This:^® and How to Try This resources and Innovative Care Models websites for additional assessment tools and information.
Suggested Reading

Abuse in Later Life Wheel
Elder Abuse Emerges From The Shadows of Public Consciousness
Assessment Tools
The Try This:® Series from the Hartford Institute for Geriatric Nursing (HIGN) at the NYU Rory Meyers College of Nursing contains many evidence-based assessment tools. The tool, an article about using the tool, and a video illustrating the use of the tool, are all available for your use. Those listed below can be used to assess, evaluate, and discuss the needs of older adults and abuse, with students.
Author Information

Tamika Curry, MSN, RN
Community College of Philadelphia
Philadelphia, PA