Question

An elderly woman, JT, recently moved in with her adult son, his wife and their 2 children, after the death of her husband. JT is being evaluated in your emergency room due to a broken rib and bruising. JT is very quiet, passive and lets her daughter in law speak for her. The daughter in law reports to the nursing staff, "JT fell down the basement steps as JT was carrying a basket of clothes to the laundry area and slipped on the step". JT doesn’t deny or refute the information. As the nurse, you interview JT alone and find out the daughter in law pushed JT and she fell down the stairs.

Your share this with a colleague who states: “I don't think it's any of our business what people do in the privacy of their own homes. Nothing will be done even if you report it”.

1. How will you respond?

2. What are you legally required to do?

3. What are your ethical responsibilities?

Answer 1

1) This is a case of elder abuse. we nurses have a responsibility to the patient safety as we care for them. so instead of protecting the culprit of this, protect the victim as she is helpless. otherwise this may happen again and again.

2) in order to prevent the recurrence of elder abuse, that is, when an elderly person who is dependent is abused at any means like physical, emotional, financial exploitation, sexual , neglect or any other kinds of mistreatment, we have to report it legally. noticing the signs of abuse is needed for person who is being may not report it. According to National Center on Elder Abuse, the elderly person may not report because of fear of retaliation, may be due to cognitive or physical impairment or sometimes if the abuser is a family member they may not report it.

In such cases, as a nurse we have to notice the signs of elder abuse like

• physical injuries
• poor physical apperaence
• depression
• broken bones and fractures
• weight loss
• deterioration in health means malnutrition
• bed sore

identify the signs of elder abuse and report it at the earliest. document the signs of abuse and report it . for this you can document

• taking photos of injuries
• victims behaviour changes
• description about injuries
• written statement from victim or from witness

report it to person concerned with this. they will investigate and solve this

3) nurses have a duty to report the elder abuse at the earliest inorder to prevent further harm to the person. The ethical responsibilities of a nurse against elder abuse include

• autonomy- it is the ability to make a decision by own
• justice- be justified
• benefience - be good for someones interest
• non-malfeacence - do not harm