Abuse, Elder, Emergency Medicine

Helen Straus Reviewed 06/2017
 


Basics

Description

Elder abuse may include the following: 
  • Emotional abuse:

    • Insults

    • Humiliation

    • Threats to institutionalize or abandon

  • Physical and/or sexual abuse:

    • Hitting

    • Slapping

    • Pushing

    • Burning

    • Inappropriate...

Diagnosis

Signs and Symptoms

Variable, possibly inconsistent, history or physical findings 

History

  • Not willing or able to obtain adequate food/clothing/shelter

  • Not providing for personal hygiene/safety

  • De...

Treatment

Pre-Hospital

Observe details of the patient's environment that may not be immediately available to the hospital care team, including the following: 
  • Interpersonal interactions at the scene:

    • Emb...

Follow-Up

Disposition

Admission Criteria

Disposition determined by medical condition and home environment: 
  • Medical condition requiring admission

  • Abuse or neglect renders home conditions unsafe.

  • Need for m...

Pearls and Pitfalls

  • Entertaining the possibility of abuse or neglect in an elder patient offers the best possibility of diagnosis and successful intervention.

  • Only ∼1/3 of healthcare providers identifi...

Additional Reading

  • Clarke  ME, Pierson  W. Management of elder abuse in the emergency department. Emerg Med Clin North Am.  1999;17:631–644.

  • Cooper  C, Selwood  A, Livingston  G. Knowledge, detect...

Codes

ICD9

  • 995.80 Adult maltreatment, unspecified

  • 995.81 Adult physical abuse

  • 995.82 Adult emotional/psychological abuse

  • 995.83 Adult sexual abuse

  • 995.84 Adult neglect (nutritional)

  • 995.85 Other adult abuse...

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