When a “ Fall ” Isn ’ t a Fall: Screening for Elder Mistreatment

Up to 1 in 10 elders experience abuse, but most cases are missed during visits to the ED. by Chloe Sidley, MD and Lauren T. Southerland, MD Emergency departments are exceptional at detecting child abuse and they’ve trained SANE forensic nurses to assist with sexual abuse cases. So why aren’t we better at detecting elder abuse? During a shift on a bitterly cold winter day, a 76-year-old man is brought in by paramedics. He is disheveled and the medic team says that the home health aide found him in a freezing apartment with the heat off. The home health aide called 911 because the patient was confused and “not acting right.” The patient is not oriented to time or place, but says his name is Frank. He has a temperature of 93 degrees Fahrenheit, pulse 52, BP 138/88, and is oxygenating 95% on room air. When the nursing staff undresses the patient to put him into a gown, you note that he is very thin and is in mismatched clothing. Thankfully, the patient’s electronic medical record has a number for an emergency contact. His son, Bob, answers the phone and you inform him that his father is in the ED. Bob says that his father has a home health aide visit three times per week to take care of him, and to ask the aide about his father’s medical needs. You inform Bob that his father will be admitted to the hospital for continued care and likely will need a better living arrangement. When you go back to check on the patient, he is covered in warm blankets and eating a t...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Tags: Uncategorized Source Type: news