Self-neglect in older adults is a geriatric syndrome.
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Activities of Daily Living↗
Biomedical subjects
Carmel Bitondo Dyer
Publications and source records attributed to Carmel Bitondo Dyer.
Enhancing victim safety through collaboration.
Elder abuse is associated with morbid and lethal outcomes. In some cases of elder abuse, particularly involving domestic violence, uninformed or improperly executed interventions can result in serious harm to the victims. Professionals from various disciplines may themselves be at risk during encounters with perpetrators. This chapter provides an overview of potentially dangerous scenarios of elder abuse such as homicide, homicide/suicide, strangulation, and stalking. Intervention strategies such as lethality assessments and safety planning are described. A case scenario illustrates the value of an interdisciplinary response to enhance victim safety. This chapter reviews potential lethality factors and the steps that can be taken to enhance the safety of victims, their families, and the professionals who serve them.
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Neglect assessment in elderly persons.
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The key elements of elder neglect:a survey of adult protective service workers.
Description of the key elements of elder neglect is critical to the development of a case definition. In this brief report, experienced protective service workers were surveyed to capture their field experiences with neglected elders. The workers cited environmental filth, poor personal hygiene and health related factors as the three most common observations. Workers also describe their definitions of the differences between self and caregiver neglect.
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Progress in elder abuse screening and assessment instruments.
The responsibility of identifying elder mistreatment (EM) often falls on the healthcare professional. Many different screening and assessment instruments have been developed to aid healthcare professionals in making determinations about EM. The purpose of this article is to review existing EM screening and assessment instruments to examine progress in this field. The value and limitations of these instruments with regard to their use in different clinical and healthcare settings are discussed. The settings in which EM screening and assessment are conducted are also considered. The authors conclude that there is much to be done in terms of achieving consensus on what constitutes an appropriate screen or assessment instrument for detecting EM. Effort must be focused on instruments that can be used for brief, rapid screenings and those that can be used for more-detailed diagnostic assessments.
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Frail older patient care by interdisciplinary teams: a primer for generalists.
Frail older patients-unlike younger persons in the health care system or even well elders-require complex care. Most frail older patients have multiple chronic illnesses. Optimum care cannot be achieved by following the paradigm of ongoing traditional health care, which emphasizes disease and cure. Because no one health care professional can possibly have all of the specialized skills required to implement such a model of health care delivery, interdisciplinary team care has evolved. This paper describes the roles of the participating team members in the context of interdisciplinary care for frail older adults. In addition, the challenges that occur when Geriatric Interdisciplinary (ID) Teams involved in providing care to frail older patients are identified and discussed.
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The hidden health menace of elder abuse. Physicians can help patients surmount intimate partner violence.
As many as 2 million elderly persons in the United States experience physical, psychologic, or sexual abuse each year. Nationally spouses or intimate partners commit between 13% and 50% of elder abuse.1 Physicians can be instrumental in preventing and intervening in intimate partner violence in their elderly patients.
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How geriatricians identify elder abuse and neglect.
BACKGROUND: Up to 2 million elderly persons are abused or neglected in the United States each year. Although elderly patients see their physicians an average of five times per year, physicians make only a small percentage of reports to Adult Protective Services (APS) agencies. The purpose of this study was to learn how practicing geriatricians define, diagnose, and address abuse and neglect to provide some guidance to the busy general internist regarding this complex issue. METHODS: Ten local geriatricians were interviewed with a standardized set of open-ended questions. A team analyzed the verbatim transcriptions using both quantitative and qualitative methods. RESULTS: The average number of cases diagnosed per year was 8.7 (range, 2-20). The geriatricians were fairly consistent in their definitions of elder abuse and neglect and how they diagnosed it through the history and physical exam. The most common findings in the history were rapport between the patient and caregiver, medical noncompliance, activities of daily living and instrumental activities of daily living assessments, and loss of social activities. The most common findings on the physical exam were bruising/trauma, general appearance/hygiene, malnutrition, and dehydration. CONCLUSIONS: The geriatricians emphasized keeping the diagnosis of abuse and neglect in mind for every patient. A variety of interventions were employed by physicians and ranged from automatically calling APS on each case to addressing cases through work with an interdisciplinary geriatrics team.
Adult↗