October 2014
Swank Health: Your monthly news from Swank HealthCare

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Did You Know?

Child, Domestic, and Elder Abuse

Top List

Top 10 helpful questions to assess a patient for abuse

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Free HCAHPS Webinar Series

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Test Your Knowledge: Elder Abuse

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  • #610314 / #31213 / #90113 Domestic Violence: Assessment/Treatment
  • #610414 / #316012 / #90512 Domestic Violence: Typology/Causality
  • #314011 / #33111 Family Violence and Abuse (Parts 1 and 2)
  • #611014 / #611114, #35412 / #36212 Child Abuse: Trauma/PTSD (Parts 1 and 2)

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Did You Know?

Child, Domestic, and Elder Abuse

In recent weeks, the issues of child and domestic violence have received heightened attention in the media spurred by reports of several high-profile cases involving players in the NFL. However, domestic violence, child, and elder abuse, are not just problems in the NFL, they are major public health threats in the U.S and worldwide. These types of abuse can happen to anyone, regardless of age, race, socioeconomic class, religion, sexual orientation, or gender. Abuse and neglect not only have immediate health consequences, but links to other life-threatening and fatal conditions that affect victims throughout their lifespan.

  • In the U.S. alone there are over 12 million cases of domestic violence every year
  • 1 in 4 women will experience domestic violence during her lifetime
  • Survivors of domestic violence have high rates of depression, anxiety, and emotional distress
  • 15 million children are exposed to domestic violence nationally, and approximately 1 million additional children experience some type of abuse from family members
  • More than 4 children die every day in the U.S. as a result of child abuse and neglect
  • More than 90% of juvenile sexual abuse victims know their perpetrator in some way
  • There are more than 2 million cases of elder abuse in the U.S. each year
  • Only 1 in 14 cases of elder abuse are ever reported
  • A 2010 study found that 47% of those with dementia had been mistreated by their caregivers

Healthcare professionals are in a unique position to recognize abuse and initiate a process to stop the cycle. When a patient presents with an unlikely or repeated injury, is in a state of constant vigilance to prevent injury, or has difficulty with or age-inappropriate behaviors concerning sexual parts of the body, you should question the nature and source of the injury and take proactive steps to help the patient. The most common physical injuries are unexplained bruises, lacerations, abrasions, head injuries and fractures. Other common signs of abuse include:

  • Injuries with a pattern, such as from a belt buckle or cigarette burn
  • Multiple injuries in various stages of healing
  • Unexplained injuries
  • Injuries in hidden areas
  • Bruising or abrasions on the buttocks or genitalia

In children, look for:

  • Contradictions in the patient’s and caregiver’s stories
  • Emotional and mental states that indicate the patient is afraid of or abnormally submissive to the caregiver

Signs of neglect in children and the elderly may be difficult to detect. The most common signs are:

  • Excessive thirst or hunger, which may be indications of malnutrition or dehydration
  • Inappropriate clothing for the weather
  • Soiled clothing and poor hygiene
  • Bedsores
  • Inattention to medical needs, such as unfilled prescriptions or missed appointments with healthcare providers

When you suspect a patient is the victim of abuse, there are several actions you should take:

  • If the patient is in immediate danger, separate him/her from the perpetrator
  • Treat the patient’s injuries
  • Question, observe, and listen for possible indications of abuse
  • Document the facts including date and time the injury took place, the patient’s version of what happened, a body map detailing the location and type of injuries, and all other pertinent facts

When there is reasonable cause to suspect abuse, follow facility policies for reporting to the proper authorities.

Access to trained professionals are available through the following hotlines to assist with emergency counseling and additional information about resources in local communities.

  • National Domestic Violence Hotline: 1-800-799-SAFE (7233)
  • ChildHelp USA National Child Abuse Hotline: 1-800-4-A-CHILD (422-4453)
  • National Youth Crisis Hotline: 1-800-442-HOPE (4673)
  • Elder Abuse Hotline: 1-800-252-8966


Centers for Disease Control and Prevention. (2012). Retrieved September 2014, from Understanding Intimate Partner Violence: Fact Sheet: www.cdc.gov

Kent, V. P., & Crusse, E. P. (2010, August). Targeting Abuse. Nursing Made Incredibly Easy!, 8, 22-28.

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Top 10 List

When concerns arise about possible abuse in a patient, it’s important to observe and ask questions. Always interview the patient alone and in an environment that is supportive, compassionate, and safe. Here are 10 helpful questions to assess a patient for abuse.

  1. I noticed that you have several bruises. Can you tell me how they happened?
  2. Are you afraid of or feel threatened by anyone in your life?
  3. Are you in a relationship with someone who has kicked, slapped, or otherwise physically hurt you?
  4. Are you in a relationship with someone who has hurt or threatened to hurt someone close to you?
  5. Do you feel controlled or isolated by anyone?
  6. Do you feel safe at home and in your current relationships?
  7. Does your partner ever watch you too closely, follow, or stalk you?
  8. Have you ever been touched in a way that made you feel uncomfortable?
  9. Has anyone forced you to do something sexual when you did not want to?
  10. During an argument at home have you ever worried about your safety or the safety of anyone close to you?

Now Trending

Test your knowledge about elder abuse by answering these questions.

Myth or Fact?

If things are really bad, a victim will take action to leave.

Myth or Fact?

Most elderly victims are victimized in or near their homes and are victims of financial crimes, neglect, and white collar offenses.

Myth or Fact?

To be considered abuse, injuries must be physical.

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Often times victims of elder abuse feel trapped by factors such as: fear, isolation, financial dependence, and low self-esteem.



It is a misconception to believe that most crimes against the elderly are violent crimes that result from being in the wrong place at the wrong time.



Many elderly people are harmed by being stripped of their savings, forced to relinquish possessions, threatened, humiliated, intimidated or neglected by a caregiver they depend on.