Elder Abuse
A 76-year-old man was brought to the emergency department by a concerned neighbor, who noticed several bruises on his arms and face. The patient lived with his adult son, who had been his primary caregiver since his wife passed away a few years ago. Upon questioning, the patient appeared hesitant to discuss the cause of his injuries, initially attributing them to accidental falls. However, his explanation seemed inconsistent with the nature and pattern of the bruises. A more detailed physical examination revealed older, healing bruises on his torso and legs. Additionally, the patient appeared malnourished, with significant weight loss noted compared to his last medical visit six months earlier. His medical history included hypertension and diabetes, both of which were poorly managed, as the patient had not been taking his prescribed medications regularly. When gently probed in a private setting, the patient admitted that his son had been physically and verbally abusive over the past year. The abuse had escalated recently, and the patient felt isolated and dependent on his son for basic needs, despite the mistreatment. The healthcare team immediately activated adult protective services and social work for intervention. A safety plan was put in place, and arrangements were made to relocate the patient to a safe living environment. The patient was offered counselling, and follow-up care was arranged to address his medical conditions and ensure he received appropriate support and protection moving forward.
a) Difficulty breathing
b) Bruises noticed by a neighbour
c) Severe chest pain
d) Complaints of dizziness
a) His daughter
b) A professional caregiver
c) His adult son
d) A neighbour
a) Evidence of recent surgery
b) Signs of malnutrition and weight loss
c) Fractures in the arms
d) A skin infection
a) Provided medication for pain relief
b) Called the police for an investigation
c) Activated adult protective services and social work intervention
d) Referred the patient for surgery
Answers
1. b) Bruises noticed by a neighbour
2. c) His adult son
3. b) Signs of malnutrition and weight loss
4. c) Activated adult protective services and social work intervention