Elder Abuse among Patients

Introduction
This paper will focus on the geriatrics service line. Elderly patients are coming in at higher rates and the geriatric population is trending upward (Advisory Board, 2018). One problem the department is having is the identification of elder abuse among geriatric patients. Elder abuse has been defined as “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” (Jackson, 2016, p. 265). According to the World Health Organization (2002), elder abuse can take any one of or combination of forms: (a) physical abuse, (b) psychological abuse, (c) sexual abuse, (d) neglect, (e) abandonment, and (f) financial exploitation or theft. Recognizing and addressing elder abuse is important for the geriatrics service line because it will help to better serve the elderly patient and the geriatric community overall and it will reduce the risk of repeat issues with returning patients. The goal of the service line is to improve quality care, and that begins with recognizing signs of abuse and providing the necessary intervention to address these matters. As McNicoll (2017) points out, education is a primary tool in helping the geriatric service line to accomplish its task of providing top notch quality care to patients. This paper will show why elder abuse among geriatric patients in the geriatric service line is a problem and why it serves as a good research topic to help care providers better serve the population.
The Problem
This research project will focus on the ways to help care providers better cope with the stress of having to care for their elderly patients so as to reduce the perception or act of elder abuse among geriatrics in the service line. As Zeller and Lamb (2011) have shown, mindfulness training can assist care providers in coping with stress. It corresponds with what Baer (2003) has recommended as an important clinical intervention: mindfulness training can help care providers to be more “in the moment,” self-possessed, and patient-centered so as to give the elderly patient all the care he or she needs. Geriatrics require some of the most advanced care in medicine, and without high levels of patience and mindfulness among care providers throughout the service line, these patients can feel or experience extreme sensitivity and neglect—at least from their perspective. It is important for care providers of the geriatric service line to be able to put themselves in the shoes of their patients and understand their feelings, place, and needs so as to provide the type of empathy, sympathy, respect and quality of care required of this population.
How Research Could Help the Department
Research on the problem of abuse in the geriatric service line could help the department by providing education and awareness on ways in which geriatric patients often experience neglect or suffer abuse from care providers. Care givers in the geriatric service line have to be able to identify abuse when they see—but they also have to be careful to not be part of that problem of abuse. Abuse can take so many different forms, as the World Health Organization (2002) has shown, that even small forms of neglect have to be realized as major issues that the service line must address.
Evans, Hunold, Rosen & Platts?Mills (2017) report that more effort needs to be made to identify elder abuse among geriatric patients as their study found elder-abuse to be an under-reported public health issue. Alone it costs billions of dollars in treatment and care and can lead to injuries that require emergency room visits and hospitalization. In the geriatric service line, care providers have to be able to understand the signs and symptoms of elder abuse so that they can treat the underlying issues and prevent problems from arising in the future.
The problem, as Evans et al. (2017) show, is that there is too little understood about how elder abuse is identified and diagnosed in hospital settings. Care providers do not have enough education on the matter and need to be better informed. The purpose of this research is to obtain a better sense of what care providers in the geriatric service line do know about elder abuse, how to identify it, and what to do to address it: this information will serve to help the geriatric service line develop a teaching tool that will train the care providers in that line to better understand, recognize and address elder abuse.
As training and preparedness, along with communication and interprofessional collaboration, is at the core of what it means to provide quality care to patients, the problem of being able to recognize elder abuse among geriatric patients is critical to the success of the geriatric service line. Research that allows for a better understanding of what care providers know and do not know in the service line will help to make that service line more effective. It will help to ensure that geriatric patients get the attention they need if they are indeed suffering from elder abuse, and it will help the hospital overall to be better functioning and attentive to the needs of its patients.
Sources of Data
Sources of data that will be used to gather information about this problem will be: 1) scholarly articles and literature published in peer-reviewed journals, 2) interviews with care providers in the geriatric service line, and 3) surveys of nurses in the geriatric service line. These three sources of data are important to developing a sense or scope of the problem and what areas need to be addressed most critically first and foremost. Each data source also helps to provide triangulation of data collection, which makes the research stronger and more compelling in terms of obtaining trustworthy data that is truly representative of the problem. The more sources of data one uses in research, the clearer the picture can become. By using both qualitative and quantitative data collection methods, the research takes on a mixed-methods approach that provides a fuller perspective on the issue.
First comes the process of gathering information from scholarly articles. This serves as the basis of all evidence based practice: health care professionals must base innovations in care service on academic literature that has been peer reviewed—articles that show how to address problems such as these. Reviewing the scholarly literature on the problem of elder abuse in peer reviewed journals (articles published within the last five years would be most appropriate) will help to create a sufficient understanding of the background of the issue and what researchers have already uncovered about the general attitudes, beliefs and knowledge of care providers in the geriatric service lines of hospitals with regard to elder abuse and what to look for.
Second comes the need for actual data on what the care providers in the hospital department of the service line know about the matter. For this part, qualitative and quantitative data can be very helpful in determining the extent of their knowledge, the kind of knowledge they possess, and in identifying the gaps in knowledge and training that need to be filled. This data can be obtained by way of interviews with care givers (which provides the qualitative data) and surveys of care givers (which provides the quantitative data). The two data sets are complementary and help the researcher to develop a solid overall picture of the issues at stake.
Research Questions
Three research questions that could be asked to help solve the problem of identifying and addressing the issue of elder abuse in the geriatric service line at the hospital are:
1) What do the care givers in the geriatric service line at the hospital know about identifying elder abuse among geriatric patients?
2) Are the care givers in the geriatric service line at the hospital aware of what it means to “neglect” an elderly patient?—i.e., are they sensitive to and mindful of the needs of geriatric patients under their care?
3) Do the care givers in the geriatric service line at the hospital understand how to address the problem of elder abuse among their geriatric patients?—if no, what gaps in their understanding exist?—if yes, are they implementing this knowledge in their care practice?
Conclusion
The geriatric patients of the hospital require some of the most high level care in the health care industry, but researchers have shown that there is too little understanding among care providers in terms of diagnosing elder abuse. Elder abuse has been found to be under-reported and a substantial factor in repeated hospital visits. Care providers need to be better trained in identifying elder abuse and in making sure they themselves are not responsible for neglecting geriatric patients. This paper aims to research what care providers actually know about identifying elder abuse among their geriatric patients and what can be done to increase their knowledge.
References
Advisory Board. (2018). Geriatrics implementation strategy guide. Retrieved from
https://www.advisory.com/research/service-line-strategy-advisor/resources/2014/geriatrics-implementation-strategy
Baer, R. A. (2003).  Mindfulness training as a clinical intervention: a conceptual and
empirical review. Clinical Psychology: Science and Practice, 10(2), 125-143.
Evans, C. S., Hunold, K. M., Rosen, T., & Platts?Mills, T. F. (2017). Diagnosis of elder
abuse in US emergency departments. Journal of the American Geriatrics Society, 65(1), 91-97.
Jackson, S. L. (2016). All elder abuse perpetrators are not alike: the heterogeneity of
elder abuse perpetrators and implications for intervention. International journal of offender therapy and comparative criminology, 60(3), 265-285.
McNicoll, L. (2017). Geriatric co-management as a service line: spreading co-
management within an institution. Innovation in Aging, 1(Suppl 1), 612.
World Health Organization. (2002). World report on violence and health. Retrieved
from http://apps.who.int/iris/bitstream/handle/10665/42495/9241545615_eng.pdf;jsessionid=850EE8DE7BE263F45077CAAF20D50343?sequence=1
Zeller, J. & Lamb, K. (2011). Mindfulness meditation to improve care quality of life in
long-term care settings. Geriatric Nursing, 32(2), 114-118.