Physical and Emotional Abuse of Children and the Elderly

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Abuse is the maltreatment of one person by another. Any abuse regarding a child involves the child being 18 years or younger and any abuse regarding an elder or an older adult is someone age 60 or older. Many individuals believe that abuse only involves violence. Contrary to some people’s beliefs, there are many different forms of abuse. Tens of thousands of children and the elderly are traumatized each year by emotional abuse, physical abuse, sexual abuse, and/or neglect. In addition, there is also elderly financial abuse. The National Child Abuse and Neglect Data System is the federal reporting system that collects and analyzes child abuse data annually (Ward, 2016).

Emotional abuse is abuse characterized by a person subjecting or exposing a child or elder to behaviors that may result in psychological trauma. Psychological trauma can lead to chronic pain, depression, anxiety, or post-traumatic stress disorder or what others call PTSD. Examples of emotional abuse include belittling, ridiculing, shaming, yelling, intimidating, and habitual blaming. Possible signs and symptoms in a child and elder are apathy, depression, hostility, avoiding eye contact, and difficulty concentrating (Ward, 2016).

Physical abuse is any intentional or unintentional use of force causing bodily injury or trauma to another person. A child or elder’s bodily injury or trauma can be inflicted by beating, biting, chocking, hitting, poisoning, slapping, kicking, pinching, shoving, and pulling of hair. Shaken baby syndrome is also a form of physical abuse in infants and young children. Signs and symptoms of physical abuse in a child and elder are suspicious bruises, welts or burn, unexplained fractures or dislocations, acting out with aggression, retinal hemorrhages, and wariness of adults or caregivers (Ward, 2016).

Sexual abuse is a complicated form of abuse and it’s important to recognize that sexual abuse doesn’t always involve physical bodily contact. For a child, exposing them to sexual situations or material is sexually abusive, whether or not touching is involved. Child sexual abuse is any sexual act involving an adult and a child, whether they’re related or not, that can include forced or assented intercourse, oral sex, fondling, sodomy, or sexual exploitation. Signs and symptoms of sexual abuse for a child include inappropriate or advanced knowledge of sexuality, poor peer relationships, sudden changes in behavior, enuresis, recurrent urinary tract infections, redness and swelling of the genitalia, suicide attempts, running away from home, and substance abuse (Ward, 2016).

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Elderly sexual abuse is any type of sexual intimacy against the elderly person’s will. Elderly sexual abuse includes forced or unwanted fondling, oral sex, and penetration of any genital openings or anal. Even if these acts are committed against a person who is not competent to give informed approval, it’s still qualified as sexual abuse. Signs and symptoms include sustaining a pelvic injury, having problems walking or sitting, panic attacks, suicide attempts, developing a sexually transmitted disease, torn, bloody, or stained underwear, bleeding and irritation from the anus or genitals, and bruises of the genitals or inner thigh. Elderly victims often deny or minimize the abuse because of fear of retaliation or embarrassment. Ordinary perpetrators of elder sexual abuse are nursing home assistants, live-in nursing aids, family members, and other types of care providers that are left alone to care for the elderly individual (CDC, 2017).

Neglect is failing to meet basic needs in a child and elder such as not providing adequate health care, supervision, housing, clothing, nutrition, safety, emotional, physical, and educational needs. Signs and symptoms of neglect are poor hygiene, clothing unsuited to the weather, hunger, and lack of supervision in a child and elder. Neglect is more common but also the most difficult to identify (Nspcc, 2015).

Financial abuse or exploitation is the unauthorized, illegal, or misuse of an elderly person’s income, for the benefit of someone other than the elderly individual by a caregiver. Examples of financial abuse include forgery, theft of money or property; use of coercion or deception to surrender finances or property; or improper use of guardianship or power of attorney (CDC, 2017).

Regardless of the type of abuse in the state of Alabama, the physicians, surgeons, medical examiners, coroners, dentists, osteopaths, optometrists, chiropractors, podiatrists, nurse practitioners, nurses, social workers, nutritionists, and disease intervention specialists are legally obligated to report the known or suspected abuse to the proper investigating agency immediately. Ohio has recently expanded the numbers of mandatory reporters. Ohio individuals in the medical professions, legal and financial services are required to report abuse. Ohio mandatory reporters such as pharmacists, nurses, health department employees, mental health agency employees, dialysis technicians, physicians, firefighters, first responders, building inspectors, real estate agents, bank employees, financial planners, and notary publics. In both the state of Alabama and Ohio, if it is suspected that elder abuse has taken place the identifying staff member must report the incident to authorities such as the police or to the Adult Protective Services so that it can be investigated further (Oda, 2019). In Ohio, if it is suspected that child abuse has taken place, the identifying staff member must report the incident to the Public Children Services Agency or a peace officer in the county in which the child resides or in which the abuse or neglect is occurring or has occurred. In Alabama, if it is suspected that child abuse has taken place, the identifying staff member must report the incident to the chief of police or sheriff, the Office of Child Protective Services, or to the Department of Human Resources. In the state of Alabama and Ohio, failure to report the known or suspected abuse can result in a penalty of a misdemeanor, monetary fine, or imprisonment (Child Abuse and Neglect, 2019).

During investigations, the nurse must remain nonjudgmental and still meet the needs of the abuser until the law takes over. As for the abused victim, the nurse needs to build a trusting relationship, let the victim know that it’s not their fault and that you believe them. Both the abused and the abuser will need counseling. After dealing with an abuse case or any clinical crisis, healthcare professionals have an opportunity to debrief. The process of debriefing is a critical conversation that helps the healthcare professionals take time together to identify the personal impact of the abuse case, but debriefing isn't meant to take the place of individual counseling if needed. If debriefing is needed the nurse manager brings in a reliable professional peer skilled in critical incident stress debriefing to assist with the debriefing process (Debriefing, 2017).

In conclusion, prevention is much better than treatment. Regardless of the type of abuse, the result is serious emotional harm. Child and elder abuse lead to several bad effects on the individual being abused and the abuser. By catching the problem as early as possible, both the child and the abuser can get the help they need. Abuse is still alive today because individuals fail to listen to the abused victims and to report the abuse. If suspicion of abuse arises, it’s important to speak out.

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