Explain how to protect older service users from abuse.

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Explain how to protect older service users from abuse

Those who are vulnerable, like the elderly are more likely to be a victim of abuse, however abuse can happen to anybody, by anyone, at any time. This is why it is important to know the different types of abuse and the possible signs of it, as it can help provide them with safety and protection. Although if somebody is exhibiting these signs it does not automatically mean they are a victim of abuse as there may be a good explanation. For example those of a more elderly age has skin that bruises much easier so bruised skin may be from where they accidentally banged themselves. This shouldn’t be assumed however and deciding if someone is being abused or not is usually a difficult and lengthy process that may not be found out for years, it is usually a combination of factors that gives more of a clue to the whole situation. Elder abuse can be 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”(who.int/ageing/projects/elder_abuse/en, 08/03/12). There are many types of abuse and some of these are usually combine together, some ways in which older service users can be abused include, physically, verbally, emotionally, sexually and financially.

Physical abuse is probably the most often thought of abuse when someone is asked about elder abuse. This may because physical injuries are sometimes easier to identify and most people don’t like the idea that someone that is stronger or in a position of trust can assault someone of a venerable position. Physical abuse is causing someone pain or injury, for example by hitting, pushing, slapping, shaking, striking, beating, shoving, kicking and/or using an item as a weapon towards somebody.  Also physically restraining somebody in an inappropriate manner is also counted as physical abuse. This can include tying them down, this can lead to bruising. ”Freedom of movement becomes limited, and over a period of time the use of restraints may result in deconditioning and muscle atrophy” (Falls in the Nursing Home, Ann Intern Med 1994 Sep 15; 121(6):442–51). Likewise an elderly person should not be given medication in a means to restrain them, unless these medications are needed to treat symptoms. Medicating an elderly person in a way that is of benefit staff or careers is physical abuse, for example giving them extra medication to make them sleep longer or to discipline them. Likewise withholding medication that is prescribed to them, for example not letting them have pain relieve medication when they are in a lot of pain, is also elder abuse, this can come under both physical abuse and neglect. “The prescription or administering of medication that is not licensed for the purpose used, often described as the 'soft cosh' because of the impact that it can have.” (elderabuse.org.uk, 08/03/12)

There can be many signs of physical abuse, however these can sometimes be covered by the abuser or victim and any injuries that go unexplained should be investigated fully. These may also be called indicators, there can be physical signs or indicators, such as bruises or behavioral indicators such as the victim changing in the way they act or interact with other people, especially in the way that the victim and abuser are towards one another. Signs should not be taken as conclusive proof and instead patterns or someone with many signs may be more of an indicator. Sometimes signs of physical elder abuse may go on noticed, “They may appear to be symptoms of dementia or signs of the elderly person’s frailty — or caregivers may explain them in that way.” (helpguide.org/mental/elder_abuse_physical_emotional_sexual_neglect.htm, 08/03/12) and it is true that some signs and symptoms are similar as those of mental deterioration; however this doesn’t mean that they should be ignored.  

Some signs that someone has physically abusing an elderly person can be malnourishment or dehydration without any other ill related causes. Also prove of medication that has been over or under dosed, been given inappropriately or not been given at all. There may be laboratory evidence of this, or there may be a report of a drug overdose or care workers may say that the service user failed to take their medication as they refused it, this may happen on an often occurrence, and although the service user may be doing this if they seem to take it fine with other service user’s that it may be a sign that that particular care worker may be withholding the prescribed drugs. Another sign that this is happening is that there may be more prescribed drugs remaining than there should be even though the care worker hasn’t said the service user refused to take them. These signs sometimes come under medication abuse which “may include withholding medication, over-medicating or not complying with prescriptions refills.” (edmontonpolice.ca/communitypolicing/familyprotection/elderabuse.aspx, 08/03/12)

Physical signs such as bruises and scars can also be a sign of physical abuse; however this may be from an accident. This can especially be a sign if they seem to be on two sides of the body in a symmetrical way or if they appear in regular patterns or clusters in areas such as the groin or neck. Although the elderly are usually fragile, broken bones, sprains and fractures can also be a sign of physical abuse. Any other signs of physical abuse can include things such as cuts, open wounds, black eyes, welts and any other injuries at any stage of healing or that haven’t been treated properly. Burns can also be a sign of physical abuse, these are most commonly around the palms, soles or buttocks, but can be in any other place, they may appear as cigarette burns or larger burns. Signs of being restrained can also be a sign of physical abuse, such as rope marks on the wrists, restraint is “any manual method, physical or mechanical device, or equipment that immobilizes or reduces the ability of the person to move his or her arms, legs, body or head freely (Centers for Medicare and Medicaid, Effective 1-1-08) this can include medicine used to restrain people. Physical restraint can be used in care settings, however this needs to be at a last resort and only if someone or the person themselves is going to come to harm if the restraint isn’t used. Even with expectable restraints there is a lot of controversy as they are believed to be unnecessary and sometimes cause further problems of distress in the service user. In most cases good care workers try and find alternatives and they may first of all discuss the use of restraint with the service user or an advocate. In the UK it is unlawful to use restraining belts, cuffs and vests that are designed to keep the service user restrained to a bed or chair; however in other countries this may be accepted. Broken frames or eyeglasses can also be a sign of physical abuse as they may have become broken due to physical abuse; however they could have broken for other reasons. Poor skin hygiene or conditions lost of weight and a solid bed or clothing can also be signs, as well as being in pain.

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There may also be a change in the service users behavior, for example they may become withdrawn and act differently, this is even often the case for service users that are less able to communicate their feelings, it may still be shown that they have a change in their behavior. They may act in a distressed, anxious way and become angry and upset, or becoming more angry then usual, for example they may shout and/or cry. They may tell someone that they have been a subject to abuse or complain via written or verbal communications. If a service user ...

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