Geriatric Nursing

Elder Abuse

Action on Elder Abuse has put forth a definition on elder abuse in which the World Health Organization (WHO) implemented 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” (2006). At the forefront of the healthcare team, nurses are primarily the identifiers of elder abuse. The central aspects that nurses have to be aware of are the different types, the possible risk factors and their role and responsibilities as a health care professionals.

Types Of Abuse

There are five different types of elder abuse that O'connor and Rowe (2005) talk about; neglect, physical, sexual, psychological, and material abuse. Neglect is defined as not meeting patient needs and failure to provide access to support. Physical abuse is any harm, injury, or restraint physically against elderly. Sexual abuse is any sexual acts towards elderly without consent. Psychological abuse consists of any emotional abuse, threats, humiliation and verbal abuse. Material abuse is any such property stolen or elder taken advantage of.

Risk Factors

Lachs and Pillemer (2004) showed in their study that substantial evidence supports the existence of risk factors for elder abuse including:

  • Shared living situations, where there are more chances for contact; therefore, more chances for conflict and tension.
  • Also, when dealing with people with dementia, involving patients with aggressive behaviours, there is a higher risk for physical abuse due to the stress put on the primary care givers.
  • Moreover, social isolation has been considered, where older people are isolated from friends and family, due to the pressure put on the caregivers and the lack of witnesses, it place the elderly at higher risk for abuse.
  • Likewise, the authors established that a history of mental illness and alcohol misuse contributes to elder abuse.
  • Physical impairment of the old person could be a predisposing factor, since it diminishes the person’s ability to defend him or herself.

Nursing Roles & Responsibilities

As primary care givers in different nursing practices, nurses act as front line health professionals in detecting and offering prevention for elder abuse. Through oral interviews and head to toe assessments, nurses must pay attention to any signs of abuse e.g. unexplained injuries. Empowering the elderly is the key to abuse prevention. Nurses also take up the role of encouranging them to speak, offering emotional support and making referrals to other healthcare providers. McGarry and Simpson ( 2009) states that by recognizing the causes of abuse, oral report can be inititated to the manager on the unit followed by a detailed written report and proper documentation. Nurses must also be willing to provide evidence in the court of law. In the event where the abused needs immediate intervention, the nurse must first call for "emergency services".

Nurses roles and responsibilities

Abuse diminishes ones dignity, self respect and pride. The geriatric population deserves to keep these qualities intact, not to be taken away from by an act of abuse. A portion of the geriatric population relies on health care team members not only for care; but for a voice, as advocates. Let the power of knowledge, prevention and action be the way to advocate - the way to diminish abuse among the geriatric population.

Links of Interest


Action on Elder Abuse. (2006). Retrieved July 31, 2009 from

Lachs, M.S., & Pillemer, K. (2004). Elder Abuse. The Lancet, 364,1265. Retrieved from

McGarry, J., & Simpson, C. (2009). Identifying, reporting and preventing elder abuse in the practice setting. Nursing Older People, 21(1), 33-38. Retrieved from

O'Connor, K.A., & Rowe, J. (2005). Elder Abuse. Reviews in Clinical Gerontology, 15, 47-54. doi:10.1017/S0959259805001668.