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Difficulty: MediumAbuse or Neglect

During a routine home health visit for a bedbound older adult, a practical nurse observes the client and the living environment. Which of the following findings should alert the nurse to suspect potential neglect? Select all that apply.

  1. An unstageable pressure injury on the sacrum with no evidence of recent wound care.Answer
  2. Prescribed daily medications for heart failure that have not been refilled in over three weeks.Answer
  3. C
    The primary caregiver frequently expresses exhaustion and asks for information about local respite care.
  4. Significant recent weight loss and a noticeable absence of nutritional food or fluids in the home.Answer
  5. E
    A fading, localized ecchymosis on the dorsal surface of the hand from a recent venipuncture.

Answer

The indicators of potential neglect include the unstageable pressure injury without wound care, the failure to refill essential cardiac medications, and the lack of nutritional food coupled with significant weight loss.
Elder neglect occurs when a caregiver fails to provide the necessary physical, medical, or emotional care required to maintain the client's health and safety. Findings such as untreated severe pressure injuries, the failure to provide or refill essential medications, and a lack of adequate food or hydration directly endanger the client and are clear, reportable indicators of neglect.

Step-by-Step Solution

1
Analyze the clinical scenario and the specific focus of the question.
The practical nurse is evaluating a bedbound older adult in a home setting for signs of neglect by the caregiver.
Understanding the setting and the vulnerability of the client is necessary to differentiate between expected findings, caregiver strain, and actual neglect.
2
Evaluate each option for signs of medical or physical neglect.
Untreated severe pressure injuries, withheld essential medications, and withholding of food and water directly endanger the client's health and are strong indicators of neglect.
Neglect involves the failure of a caregiver to provide necessary physical, medical, or emotional care.
3
Differentiate actual neglect from expected medical findings or healthy caregiver coping mechanisms.
Bruising from a known venipuncture is a normal medical occurrence. A caregiver expressing exhaustion and seeking respite care is appropriately asking for help, not demonstrating neglect.
Mandated reporting requires distinguishing between actual signs of abuse/neglect and routine clinical or psychosocial findings.

Key Concept

Indicators of Elder Neglect
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Topics

Abuse or Neglect

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