What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Sample Answer for What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429 Included After Question
Topic 5 DQ 2
What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? Discuss your facility’s procedure for reporting these types of abuse.
Although it is generally agreed that there is no specific ‘type’ of person who is more likely to be abused, and the different types of abuse include physical abuse, psychological abuse, sexual abuse, verbal abuse, financial abuse, etc. There are general characteristics which people in an abusive situation tend to have in common and this includes the follow:
- Low self esteem
- Emotional and economic dependency
- Continued faith and hope abuser will “grow up”
- Depression
- Stress disorders and/or psychosomatic complaints
- Accepts blame and guilt for violence
- Socially isolated, e.g. avoids social interaction, never seems to be alone
- Believes social myths about battering
- Believes in stereotypical sex roles
- Has poor self image
- Contemplates or attempts suicide, or self-harms
- Participation in pecking-order battering
- Appears nervous or anxious
- May defend any criticism of abuser
- May have repeatedly left, or considered leaving the relationship
- Broken bones, bruises, marks on the body, or bite, burn or scald marks.
- Frequent injuries that are unexplained or inconsistent with the account of what happened.
Anybody may fall victim to abuse, with all adults (those aged 18 and over) potentially being affected. However, there are some situations that increase an adult’s vulnerability and therefore put them at increased risk. For example, people with particular care and support needs, such as dementia or a learning disability, may struggle to communicate what is happening to them, or their communication may be misinterpreted as a symptom of their condition. Sadly, abusers target these vulnerable adults knowing this. This is why it’s so crucial for you to know the signs. At my facility, It is every nurse’s duty to report any type of abuse whether they are sure it happened or not to the supervisor who then goes to the manager and it finally gets reported to the Texas department of family and protective services.
Reference
https://www.domesticviolenceinfo.ca/types-of-abuse/
A Sample Answer For the Assignment: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Title: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Great post Oluchi. I agree with your part that the vulnerable individuals are at higher risk of abuse mainly because abusers mainly target these particular individuals because they may have dementia or other underlying illness that prevents them from speaking up and reporting the issue themselves. We as nurses indeed need to be very mindful of this fact and fully assess our patients for signs and symptoms of abuse as you mentioned in your post.
Yeah I agree with you that anyone can be a victim of abuse. Statistics have shown that the female folks have a higher rate of domestic violence and sexual abuse although some men have been seem to have experienced domestic violence. Like you stated, those more vulnerable for abuse such as people with dementia and learning disabilities. This sometimes occurs as a result of burn out from thier care givers and significant others. As nurses we should learn ways to deal with this group of people to prevent abuse on them
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Domestic violence is not always easily detected. This is because abuse within families is often concealed by the abuser. Registered Nurses are mandated reporters. This means that the nurse must report the suspected abuse to APS (Adult Protective Services) or CPS (Child Protective Services). (Rakovec-Felser, 2014.)
I work in an Emergency Department as a Complex Care Manager. I am often asked to consult with patients who mention domestic violence, child abuse, and/or elder abuse. Some patients or their Caregivers are ready to share this information with the nursing staff. We have a specific ER Triage question which asks the patient if they currently feel safe at home. This question can help a victim of violence to have an opportunity to speak openly with the nurse about the things that they are experiencing.
Domestic violence can be quite complex. Beyond bruises, this type of abuse has physical, emotional, mental, and even spiritual components. A Provider might suspect domestic violence when a patient has had multiple injuries without plausible rationale. Multiple ER visits can also provide a clue. Patients often invent a “cover story” and things do not always seem to add up. Another interesting factor is being new to the area, with a recent and unexpected move, with no connection to or knowledge of, resources. The patient appears to be a refugee, because they truly are one.
Child abuse is suspected when a child has non-accidental trauma, or unexplained marks on the skin. Child abuse can also take many forms. In addition to physical injuries, children can also be chemically restrained by parents who are not interested in engaging in parent training. Again, the presentation of these children can be quite concealed and convoluted, because most abusers have a degree of understanding that they can be prosecuted for child abuse. One of the most disturbing situations is found when children are not fed a nutritious diet and therefore, have failure to thrive. These children are literally starving in this country of wealth and abundance. (Towler, et al, 2020.)
The most common type of elder abuse that I witness is financial exploitation. Adult children live with patients and expect them to pay all of the expenses while they refuse to work or refuse to pay for items that the elderly patient needs to survive, such as food and clothing. Social security checks can be diverted away from patients. Financial exploitation is one of the most difficult forms of abuse to prosecute, even though it is very common. We also see neglect of personal care and nutrition, which causes adult failure to thrive.
It is important for the nurse to be aware of the unspoken and subtle signs of abuse. Does the abuser allow the patient to speak for themselves, or do they try to speak for them? Does the patient appear withdrawn or afraid? Is the patient trying to give you a subtle sign of abuse or pass a note to you? It is so important for nurses to remain fully awake and aware of the unspoken in every patient care environment. This is because lives are truly depending on us for help. Sometimes the nurse is the only one who can help a patient to take back their Voice and speak up. Sometimes the nurse becomes the Advocate and Voice for the patient.
References:
- Rakovec-Felser Z. (2014). Domestic Violence and Abuse in Intimate Relationship from Public Health Perspective. Health psychology research, 2(3), 1821. https://doi.org/10.4081/hpr.2014.1821
- Towler, A., Eivers, A., & Frey, R. (2020). Warning Signs of Partner Abuse in Intimate Relationships: Gender Differences in Young Adults’ Perceptions of Seriousness. Journal of Interpersonal Violence, 35(7–8), 1779–1802. https://doi.org/10.1177/0886260517696869
A Sample Answer 2 For the Assignment: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Title: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
“Family and domestic violence including child abuse, intimate partner abuse, and elder abuse is a common problem in the United States. Family and domestic health violence are estimated to affect 10 million people in the United States every year. It is a national public health problem, and virtually all healthcare professionals will at some point evaluate or treat a patient who is a victim of some form of domestic or family violence.” (Huecker, et al., 2022, p.1) It is extremely important that nurses and healthcare providers are educated on the signs of domestic violence.
Reference:
Huecker, M. R., King, K. C., Jordan, G. A., & Smock, W. (2022, January). Domestic violence. National Center for Biotechnology Information. Retrieved October 27, 2022, from https://pubmed.ncbi.nlm.nih.gov/29763066/
A Sample Answer 3 For the Assignment: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Title: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Some warning signs of physical abuse include:
Bruising, welts or burns that cannot be sufficiently explained, particularly bruises on the face, lips and mouth of infants or on several surface planes at the same time
Unusual bruising patterns that reflect the shape of the instrument used to cause injury (e.g., belt, wire hanger, hairbrush, hand, human bite marks)
Clusters of bruises, welts or burns, indicating repeated contact with a hand or instrument
We should always be attentive and on the look out for any type of abuse and report it immediately.
A Sample Answer 4 For the Assignment: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Title: What characteristics would lead a provider to suspect domestic violence, child abuse, or elder abuse is taking place within a family? NRS 429
Violence in a family encompasses a lot of issues, including domestic abuse, child abuse, and elder abuse, to name a few. Certain characteristics may lead a provider to suspect domestic violence, child abuse, or elder abuse within a family. When it comes to child abuse, signs and symptoms vary depending on the type of abuse, but common indicators may include unexplained injuries, changes in behavior or school performance, withdrawal, fearfulness, or excessive aggression (Falkner et al., 2022). The presence of risk factors such as poverty, mental illness, or substance abuse in the family can also raise suspicion. In the case of domestic violence, healthcare providers should be attentive to signs such as frequent injuries, unexplained bruises or fractures, depression or anxiety, substance abuse, and controlling or coercive behaviors from one partner toward the other. Patients may present with physical injuries that do not align with their explanation or delay seeking medical care for injuries (Falkner et al., 2022). Nurses need to ask sensitive and direct questions compassionately to gather more information about potential abuse. Creating a safe and supportive environment for victims to disclose their experiences is essential. Interdisciplinary collaboration with social workers and other healthcare professionals, such as nurses, is crucial in providing appropriate healing and restoration services, protection, and resources.
Facility’s procedure for reporting these types of abuse.
In our facility, we have implemented a comprehensive procedure for dealing with domestic violence based on the standard protocol of our state. Firstly, we emphasize the importance of understanding domestic violence’s physical, emotional, financial, and health impacts. We ensure that healthcare providers are familiar with the documenting and reporting guidelines as per the Virginia Revised Code. To create an environment that encourages disclosure, we utilize environmental prompts such as wearing pins that say “You can talk to me about family violence” and displaying posters and safety cards throughout the facility, including in all bathrooms. This helps raise awareness about domestic violence, its impact on reproductive health, and local resources available for support.
Our screening process is universal and routine, covering all points of contact within the healthcare system, including emergency room visits, hospital admissions, checkups, family planning visits, and prenatal care. Importantly, screenings are conducted privately and confidentially, ensuring that patients are screened alone without any exceptions. During the screening process, we are honest with patients, explaining why we are asking about domestic violence and how we will handle the information (Virginia Department of Social Services, 2018). We inform them about state laws regarding reporting domestic violence and child abuse, making it clear what will and will not be reported. Normalizing the conversation creates a safe space for patients to open up about their experiences (Huecker & Smock, 2022).
When assessing a patient who discloses current abuse, we prioritize their immediate safety (Falkner et al., 2022). We evaluate factors such as the presence of immediate danger, the abuser’s presence in the facility, escalation of violence, threats of harm to the patient or their children, and access to lethal weapons. We also explore their coping strategies and identify any risks to children in the household.
Our intervention involves reassurance of confidentiality, ensuring that patients understand that their experiences will not be revealed to their families or perpetrators. We keep the documentation of abuse in a locked, secure area isolated from visitors. It is emphasized that we treat the perpetrators no differently to protect the patient’s safety (Falkner et al., 2022). We explain the limits of confidentiality and the legal obligation to report felonious assaults and child abuse. We affirm to patients that no one deserves to be hurt by their partner and acknowledge their courage in discussing their situation. We let them know that they are not alone and that help is available. We assist patients in identifying trusted individuals they can approach for assistance and discuss the importance of creating a safety plan. We provide information about community agencies and offer to make calls on their behalf if they are hesitant or afraid to seek help.
Documentation is done by authorized healthcare providers in compliance with HIPAA regulations. Providers are mindful of their language, documenting the patient’s statements and avoiding negative or judgmental documentation. Legal terms are used only if expressed by the patient. Follow-up appointments are scheduled, and patients are informed about invisible birth control options for added safety (Huecker & Smock, 2022). Throughout the process, our facility ensures that domestic violence survivors receive comprehensive care, support, and appropriate referrals to specialized services. Lastly, we evaluate the to see how things are going. Each milestone is celebrated. If police are involved, we preserve the physical evidence.
References
Falkner, A., Green, S. Z., & Whitney, S. (2022). Health Promotion: Health & Wellness Across the Continum. Grand Canyon University.
Huecker, M., & Smock, W. (2022). Domestic Violence. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499891/
Virginia Department of Social Services. (2018). Domestic Violence (DV). Www.dss.virginia.gov. https://www.dss.virginia.gov/family/domestic_violence/index.cgi