eMedicine Specialties > Emergency Medicine > Psychosocial
Elder Abuse: Differential Diagnoses & Workup
Updated: Apr 20, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
| Abdominal Trauma, Blunt | Domestic Violence |
| Alcohol and Substance Abuse Evaluation | Epidural Hematoma |
| Bites, Human | Sexual Assault |
| Burns, Thermal | Subdural Hematoma |
| Depression and Suicide |
Other Problems to Be Considered
Apathy
Dehydration
Falls
Gait disturbances
Pathologic fractures
Workup
Laboratory Studies
- Evaluate for evidence of infection, dehydration, electrolyte abnormalities, malnutrition, improper medication administration, and substance abuse in patients who have been abused.
- CBC
- Chem-7
- Urinalysis
- Calcium, magnesium, phosphorus
- Serum levels of relevant medications
- Urine drug screen
- Ethanol level
Imaging Studies
- X-rays of relevant body parts - To detect fractures (unusual or pathologic)
- Head CT scan - To detect intracranial bleeding as a result of abuse or to detect a possible explanation for injuries (hydrocephalus causing ataxia leading to falls) or altered mental status
Procedures
- Pelvic examination with forensic evidence collection in cases of sexual assault
More on Elder Abuse |
| Overview: Elder Abuse |
Differential Diagnoses & Workup: Elder Abuse |
| Treatment & Medication: Elder Abuse |
| Follow-up: Elder Abuse |
| References |
| Further Reading |
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References
U.S. Population Projections. U.S. Census Bureau: Population Division; August 2008. [Full Text].
National Center on Elder Abuse. Types of abuse. Updated September 28, 2007. Available at http://www.ncea.aoa.gov/NCEAroot/Main_Site/FAQ/Basics/Types_Of_Abuse.aspx. Accessed April 20, 2009.
Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America. Washington, DC: National Research Council Panel to Review Risk and Prevalence of Elder Abuse and Neglect; 2003.
American Medical Association. Diagnostic treatment guidelines on elder abuse and neglect. Chicago, IL: American Medical Association; 1992:4-37.
Heath JM, Kobylarz FA, Brown M, Castano S. Interventions from home-based geriatric assessments of adult protective service clients suffering elder mistreatment. J Am Geriatr Soc. Sep 2005;53(9):1538-42. [Medline].
Allison EJ, Ellis PC, Wilson SE. Elder abuse and neglect: the emergency medicine perspective. Eur J Emerg Med. Sep 1998;5(3):355-63. [Medline].
American College of Emergency Physicians. Management of elder abuse and neglect. Policy statement. Ann Emerg Med. Jan 1998;31(1):149-150. [Medline].
Birrer R, Singh U, Kumar DN. Disability and dementia in the emergency department. Emerg Med Clin North Am. May 1999;17(2):505-17, xiii. [Medline].
Carney MT, Kahan FS, Paris BE BE. Elder abuse: is every bruise a sign of abuse?. Mt Sinai J Med. Mar 2003;70(2):69-74. [Medline].
Ciccarello MJ. Recent legal trends affecting your older patients. Clin Obstet Gynecol. Sep 2007;50(3):790-9. [Medline].
Clarke ME, Pierson W. Management of elder abuse in the emergency department. Emerg Med Clin North Am. Aug 1999;17(3):631-44, vi. [Medline].
Dyer CB, Heisler CJ, Hill CA, Kim LC. Community approaches to elder abuse. Clin Geriatr Med. May 2005;21(2):429-47. [Medline].
Fulmer T, Guadagno L, Bitondo Dyer C, Connolly MT. Progress in elder abuse screening and assessment instruments. J Am Geriatr Soc. Feb 2004;52(2):297-304. [Medline].
Jogerst GJ, Daly JM, Brinig MF. Domestic elder abuse and the law. Am J Public Health. Dec 2003;93(12):2131-6. [Medline].
Jones JS, Holstege C, Holstege H. Elder abuse and neglect: understanding the causes and potential risk factors. Am J Emerg Med. 1997;15(6):579-583. [Medline].
Jones JS, Veenstra TR, Seamon JP, Krohmer J. Elder mistreatment: national survey of emergency physicians. Ann Emerg Med. 1997;30(4):473-479. [Medline].
Kahan FS, Paris BE BE. Why elder abuse continues to elude the health care system. Mt Sinai J Med. Jan 2003;70(1):62-8. [Medline].
Kennedy RD. Elder abuse and neglect: the experience, knowledge, and attitudes of primary care physicians. Fam Med. Jul-Aug 2005;37(7):481-5. [Medline].
Kleinschmidt KC. Elder abuse: a review. Ann Emerg Med. Oct 1997;30(4):463-72. [Medline].
Koenig RJ, DeGuerre CR. The legal and governmental response to domestic elder abuse. Clin Geriatr Med. May 2005;21(2):383-98. [Medline].
Kruger RM, Moon CH. Can you spot the signs of elder mistreatment?. Postgrad Med. Aug 1999;106(2):169-73, 177-8, 183. [Medline].
Lachs MS, Pillemer K. Abuse and neglect of elderly persons. N Engl J Med. Feb 16 1995;332(7):437-43. [Medline].
Lachs MS, Pillemer K. Elder abuse. Lancet. Oct 2-8 2004;364(9441):1263-72. [Medline].
Lachs MS, Williams CS, O'Brien S, et al. ED use by older victims of family violence. Ann Emerg Med. 1997;30(4):448-454. [Medline].
McDonald AJ, Abrahams ST. Social emergencies in the elderly. Emerg Med Clin North Am. May 1990;8(2):443-59. [Medline].
Nelson HD, Nygren P, McInerney Y, Klein J. Screening women and elderly adults for family and intimate partner violence: a review of the evidence for the U. S. Preventive Services Task Force. Ann Intern Med. Mar 2 2004;140(5):387-96. [Medline].
Paris BE, Meier DE, Goldstein T, et al. Elder abuse and neglect: how to recognize warning signs and intervene. Geriatrics. Apr 1995;50(4):47-51. [Medline].
Profiles of General Demographic Characteristics. 2000 Census of Population and Housing: United States. U.S. Census Bureau: Population Division; May 2001. [Full Text].
Quinn K, Zielke H. Elder abuse, neglect, and exploitation: policy issues. Clin Geriatr Med. May 2005;21(2):449-57. [Medline].
Rosenblatt DE, Cho K, Durance PW. Reporting mistreatment of older adults: the role of physicians. J Am Geriatr Soc. 1996;44:65-70. [Medline].
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Further Reading
Clinical guidelines
Elder abuse prevention. Daly JM. Elder abuse prevention. Iowa City (IA): University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core; 2004 Dec. 68 p
Keywords
elder mistreatment, elder abuse, elderly abuse, domestic violence, abusive relationship, elder neglect, self-neglect in elderly persons, elder abuse prevention
Differential Diagnoses & Workup: Elder Abuse