Critical care nurses' perspectives on elder abuse

Aims: To explore through interviews of critical care nurses their perspectives on elder abuse to achieve a better understanding of the problems of reporting and generate ideas for improving the process. Background: In 44 states and the District of Columbia health care providers are required by law to report elder abuse but the patient, patient's family and health care providers all have barriers to reporting allegations of elder abuse. Design: This study design is qualitative. Method: Through a mailed survey, critical care nurses were invited to participate in a taped in-depth qualitative interview. Results: Ten nurses were interviewed. A thematic analysis was used to describe the following core themes: types of elder abuse, suspicions of elder abuse, reporting of elder abuse, barriers to reporting elder abuse, legislation and improvement in practice. Conclusions: Critical care nurses are aware of elder abuse and somewhat systematically evaluate for abuse at admission to their unit. They recognize signs and symptoms of abuse and are suspicious when it is warranted. They are aware of why an older person does not want to report abuse and take this into consideration when soliciting information. Facts, values and experience influence personally defining abuse, suspicion and dependence for each individual health care professional. Relevance to clinical practice: Critical care unit protocols and/or policies and procedure for reporting elder abuse are needed in critical care settings and are warranted for providing quality of care.