Geriatric dermatology : Part II. Risk factors and cutaneous signs of elder mistreatment for the dermatologist - 21/03/13

Doi : 10.1016/j.jaad.2013.01.001

Anne Lynn S. Chang, MD ^a,^⁎ , Jillian W. Wong, MS ^b, Justin O. Endo, MD ^c, Robert A. Norman, DO ^d
^a Department of Dermatology, Stanford University School of Medicine, Redwood City, California
^c Department of Dermatology, University of Wisconsin-Madison, Madison, Wisconsin
^d Department of Dermatology, Nova Southeastern Medical School, Fort Lauderdale, Florida
^b University of Utah School of Medicine, Salt Lake City, Utah

^∗Reprint requests: Anne Lynn S. Chang, MD, Department of Dermatology, Stanford University School of Medicine, 450 Broadway St, Mail Code 5334, Redwood City, CA 94063.

Abstract

Cutaneous signs may be the most visible hint of elder mistreatment. Dermatologists are in a unique position to recognize and report physical abuse and neglect in the older patient population. In this review, we describe the scope and impact, risk factors, cutaneous signs, and appropriate responses to suspected elder mistreatment. There is a critical need for additional evidence to inform clinical practice in the field of elder abuse and neglect. Recognition and reporting of suspected elder mistreatment by the dermatologist can be life-saving for the older patient.

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Key words : abuse, elder abuse, elder mistreatment, elder neglect, geriatrics, neglect, nutritional deficiency, pressure ulcer, purpura

Plan

Scope and impact of the problem

Definition of elder abuse and neglect

Barriers to physician reporting or referral in elder mistreatment

Risk factors for elder abuse and neglect

Screening questions for elder mistreatment

Cutaneous manifestations of elder abuse

Cutaneous manifestations of elder female sexual abuse

Cutaneous manifestations of elder neglect

Responding to suspected cases of elder abuse or neglect

Future education and research needed

Conclusion

	Supported in part by the D. W. Reynolds Foundation, American Federation for Aging Research, and the John A. Hartford Foundation (Dr Endo).
	Dr Chang is an investigator in clinical trials sponsored by Genentech, Novartis, Galderma, and Nuskin.