Clinics in geriatric medicine
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Home hospice care, which helps patients with terminal illnesses remain at home, is becoming more common and accepted in the United States. The Medicare hospice benefit reimburses hospices for the care of elderly patients. ⋯ Palliative care rather than the extension of life is emphasized. Hospice techniques for controlling symptoms such as pain, nausea, and vomiting are discussed in this article.
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Elder abuse encompasses physical, psychological, and financial abuse and also includes the violation of an individual's rights, or social abuse. Detection of elder abuse is often obstructed by the denial or shame of the abused older adult and the denial or improper assessment by health care professionals. The ethical struggle professionals face when they suspect abuse may also impede assessment or intervention. ⋯ The psychological history of the patient and caregiver is also important. Reporting laws exist in all states, and health care practitioners must become familiar with the laws in their states. Awareness of elder abuse by professionals working in home care is essential, because the failure to detect abuse can interfere with interventions and in some cases lead to death.