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Safeguarding concern for elder abuse — SCE Acute Medicine MCQ

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HardPatient safety and risk managementSafeguarding concern for elder abuseSCE Acute Medicine

An 82-year-old woman is admitted with dehydration and extensive bruising in different stages of healing. Her son answers most questions and insists she should be discharged immediately; she appears frightened and says quietly that she does not feel safe at home. She has capacity to discuss her care. What is the most appropriate next step in management?

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Correct answer: E — Address immediate safety, speak with her alone and make a safeguarding referral with her involvement

Possible elder abuse requires private discussion with the patient, capacity assessment, careful documentation, immediate safety planning and safeguarding referral. Next of kin does not have authority to override a capacitous adult's expressed safety concerns. Acute clinicians have a duty to act on safeguarding concerns rather than treating them as social background.

Reference: NICE NG189 safeguarding adults in care homes; Care Act 2014 safeguarding duties