A 79-year-old client with moderate dementia and limited mobility is being cared for at home by her son who lives with her. She has been receiving home health for care of a nonhealing diabetic foot ulcer. The home health nurse encourages the son to bring his mother to the ED for more aggressive treatment in an in-patient setting. The son responds that he cannot afford to pay for the medical bills and prefers to care for her at home. The nurse then notices a stage 2 decubitus ulcer on the client’s sacrum. The son claims to have his sister come every day and assist with bathing and turning in the bed. Which type of violence is the son guilty of?
Rationale: Nonhealing ulcers and the presence of a stage 2 ulcer indicate a situation that has been going on more than just a few days; the client’s limited mobility makes her more vulnerable to decubitus than someone more mobile. No specific findings indicate intentional physical violence. Emotional violence involves inflicting mental anguish or making threats. Economic exploitation involves illegally using one’s assets and other funds for personal gain instead of ensuring that the funds are used to care for the client. The son is worried about treatment cost, and this is not an unreasonable concern for family members who care for elderly family members on limited incomes. He may be unaware of assistive programs available for his mother. The home health nurse should seek social services to assist the client in getting proper medical help and notify the client’s health care provider.