{"id":436,"date":"2022-08-16T13:35:13","date_gmt":"2022-08-16T10:35:13","guid":{"rendered":"https:\/\/tatd.org.tr\/geriatri\/?p=436"},"modified":"2022-08-16T13:35:13","modified_gmt":"2022-08-16T10:35:13","slug":"yasli-istismarinin-farkli-bicimleri","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/geriatri\/akademik-blog-yazisi\/yasli-istismarinin-farkli-bicimleri\/","title":{"rendered":"Ya\u015fl\u0131 \u0130stismar\u0131n\u0131n Farkl\u0131 Bi\u00e7imleri"},"content":{"rendered":"

\u201cEsefsiz,<\/p>\n

\u00a0G\u00fcvenle,<\/p>\n

\u00a0Emniyetle g\u00f6lgeli bir bah\u00e7eye girer gibi<\/p>\n

\u00a0Girebilmek usulca ihtiyarl\u0131\u011fa\u201d<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Naz\u0131m Hikmet Ran<\/em><\/strong><\/p>\n

\n

Ya\u015fl\u0131 ihmal ve istismar\u0131 s\u00f6zlerini duydu\u011fumuzda hepimizin duyarl\u0131l\u0131\u011f\u0131 \u00f6n plana \u00e7\u0131k\u0131yor. G\u00fcn\u00fcm\u00fcz toplum yap\u0131s\u0131n\u0131n de\u011fi\u015fimi, yaln\u0131z kalan ya\u015fl\u0131lar, bak\u0131m evleri, bak\u0131c\u0131lar ya da bak\u0131m veren ki\u015filer\u2026 Hepsi birer su\u00e7lu gibi g\u00f6r\u00fcnmeye ba\u015fl\u0131yor ya\u015fl\u0131 ihmal ve istismar\u0131 s\u00f6z konusu olunca. Peki ne kadar tan\u0131yoruz ya\u015fl\u0131 ihmal ve istismar\u0131n\u0131? Hangi durumlar\u0131 i\u00e7eriyor? Neler yapmal\u0131y\u0131z?<\/p>\n

Bu yaz\u0131 ile niyetim sizleri bu konu ile ilgili biraz fark\u0131ndal\u0131\u011fa davet etmek.<\/p>\n

Ya\u015fl\u0131 ihmal ve istismar\u0131 ilk olarak 1975 y\u0131l\u0131nda Baker ve Burston taraf\u0131ndan \u00e7ocuk istismar\u0131n\u0131n g\u00fcndem olmas\u0131n\u0131n ard\u0131ndan dikkate al\u0131nm\u0131\u015ft\u0131r. Bruston yaz\u0131lar\u0131nda ya\u015fl\u0131 istismar\u0131n\u0131 vurgulamak i\u00e7in \u201cgranny battering\u201d tan\u0131m\u0131 kullanm\u0131\u015ft\u0131r (1). Ard\u0131ndan Uluslararas\u0131 Ya\u015fl\u0131 \u0130stismar\u0131n\u0131n \u00d6nlenmesi Komitesi ve D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc 2002 y\u0131l\u0131nda Toronto Deklarasyonunu yay\u0131nlam\u0131\u015f ve ya\u015fl\u0131 istismar\u0131n\u0131 resmen tan\u0131mlam\u0131\u015ft\u0131r. Deklarasyonda ya\u015fl\u0131 ihmal ve istismar\u0131; ya\u015fl\u0131 insanlara kar\u015f\u0131, herhangi bir g\u00fcven beklentisi i\u00e7inde ger\u00e7ekle\u015fen, s\u0131k\u0131nt\u0131 ve zarara neden olabilecek bir kez veya tekrarlanan hareket ve davran\u0131\u015f eksikli\u011fi olarak tan\u0131mlanm\u0131\u015ft\u0131r (2).<\/p>\n

Birle\u015fmi\u015f Milletler (BM) Genel Kurulu 66\/127 say\u0131l\u0131 karar\u0131yla 15 Haziran g\u00fcn\u00fcn\u00fc 2006 y\u0131l\u0131nda \u201cD\u00fcnya Ya\u015fl\u0131 \u0130stismar\u0131 Fark\u0131ndal\u0131k G\u00fcn\u00fc\u201d olarak ilan ederek ya\u015fl\u0131 ihmal ve istismar\u0131na dikkat \u00e7ekmi\u015ftir (3). Her y\u0131l 15 Haziran fark\u0131ndal\u0131k g\u00fcn\u00fc kapsam\u0131nda etkinlikler d\u00fczenlenmektedir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc; 60 ya\u015f\u0131n \u00fczerindeki 6 ki\u015fiden 1\u2019i istismara maruz kald\u0131\u011f\u0131n\u0131 ve d\u00fcnya \u00e7ap\u0131nda yakla\u015f\u0131k 141 milyon istismar ma\u011fduru oldu\u011fu bildirmektedir (4).<\/p>\n

Ya\u015fl\u0131 istismar\u0131 b\u00fcy\u00fcyen bir sorundur. K\u00f6t\u00fcye kullan\u0131m\u0131n neden meydana geldi\u011fi veya nas\u0131l durdurulaca\u011f\u0131 hen\u00fcz net olmasa da, olas\u0131 bir sorunun uyar\u0131 i\u015faretlerini fark edebilecek ki\u015filerin hekimler oldu\u011fu nettir (5). Ya\u015fl\u0131 ihmal ve istismar\u0131, tan\u0131nmas\u0131 ve y\u00f6netilmesi zor bir durumdur. Mortalite ve morbidite ile sonu\u00e7lanmas\u0131 nadir de\u011fildir. Hayat\u0131 tehdit eden sa\u011fl\u0131k sorunlar\u0131n\u0131 tan\u0131makla y\u00fck\u00fcml\u00fc acil t\u0131p hekimlerinin bu konuya duyarl\u0131 olmas\u0131 gereklidir (6,7). Eziyet, ihmal ve istismar belki de sadece g\u00f6rebildi\u011fi acil t\u0131p hekimince tan\u0131nmaya ihtiya\u00e7 duyan bir ya\u015fl\u0131n\u0131n bulgular\u0131 olabilir. \u00c7o\u011fu ya\u015fl\u0131 ailesi ile ya\u015famakta, eziyet ve ihmale maruz kalmaktad\u0131r. Toplum yap\u0131s\u0131, tan\u0131mlamalardaki eksiklikler nedeniyle net say\u0131lara ula\u015fmak \u015fu an i\u00e7in m\u00fcmk\u00fcn de\u011fildir (6).<\/p>\n

\u0130stismar ve ihmal en s\u0131k kad\u0131nlarda ve 74 ya\u015f \u00fczerinde bildirilmektedir. Yata\u011fa ba\u011f\u0131ml\u0131l\u0131k, kogntif fonksiyonlarda bozukluk, sosyal izolasyonun riski art\u0131rd\u0131\u011f\u0131 bilinmektedir. Genellik uygulayan en yak\u0131n\u0131 e\u015f ya da \u00e7ocuklar\u0131 olmaktad\u0131r. Bak\u0131m evinde kalanlar i\u00e7in bak\u0131m verenlerin ihmal ve istismar\u0131 yan\u0131nda birlikte ya\u015fayan ya\u015fl\u0131lar aras\u0131nda da g\u00f6r\u00fclebilmektedir (5,6).<\/p>\n

Ya\u015fl\u0131 \u0130stismar\u0131n\u0131n \u00c7e\u015fitleri <\/strong>(Tablo-1).<\/p>\n

Fiziksel istismar;<\/em><\/strong> bedensel yaralanma, fiziksel ac\u0131 ile sonu\u00e7lanabilecek g\u00fc\u00e7 kullan\u0131m\u0131 olarak tan\u0131mlan\u0131r. Fiziksel istismar, vurma (bir nesneyle veya nesnesiz), d\u00f6vme, itme, sallama, tokat atma, tekmeleme, \u00e7imdikleme ve yakma gibi \u015fiddet eylemlerini i\u00e7erebilir ancak bunlarla s\u0131n\u0131rl\u0131 de\u011fildir. Ayr\u0131ca uygunsuz uyu\u015fturucu kullan\u0131m\u0131na zorlama, fiziksel k\u0131s\u0131tlamalar, zorla besleme ve her t\u00fcrl\u00fc fiziksel ceza da fiziksel istismar \u00f6rnekleridir (7,8).<\/p>\n

Cinsel istismar<\/em><\/strong>;<\/em><\/strong> ya\u015fl\u0131 bir ki\u015fiyle her t\u00fcrl\u00fc r\u0131za d\u0131\u015f\u0131 cinsel temas olarak tan\u0131mlan\u0131r. \u0130stenmeyen dokunma, tecav\u00fcz, zorla \u00e7\u0131plakl\u0131k ve m\u00fcstehcen foto\u011fraf \u00e7ekme gibi her t\u00fcrl\u00fc cinsel sald\u0131r\u0131 veya sald\u0131r\u0131y\u0131 i\u00e7erir (7-9).<\/p>\n

Duygusal ya da psikolojik istismar<\/em><\/strong>;<\/em><\/strong> s\u00f6zl\u00fc ya da s\u00f6zs\u00fcz eylemler yoluyla \u0131st\u0131rap, ac\u0131 ya da s\u0131k\u0131nt\u0131 verilmesi olarak tan\u0131mlan\u0131r. Duygusal\/psikolojik istismar, s\u00f6zl\u00fc sald\u0131r\u0131lar, hakaretler, tehditler, y\u0131ld\u0131rma, a\u015fa\u011f\u0131lama ve tacizi i\u00e7erir. Ya\u015fl\u0131 birine bebek muamelesi yapmak, ya\u015fl\u0131 bir ki\u015fiyi ailesinden, arkada\u015flar\u0131ndan veya d\u00fczenli aktivitelerinden izole etmek ve zorla sosyal izolasyon, duygusal\/psikolojik istismar \u00f6rnekleridir (6,8).<\/p>\n

\u0130hmal<\/em><\/strong>;<\/em><\/strong> bir ki\u015finin bir ya\u015fl\u0131ya kar\u015f\u0131 y\u00fck\u00fcml\u00fcl\u00fcklerinin veya g\u00f6revlerinin herhangi bir b\u00f6l\u00fcm\u00fcn\u00fc yerine getirmeyi reddetmesi veya yerine getirmemesi olarak tan\u0131mlan\u0131r. \u0130hmal ayr\u0131ca, bir ya\u015fl\u0131ya bak\u0131m sa\u011flamada (\u00f6r; gerekli evde bak\u0131m hizmetleri i\u00e7in \u00f6deme yapma) vekalet sorumluluklar\u0131 olan bir ki\u015finin bu g\u00f6revi yerine getirmemesini de i\u00e7erir. Ya\u015fl\u0131 bir ki\u015fiye yiyecek, su, giyecek, bar\u0131nak, ki\u015fisel hijyen, ila\u00e7, konfor, ki\u015fisel g\u00fcvenlikten yoksun b\u0131rakmak ihmal \u00f6rnekleridir (6-8).<\/p>\n

Terk<\/em><\/strong>;<\/em><\/strong> ya\u015fl\u0131n\u0131n bak\u0131m\u0131n\u0131 \u00fcstlenen veya fiziksel velayetini elinde bulunduran bir ki\u015fi taraf\u0131ndan terk edilmesi olarak tan\u0131mlan\u0131r (6).<\/p>\n

Mali veya Maddi S\u00f6m\u00fcr\u00fc;<\/em><\/strong> mali veya maddi istismar, ya\u015fl\u0131 bireyin fonlar\u0131n\u0131n, m\u00fclk\u00fcn\u00fcn veya varl\u0131klar\u0131n\u0131n yasa d\u0131\u015f\u0131 veya uygunsuz kullan\u0131m\u0131 olarak tan\u0131mlan\u0131r. Ya\u015fl\u0131 bir ki\u015finin paras\u0131n\u0131 veya e\u015fyalar\u0131n\u0131 k\u00f6t\u00fcye kullanmak veya \u00e7almak, ya\u015fl\u0131 bir ki\u015fiyi herhangi bir belgeyi imzalamaya zorlamak veya kand\u0131rmak, vesayet veya vekaletnamenin uygunsuz kullan\u0131m\u0131 \u00f6rnekleridir (6,7).<\/p>\n

AC\u0130L SERV\u0130S YAKLA\u015eIMI<\/strong><\/p>\n

    \n
  1. Ya\u015fl\u0131 hastada ihmal ve istismar\u0131 risk fakt\u00f6r\u00fc var m\u0131, belirlenmelidir (Tablo-2).<\/li>\n
  2. Medikal ge\u00e7mi\u015fi ayr\u0131nt\u0131land\u0131r\u0131lmal\u0131d\u0131r. Ayn\u0131 yaralanmaya daha \u00f6nce maruz kalm\u0131\u015f m\u0131? S\u0131k hastane ba\u015fvurusu var m\u0131? Kronik hastal\u0131k takipleri yap\u0131l\u0131yor mu? (Tablo-3).<\/li>\n
  3. Fizik muayenede \u00f6zelliklere dikkat edilmelidir. \u00d6zel bir belirtisi olmasa da \u00fcrkek bak\u0131\u015flar, muayene s\u0131ras\u0131nda tedirginlik, \u00f6zellikle ba\u015f boyun, \u00f6n kol laterali ve zigomada morluklar\u0131n varl\u0131\u011f\u0131nda \u015f\u00fcphelenilmelidir.<\/li>\n
  4. G\u00f6r\u00fcnt\u00fclemede \u00f6nerilen alt\u0131n standart bir y\u00f6ntem bulunmamakla birlikte, eski yeni k\u0131r\u0131klar\u0131n birlikteli\u011fi, d\u00fc\u015f\u00fck enerji ile olu\u015fan y\u00fcksek enerjili k\u0131r\u0131klar (ulnar diyafiz k\u0131r\u0131\u011f\u0131, ince barsak hematomu gibi) varl\u0131\u011f\u0131nda ara\u015ft\u0131r\u0131lmal\u0131d\u0131r (7).<\/li>\n<\/ol>\n

    Ya\u015fl\u0131 \u0130stismar\u0131 \u015e\u00fcphe \u0130ndeksi (<\/strong>Elder Abuse Suspicion Index) (EASI) (10) (Tablo-4), Elder assessment instrument (EAI) ya da ED senior AID riski belirlemede kullan\u0131lan tan\u0131 ara\u00e7lar\u0131d\u0131r. Teknolojinin geli\u015fmesi ile tan\u0131da kolayl\u0131k sa\u011flayaca\u011f\u0131 \u00f6n g\u00f6r\u00fclmektedir. Hastalar\u0131n s\u0131k ba\u015fvurular\u0131, tekrarlayan benzer yaralanmalar\u0131 ile gelecekte uyar\u0131 sistemleri kurulabilir (6).<\/p>\n

    YASAL B\u0130LD\u0130R\u0130M<\/strong><\/p>\n

    Acil servis tan\u0131 ve tedavisi sonras\u0131nda bildirim zorunlulu\u011fu vard\u0131r. T\u00fcrk Ceza Kanunu\u2019nun 97. maddesinde; \u201cYa\u015f\u0131 veya hastal\u0131\u011f\u0131 dolay\u0131s\u0131yla kendini idare edemeyecek durumda olan ve bu nedenle koruma ve g\u00f6zetim y\u00fck\u00fcml\u00fcl\u00fc\u011f\u00fc alt\u0131nda bulunan bir kimseyi kendi h\u00e2line terk eden ki\u015fi, \u00fc\u00e7 aydan iki y\u0131la kadar hapis cezas\u0131 ile cezaland\u0131r\u0131l\u0131r\u201d h\u00fckm\u00fc yer almaktad\u0131r. Madde 98 ise bu bildirimin zorunlulu\u011funu belirtip, ilgili cezay\u0131 kapsamaktad\u0131r (11).<\/p>\n

    Literat\u00fcrde ya\u015fl\u0131 istismar\u0131 ile ilgili multidisipliner yakla\u015f\u0131m vurgulanmaktad\u0131r. Rosen ve arkada\u015flar\u0131n\u0131n 2022 \u015eubat ay\u0131nda yay\u0131nlad\u0131klar\u0131 makalede acil servis tabanl\u0131 ya\u015fl\u0131 istismar\u0131 interdisipliner ekibi sayesinde daha g\u00fcvenli ortamlarda ya\u015famas\u0131 sa\u011fland\u0131\u011f\u0131 belirtilmektedir (12).<\/p>\n

    \n\n\n\n\n\n\n\n\n\n
    Tablo-1: <\/strong>\u0130stismar T\u00fcrleri ve Belirtileri.<\/p>\n

    \u00a0<\/strong><\/td>\n<\/tr>\n

    \u0130ST\u0130SMAR<\/strong><\/td>\nBEL\u0130RT\u0130LER\u0130<\/strong><\/td>\n<\/tr>\n
    F\u0130Z\u0130KSEL<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Morluklar, siyah g\u00f6zler, kesikler ve ip izleri<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A\u00e7\u0131klanamayan kemik k\u0131r\u0131klar\u0131<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A\u00e7\u0131k yaralar, kesikler, delikler, iyile\u015fmenin \u00e7e\u015fitli a\u015famalar\u0131nda tedavi edilmemi\u015f yaralanmalar<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Burkulmalar, \u00e7\u0131k\u0131klar ve i\u00e7 kanamalar<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 K\u0131r\u0131k g\u00f6zl\u00fck\/\u00e7er\u00e7eve, cezaya maruz kalman\u0131n fiziksel belirtileri veya k\u0131s\u0131tlanma belirtileri<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A\u015f\u0131r\u0131 dozda veya re\u00e7eteli ila\u00e7lar\u0131n yetersiz kullan\u0131m\u0131na ili\u015fkin laboratuvar bulgular\u0131<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bir ya\u015fl\u0131n\u0131n vurulma, tokatlanma, tekmelenme veya k\u00f6t\u00fc muamele g\u00f6rme raporu varl\u0131\u011f\u0131<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ya\u015fl\u0131n\u0131n davran\u0131\u015f\u0131ndaki ani de\u011fi\u015fiklik<\/p>\n

     <\/td>\n<\/tr>\n

    DUYGUSAL\/PS\u0130KOSOSYAL<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Duygusal olarak \u00fczg\u00fcn veya heyecanl\u0131 olmak<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A\u015f\u0131r\u0131 geri \u00e7ekilme ve ileti\u015fim kurmama veya tepki vermeme<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00dcrkek bak\u0131\u015flar, muayeneden \u00e7ekinme<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bir ya\u015fl\u0131n\u0131n s\u00f6zl\u00fc veya duygusal olarak k\u00f6t\u00fc muamele g\u00f6rd\u00fc\u011f\u00fcne dair raporu<\/p>\n

     <\/td>\n<\/tr>\n

    C\u0130NSEL<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G\u00f6\u011f\u00fcs veya genital b\u00f6lge \u00e7evresinde morluklar<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A\u00e7\u0131klanamayan cinsel yolla bula\u015fan hastal\u0131k veya genital enfeksiyonlar<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A\u00e7\u0131klanamayan vajinal veya anal kanama<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Y\u0131rt\u0131k, lekeli veya kanl\u0131 i\u00e7 \u00e7ama\u015f\u0131r\u0131<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bir ya\u015fl\u0131n\u0131n cinsel sald\u0131r\u0131ya veya tecav\u00fcze u\u011frama raporu varl\u0131\u011f\u0131<\/p>\n

     <\/td>\n<\/tr>\n

    \u0130HMAL<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Dehidratasyon, yetersiz beslenme, tedavi edilmeyen yatak yaralar\u0131 ve k\u00f6t\u00fc ki\u015fisel hijyen<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G\u00f6zetimsiz veya tedavi edilmemi\u015f sa\u011fl\u0131k sorunlar\u0131<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tehlikeli veya g\u00fcvenli olmayan ya\u015fam ko\u015fullar\u0131\/d\u00fczenlemeleri<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sa\u011fl\u0131ks\u0131z ve kirli ya\u015fam ko\u015fullar\u0131 (\u00d6r; kirli g\u00f6r\u00fcn\u00fcm, pire, bit varl\u0131\u011f\u0131, d\u0131\u015fk\u0131\/idrar kokusu, yetersiz giysi)<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bir ya\u015fl\u0131n\u0131n k\u00f6t\u00fc muameleye maruz kald\u0131\u011f\u0131na dair rapor varl\u0131\u011f\u0131<\/td>\n<\/tr>\n

    TERK<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bir ya\u015fl\u0131n\u0131n hastanede, bak\u0131mevinde veya benzeri bir kurumda terk edilmesi<\/td>\n<\/tr>\n
    MADD\u0130 S\u00d6M\u00dcR\u00dc<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ya\u015fl\u0131ya e\u015flik eden bir ki\u015fi taraf\u0131ndan a\u00e7\u0131klanamayan b\u00fcy\u00fck miktarda para \u00e7ekilmesi de dahil olmak \u00fczere banka hesab\u0131nda veya bankac\u0131l\u0131k uygulamas\u0131nda ani de\u011fi\u015fiklikler<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bir ya\u015fl\u0131n\u0131n banka imza kart\u0131na ek isimlerin dahil edilmesi<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ya\u015fl\u0131n\u0131n ATM kart\u0131n\u0131 kullanarak ya\u015fl\u0131n\u0131n paras\u0131n\u0131n yetkisiz olarak \u00e7ekilmesi<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vasiyetname veya di\u011fer finansal belgelerdeki ani de\u011fi\u015fiklikler<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Yeterli mali kaynaklar\u0131n mevcudiyetine ra\u011fmen, standartlar\u0131n alt\u0131nda bak\u0131m sa\u011flanmas\u0131 veya faturalar\u0131n \u00f6denmemesi<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bir aile \u00fcyesine veya aile d\u0131\u015f\u0131ndan birine a\u00e7\u0131klanamayan ani mal transferi<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n

    \n\n\n\n
    Tablo-2: <\/strong>Ya\u015fl\u0131 \u0130stismar\u0131 i\u00e7in Potansiyel Risk Fakt\u00f6rleri.<\/td>\n<\/tr>\n
     <\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Fonksiyonel ba\u011f\u0131ml\u0131l\u0131k veya sakatl\u0131k<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 K\u00f6t\u00fc fiziksel sa\u011fl\u0131k<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bili\u015fsel bozukluk\/demans<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 K\u00f6t\u00fc ruh sa\u011fl\u0131\u011f\u0131<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 D\u00fc\u015f\u00fck gelir\/sosyo-ekonomik durum<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sosyal izolasyon\/d\u00fc\u015f\u00fck sosyal destek<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Daha \u00f6nce aile i\u00e7i \u015fiddet \u00f6yk\u00fcs\u00fc<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00d6nceki travmatik olaya maruz kalma<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131<\/p>\n

    \u00a0<\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n

    \n\n\n\n
    Tablo-3: <\/strong>Ya\u015fl\u0131 \u0130stismar\u0131 veya \u0130hmali \u015e\u00fcphesinin G\u00f6stergeleri.<\/td>\n<\/tr>\n
     <\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Mekanizmaya uymayan yaralanmalar<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 S\u0131k yaralanma \u00f6yk\u00fcs\u00fc<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u0131bbi hastal\u0131k veya yaralanma ba\u015flang\u0131c\u0131 ile t\u0131bbi yard\u0131ma ge\u00e7 ula\u015ft\u0131r\u0131lmas\u0131<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Bak\u0131m i\u00e7in tek bir birinci basamak hekimi yerine birden fazla doktor ve acil servis kullanmak<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Benzer yaralanmalar i\u00e7in acil servise tekrarlayan ziyaretler<\/p>\n

    \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0130la\u00e7lara, randevulara veya doktor talimatlar\u0131na uymama<\/p>\n

     <\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n

    \n\n\n\n\n\n\n\n\n\n\n\n
    Tablo-4: <\/strong>Ya\u015fl\u0131 \u0130stismar\u0131 \u015e\u00fcphe \u0130ndeksi.<\/p>\n

    \u00a0<\/strong><\/td>\n<\/tr>\n

    YA\u015eLI \u0130ST\u0130SMARI \u015e\u00dcPHE \u0130NDEKS\u0130 (EASI)<\/strong><\/p>\n

    \u00a0(Elder Abuse Suspicion Index (EASI))<\/strong><\/td>\n<\/tr>\n

    EASI Sorular\u0131<\/p>\n

    S.1 – S.5 hastaya sorulur; S.6 doktor taraf\u0131ndan cevaplan\u0131r.<\/p>\n

    Son 12 ay i\u00e7erisinde;<\/td>\n<\/tr>\n

    1)<\/strong> \u015eunlardan herhangi birisi i\u00e7in ba\u015fkalar\u0131na bel ba\u011flad\u0131\u011f\u0131n\u0131z oldu mu? y\u0131kanma, giyinme, al\u0131\u015fveri\u015f, banka i\u015flemleri veya yemek.<\/td>\nEVET<\/td>\nHAYIR<\/td>\nYANIT YOK<\/td>\n<\/tr>\n
    2)<\/strong> Herhangi bir ki\u015fi yemek yemenizi, giyinmenizi, ila\u00e7 alman\u0131z\u0131, g\u00f6zl\u00fck takman\u0131z\u0131, i\u015fitme cihaz\u0131 kullanman\u0131z\u0131, t\u0131bbi bak\u0131m alman\u0131z\u0131 veya istedi\u011finiz ki\u015filerle birlikte olman\u0131z\u0131 engelledi mi?<\/td>\nEVET<\/td>\nHAYIR<\/td>\nYANIT YOK<\/td>\n<\/tr>\n
    3)<\/strong> Herhangi bir ki\u015fi sizinle, kendinizi utanm\u0131\u015f veya tehdit edilmi\u015f gibi hissettirecek \u015fekilde konu\u015ftu\u011fu i\u00e7in \u00fcz\u00fcld\u00fcn\u00fcz m\u00fc?<\/td>\nEVET<\/td>\nHAYIR<\/td>\nYANIT YOK<\/td>\n<\/tr>\n
    4)<\/strong> Herhangi bir ki\u015fi sizi, istemedi\u011finiz halde, k\u00e2\u011f\u0131t imzalamaya veya paran\u0131z\u0131 kullanmaya zorlamaya \u00e7al\u0131\u015ft\u0131 m\u0131?<\/td>\nEVET<\/td>\nHAYIR<\/td>\nYANIT YOK<\/td>\n<\/tr>\n
    5)<\/strong> Herhangi bir ki\u015fi sizi korkuttu mu, istemedi\u011finiz \u015fekilde size dokundu mu veya size fiziksel olarak zarar verdi mi?<\/td>\nEVET<\/td>\nHAYIR<\/td>\nYANIT YOK<\/td>\n<\/tr>\n
    6) Doktor:<\/strong> Ya\u015fl\u0131 istismar\u0131; yetersiz g\u00f6z temas\u0131, i\u00e7e kapan\u0131k miza\u00e7, yetersiz beslenme, hijyen sorunlar\u0131, kesikler, \u00e7\u00fcr\u00fckler, uygun olmayan giyim veya ila\u00e7la tedaviye uyum sorunlar\u0131 gibi bulgularla ili\u015fkili olabilir. Bug\u00fcn veya son 12 ay i\u00e7inde bunlardan herhangi birini fark ettiniz mi?<\/td>\nEVET<\/td>\nHAYIR<\/td>\nYANIT YOK<\/td>\n<\/tr>\n
    http:\/\/www.mcgill.ca\/familymed\/research\/projects\/elder<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n

    Kaynaklar<\/strong><\/p>\n

      \n
    1. Burston GR. Letter: Granny-battering. Br Med J. 1975 Sep 6;3(5983):592. doi: 10.1136\/bmj.3.5983.592-a. PMID: 1174833; PMCID: PMC1674523.<\/li>\n
    2. World Health Organization, The Toronto Declaration on the Global Prevention of Elder Abuse (2002).<\/li>\n
    3. https:\/\/www.un.org\/development\/desa\/ageing\/news\/2022\/05\/weaad-2022\/<\/a><\/li>\n
    4. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/abuse-of-older-people<\/a><\/li>\n
    5. https:\/\/ncea.acl.gov\/Suspect-Abuse\/Abuse-Types.aspx<\/a><\/li>\n
    6. Emerg Med Clin North Am. 2021 May;39(2):405-417. doi: 10.1016\/j.emc.2021.01.009.<\/li>\n
    7. Rosen T, Stern ME, Elman A, Mulcare MR. Identifying and Initiating Intervention for Elder Abuse and Neglect in the Emergency Department. Clin Geriatr Med. 2018 Aug;34(3):435-451. doi: 10.1016\/j.cger.2018.04.007. Epub 2018 Jun 15. PMID: 30031426; PMCID: PMC6057151.<\/li>\n
    8. Johnson MJ, Fertel H. Elder Abuse. [Updated 2022 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560883\/<\/a><\/li>\n
    9. Pond, D. Phillips, J. Day, J. McNeil, K. 2019. Elder Abuse \u2013 People with Dementia. NHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People<\/li>\n
    10. https:\/\/www.mcgill.ca\/familymed\/research\/projects\/elder<\/li>\n
    11. https:\/\/www.mevzuat.gov.tr\/MevzuatMetin\/1.5.5237.pdf<\/li>\n
    12. Rosen T, Elman A, Clark S, et al. Vulnerable Elder Protection Team: Initial experience of an emergency department-based interdisciplinary elder abuse program. J Am Geriatr Soc. 2022 Jul 21. doi: 10.1111\/jgs.17967. Epub ahead of print. PMID: 35860986.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

      \u201cEsefsiz, \u00a0G\u00fcvenle, \u00a0Emniyetle g\u00f6lgeli bir bah\u00e7eye girer gibi \u00a0Girebilmek usulca ihtiyarl\u0131\u011fa\u201d \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Naz\u0131m Hikmet Ran Ya\u015fl\u0131 ihmal ve istismar\u0131 s\u00f6zlerini duydu\u011fumuzda hepimizin…<\/p>\n","protected":false},"author":1185,"featured_media":437,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[10014],"tags":[],"class_list":["post-436","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademik-blog-yazisi"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/436","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/users\/1185"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/comments?post=436"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/436\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media\/437"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media?parent=436"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/categories?post=436"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/tags?post=436"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}