The following article features coverage from ONS Bridge 2020. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Multifocal elements underlying the abuse of older patients with cancer, including types of elder abuse, the warning signs of different types of elder abuse, and major abuse risk variables, were outlined in a poster presentation on the Oncology Nursing Society (ONS) Bridge, a virtual conference.

Despite cancer typically being a disease of older persons who represent a high percentage of all cancer diagnoses, a literature search conducted by 2 academic librarians did not reveal any publications on the topic of elder abuse within the context of cancer care.

“It is critical to escalate awareness of this societal phenomenon such that assessment initiatives are implemented broadly within cancer care,” stated Deborah Boyle, MSN, RN, of Advanced Oncology Nursing Resources, Huntington Beach, California, and presenter.

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Oncology nurses should be alert for signs of these 5 types of elder abuse: caregiver neglect, emotional abuse, financial exploitation, physical abuse, and sexual abuse. Ms Boyle identifies red flags associated with elder abuse as dehydration and poor personal hygiene indicating patients may have been subjected to caregiver neglect, and bruises in areas near the breast and genitals as well as unexplained genital infections may indicate sexual abuse. 

Furthermore, major risk variables specific to the victim, perpetrator, and setting of elder abuse are also red flags. These included frailty and/or cognitive deficits in the victim, mental illness or a history of substance abuse in the perpetrator, and a setting typified by social isolation. For example, an 80-year old man with cancer reports unrelieved pain despite being prescribed an opioid-based medication at a palliative care clinic, and the man lives with a son who has a history of substance abuse.

Ms Boyle notes that “oncology nurses are key to this awareness due to their primary and ongoing contact with patients and families in ambulatory, acute care, and home health settings.”

She further stated that “intervention within this novel realm of patient care represents a unique opportunity for oncology nurses to engage in advocacy efforts for a vulnerable and under-served patient population.


Boyle D. Thinking the unthinkable: elder abuse in cancer care. Presented at: ONS Bridge; September 8-17, 2020. Accessed September 14, 2020.