Abstract
Geriatric patients in various outpatient department (OPDs) have been found to agonize from elder abuse and neglect (EAN). Such suffering imposes depressive states within individuals, which in turn affects treatment compliance. The objective of this study was to evaluate the impact of sensitization (psychotherapeutic) of family caregivers (FCGs) upon two denture treatment parameters (maintenance and treatment satisfaction) among EAN patients and compare the differences in outcome with non-abused patients. A survey of completely edentulous subjects (n = 860, aged 41–80 years) provided a sampling frame of 332 EAN patients from which 150 patients (including FCGs) fulfilling the study criteria were distributed (simple random, convenient) into two groups (Group A—control, Group B—test). FCG sensitization for subjects in Group B was performed by a clinical psychologist in 2–4 short (30 min) sessions. Demographic characteristics (frequency) were measured using a self-reported questionnaire, denture maintenance was measured using a denture hygiene index (scores), and treatment satisfaction was analyzed on a 10-point visual analog scale. Relevant data were calculated for means and absolute/relative frequencies. Any difference between two groups was estimated using an unpaired t-test while the level of relationship was determined by Karl Pearson’s test at a p-value of < 0.05. The results showed highest frequency (38.6%) for neglect, with elder neglect (EN) being most common (38.14% alone and 14% in combination). EN was found more if the FCG was a son (52%), in the age group (21–30 years), and with low education and low income (75%). Patients whose FCGs were counselled (Group B) demonstrated low denture plaque scores (mean = 1.38 ± 0.618), while demonstrating comparatively higher scores in six different parameters of treatment satisfaction. Differences between the two groups for both parameters were also found to be statistically significant. Psychotherapeutic counselling in the form of FCG sensitization brings better results of denture maintenance and treatment satisfaction.
Highlights
Elder abuse (EA) and neglect (EAN) by their respective caregivers has been ongoing for hundreds of years
This study involved two clinical stages, an analytical survey to find the existence of EA among patients in the outpatient department (OPD), and an interventional, comparative case control stage, in which the intervention was in the form of counselling of family caregivers (FCGs) of each individual subject selected in the study
The overall results suggest that patients who are suffering from neglect from their caretakers show decreased treatment compliance to prosthodontic treatment
Summary
Elder abuse (EA) and neglect (EAN) by their respective caregivers (family or nonfamily members) has been ongoing for hundreds of years. Until the advent of initiatives to address various forms of domestic violence (child and spouse abuse) since around 1975, the subject of EA in general remained a personal/private matter, hidden from public view or governmental scrutiny. Seen as a highly sensitive social issue and subsequently a problem of ageing, EA received recognition as a public health and criminal justice concern, that subsequently changed the perception of many to rethink how abuse of the elderly should be viewed and/or how it should be analyzed and/or dealt with [1]. Contemporary reports by the World Health Organization (WHO) predicts that people aged 60 years and older will increase from 900 million to about two billion by the year 2050.
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