Domestic Elder Research Articles

Prevalence of Elder Abuse Among Shiraz Education Retirees: A Cross-sectional Study

Objectives: To investigate the prevalence of elder abuse and its related factors among retirees of the Department of Education. Design: A cross-sectional study. Setting(s): The current study was conducted in Shiraz, the capital of Fars province, Iran. Participants: A sample of 280 (157 females and 123 males) community-dwelling older adults aged≥60 were selected using a systematic random sampling method. Outcome measures: The data were collected through a demographic questionnaire and the Domestic Elder Abuse Questionnaire (DEAQ). Demographic characteristics, including age, gender, marital status, living arrangement, household size, number of children, disease and its type, health status, education level, income, and house ownership, were examined to evaluate their impact on elder abuse. In addition, the prevalence of elder abuse and its subscales (i.e., emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, physical abuse, financial abuse, and abandonment) was also measured. Results: Approximately 40% of participants underwent at least one type of abuse. Financial abuse (32%) and physical abuse (3.9%) were reported as the most and least frequent types of abuse, respectively. Moreover, there was a statistically significant relationship between some demographic variables (e.g., age, presence of disease, duration of disease, health status, and income level) and the total abuse index. Additionally, some variables had statistically significant relationships with various subscales of abuse. Conclusions: Findings highlight the need to develop efficient policies to prevent elder abuse. Further research is thus recommended to determine influencing factors and appropriate interventions.

Investigation of Correlation between Communication Skills and Self-Reported Elder Mistreatment in Family Abuse

Abstract Introduction In today's world, old age has become an important global phenomenon following the increase in life expectancy and the decrease in birth rates. Communication skills are an important requirement in old age. Changing role of the family and existing tensions, mental pressures, and modern life undermine the social position of the elderly and lead to abuse of the elderly by family members. The goal of the present study is to determine the relationship between communication skills and family self-reported domestic abuse among older adult in Iran. Materials and Methods For this cross-sectional-analytical study, 153 elderly adult people admitted in hospitals of the Guilan province were randomly selected. The research instruments were the following questionnaires: demographic characteristics, abbreviated mental test (AMT), the Persian version of Domestic Elder Abuse Questionnaire, family mistreatment of the elderly (Heravy), and Queendom Communication Skill Test–Revise (QCSTR). The data were analyzed by SPSS software (version 22) using descriptive (frequency distribution tables, mean, and standard deviation [SD]) and analytical statistics (Mann–Whitney, Kruskal–Wallis, and Spearman's correlation tests) considering the significance level of 0.05. Results A majority of the elderly were men (51%), were in the age group of 60 to 69 years (72.5%) and married (75.5%), did not hold high school diploma (88.8%), had four to five children (41.2%) with low income (75.9%), and suffered from chronic diseases (68.6%). The mean score of communication skills was 129.09 ± 12.60. The mean score of domestic elder abuse was 2.89 ± 3.97. Communication skills have a significant relationship with age and marital status, but not with sex, education level, income, and chronic disease. There is an inverse correlation between communication skills and domestic elder_abuse (p < 0.001, r = −0.468). Conclusion Communication skills are one of the influential factors of domestic violence. Therefore, to prevent or reduce the amount of violence, it is recommended that family members increase the communication skills of the elderly.

The domestic elder abuse in China: Scale development and psychometric properties

An effective screening tool is essential to elder abuse research. Although several instruments have been developed in China to measure elder abuse, they present several limitations. The instrument development involved three components: (1) generating questionnaire items; (2) questionnaire testing and data collection in older adults; and (3) psychometric evaluation of the Domestic Elder Abuse Scale (DEAS). We collected questionnaire responses from 3725 community-dwelling Chinese older adults. The 26-item DEAS showed good reliability and validity across five dimensions: physical abuse, psychological abuse, financial exploitation, neglect, and abandonment. These five factors accounted for 78.432 % of the total variance, and model fitting results were acceptable. The Cronbach's alpha coefficient of the scale was 0.975, and the test-retest intraclass correlation coefficient (ICC) was 0.934 after 2 weeks. This study developed a five-dimension instrument to measure elder abuse, with good psychometric properties, which can play an essential role in community-based studies in China.

Development and validation of the short form domestic elder abuse assessment questionnaire (SF-DEAQ)

BackgroundThe present study aimed to design and determine the psychometric properties of a short-form questionnaire to investigate the domestic elder abuse.MethodsThis study consisted of two phases: in phase 1 we employed a modified Delphi approach with 18 participants. Consequently, content and face validity, and item analysis were applied. In Phase 2 we evaluated structural validity and convergent validity. Reliability was assessed by looking at internal consistency, stability, and absolute reliability.ResultsThe findings led to the development of a 27-items short form of domestic elder abuse in four domains that jointly accounted for 74.14% of the variance observed. The short form showed high internal consistency (Cronbach’s alpha = 0.93) and significantly correlated (r = 0.91; p < 0.001 for both scales) with the comprehensive (49-item) domestic elder abuse.ConclusionThe short form of domestic elder abuse was found to be reliable and valid as the longer version. The short form of domestic elder abuse could lessen the burden on respondents.

The prevalence of elder abuse and risk factors: a cross-sectional study of community older adults

BackgroundThe old people population is increasing worldwide. Along with their increasing population, an increase in elder abuse cases is predicted. Elder abuse is a neglected problem, and many cases go unreported. This study was conducted to identify types of elder abuse and examine associated risk factors.MethodsThis cross-sectional analytical study was conducted on 500 older people in Ardabil (northwestern Iran). Data was collected over three months, from June to September 2020. Data was collected using a demographic information form and the Domestic Elder Abuse questionnaire. The data were analyzed using SPSS software (version 22). Logistic regression was used to identify factors related to elder abuse.ResultsThe results showed that out of the 500 participants, 258 (51.6%) were male, and 242 (48.2%) were female. Among the 500 participants, 377 individuals (75/4%) reported experiencing at least one type of abuse in the past year. The highest rate of elder abuse was observed for emotional neglect (47.2%) and psychological abuse (40.8%), while the lowest rate was measured for rejection (15.4%) and physical abuse (12.4%). The results indicated that elder abuse was significantly associated with chronic illness (OR = 0.601, 95% CI: 0.391–0.922) and having 1–4 children (OR = 1.275, 95% CI: 1.137–1.430).ConclusionConsidering the high level of elder abuse and its dangerous effects on the quality of life for older people, it is essential to develop appropriate programs to increase awareness among older people and their families.

Prevalence of Elder Abuse and its Related Factors among Elderly Referring to Social Security Outpatient Clinic in Yasouj, Iran

Introduction: Elder abuse is a major public health concern worldwide. Considering the high prevalence of misbehavior towards the elderly, this study investigated the prevalence of elder abuse and its related factors among the elderly people in Yasouj, Iran in 2021.&#x0D; &#x0D; Methods: Using a convenience sampling method, this cross-sectional study included 299 older adults aged over 60 years referring to the Social Security Outpatient Clinic in Yasouj. To collect data, we used the Domestic Elder Abuse Questionnaire. To analyze the data, chi-square and multiple logistic regression statistical tests were used.&#x0D; &#x0D; Results: Of the participants, 55.2 % reported at least one type of misbehavior. While psychological misbehavior had the highest prevalence (41.8 %), rejection had the lowest prevalence (10.7 %). Multiple regression analysis showed that elder abuse was statistically associated with higher educational status (p = 0.002), lower economic status (p = 0.002), and single people reported a higher rate of elder abuse (p = 0.001).&#x0D; &#x0D; Conclusion: According to our results, more than half of the participants reported at least one type of elder abuse, and psychological abuse was the most common type of abuse experienced by the elderly. Since elder abuse can have serious effects on the health and well-being of the elderly, it is critical to identify the related risk factors. Furthermore, it is essential to implement screening programs to increase the awareness of the elderly and caregivers.

Elder Abuse by Household Members and Education of Elders’ Own Children Living in the Same Household: Empirical Evidence from Vietnam

The authors focus on a traditional culture in which the elderly tend to live with their children, aiming to shed light on whether the education of own children within the same household helps reduce the chances of elderly parents’ being mentally and physically abused by family members. Using multivariate analysis to investigate the association between children’s education and domestic elder abuse from the Vietnam Aging Survey 2011, comprising 2,700 elderly individuals aged 60 years and older, the authors find that the higher the education level of an elderly person’s children living in the same household, the lower the risk for the elderly person’s being abused. Those facing the highest risk for violence are women aged 80 years and older, those who have some difficulty with daily activities, and those who live in urban areas. The authors call for policy attention to an issue that is rarely investigated, especially in traditional households where elderly parents live with their children.

DETECTION OF ELDER ABUSE IN JAPAN NOT COVERED BY THE ELDER ABUSE PREVENTION LAW IN COMPARISON WITH WHO DEFINITION

Abstract The Elder Abuse Prevention Law mainly defines “elder abuse” inflicted by caregivers. Elder abuse by non-caregivers is therefore rarely covered by the law. We investigated domestic elder abuse reported in Matsudo City, Chiba, Japan, to determine the number of domestic elder abuse cases excluded from legal protection but constituting elder abuse defined by WHO. From April 2017 to March 2020, the municipal elder protection services agency received 525 reports of domestic elder abuse. We studied the effective records of 497 of these cases. 299 cases were confirmed elder abuse cases defined by the law, with 198 excluded. However, 176 out of the 198 excluded cases constitute elder abuse defined by WHO. In these 176 cases, abuse was perpetrated by non-caregivers. Due to the current formation of the law, this abuse went undetected and unprotected. We think amendment of the law is required to protect these excluded cases.

Prevalence and predictive factors of elder mistreatment in Chinese migrant families†

Abstract Objectives To examine the prevalence of and identify the predictive factors for elder mistreatment (EM) in Chinese migrant families. Methods This was a cross-sectional study. A total of 489 rural migrant elderly were recruited using multistage sampling technique from communities in Wenzhou city between June 2020 and October 2020. All participants completed the Mini-Cog, and then data were collected in a survey using the 12-Item Short-Form Health Survey Questionnaire, Abuser's Dependency Scale, the Friendship Scale (FS), Intergenerational Ambivalence Scale, Filial Piety Index, the Assessment Tool of Domestic Elder Abuse, and a demographic questionnaire. Descriptive statistics and multiple regression were carried out to analyze the data. Results The prevalences of physical mistreatment, psychological mistreatment, neglect, economic mistreatment, and social mistreatment among the migrant elderly were 1.23%, 20.65%, 22.50%, 0.61%, and 9.41%, respectively. Significant predictive factors were migrant elderlies’ mental health status (β = −0.118, P &lt; 0.01), adult children's filial piety (FP) (β = −0.245, P &lt; 0.001), and intergene rational ambivalence (β = 0.365, P &lt; 0.001). Conclusions EM was common among the migrant elderly. Predictive factors for EM in Chinese migrant families were identified. The findings could be useful in developing nursing interventions to promote migrant elderlies’ mental health, uphold their children's FP, and harmonize intergenerational relationship to avoid EM.

Fatality Review and the Role of the Forensic Psychiatrist.

Multidisciplinary Fatality Review teams have operated for decades in the United States and across the developed world. Goals of these teams include examining individual deaths in the community to determine preventability and to make recommendations for future prevention. Fatality Review teams initially focused on child deaths but have expanded to include deaths from domestic violence, elder abuse, overdose, and maternal mortality. Case reviews include data from various agencies that have had contact with victims and perpetrators prior to the deaths. Cause of death and preventability are analyzed. Preventable deaths often include those with risk from mental illness or addiction. Recommendations made by Fatality Review teams have led to important changes for mental health services and prevention, including the Safe Haven laws for neonaticide prevention, suicide and homicide prevention, child murder prevention, firearm laws, and domestic violence screening. Fatality Review teams, which already include law enforcement and forensic pathologists, can benefit from collaboration with forensic psychiatrists because of their specialized knowledge about the intersection of mental illness and violence, should forensic psychiatrists have an opportunity to join them.

Working with a Family. How a Family-Oriented Welfare System Opens the Border for Migrant Care Workers

In Italy, the strong desire to take care of the elderly at home and within the family opens the border to migrant care workers. Despite an increasing focus on the closure of borders, migrant care workers are considered desirable immigrants and are generally socially accepted in Italian society because they are believed to fulfil an indispensable role in Italian families. Based on ninety-three qualitative interviews with migrant care workers, elderly care recipients, and the family members responsible for the organization of their care, this article considers the favourable position of care workers vis-à-vis the selectivity of immigration governance. Moreover, it discusses the relations established by Italian families with immigrant care workers, in comparison with what the scholarship says about the relationships between immigrant care workers and native families. For this purpose, we propose a typology of domestic elder care relationships, arranging them along a continuum where at one extreme they are asymmetrical and exploitative, whilst at the other they are warm and reciprocal. Finally, we observe a process of “familization” whereby employers and care workers begin to see each other as members of the same “family”. Whilst familialization can be interpreted as genuine affection, it also creates a web of obligations that prioritizes expectations by employers and duties of care workers.

Prevalence and Gender Differences of Elder Abuse among Community-dwelling Older Adults in Tabriz, Iran

Objectives: Elder abuse is a phenomenon that has become more apparent with the increase in aging population, but there are insufficient evidences about the prevalence of elder abuse and gender differences in this area. Therefore, this study aims to investigate the prevalence of elder abuse and its gender differences among community-dwelling older adults in Tabriz, Iran. Methods &amp; Materials: In this cross-sectional study, 414 older adults aged ≥60 years were recruited from health complexes and centers in Tabriz, Iran in 2018 by using random sampling method. Data collection tools were a demographic form and the Domestic Elder Abuse Questionnaire which were completed through interview. The collected data were analyzed in SPSS V. 22 software. Results: It was reported that 52.6% had experienced abuse by family members. Emotional neglect was the most common type of elder abuse (26.6%) followed by financial abuse (17.6%). Physical abuse was the least common type of elder abuse. Except for financial abuse, older women had experienced more abuse than older men. Of those who were abused, only 31.7% recognized it as elder abuse. Conclusion: Most of older adults experience emotional neglect and financial abuse from family members and perceive them as their normal behaviors. Older women experience more abuse than older men. It is necessary to prevent elder abuse and familiarize older adults with different types of elder abuse.

Definitions and Theories of Elder Abuse

Old age is one of the most crucial stages of human development that encompasses the dynamics of biological processes, perception, growth and development and maturity, as a natural process of life. The elderly as one of the vulnerable groups, they face different biological, psychological and social needs. As the population gets older, the elderly will need more support in their daily activities, and these will put more pressure on family members. Failure of families to take care of the elderly as well as specific social conditions such as urbanization, modernization, change in traditional values, contradiction of the new and old generation value system, and failure to accept care of an elderly family enables the family to fulfill its role and duties. In such circumstances, the elderly may be at risk of domestic elder abuse. Elder abuse is in fact the intentional or unintentional behavior of the elderly, which may be of a physical, emotional or psychological nature and may cause complications such as unnecessary suffering, injury or physical pain, violating the human rights and impairing the quality of life of the elderly person. The present study aimed to provide definitions and theories of elder abuse.

Screening for domestic abuse and its relationship with demographic variables among elderly individuals referred to primary health care centers of Shiraz in 2018

BackgroundElder abuse is an important public health problem. The present study was aimed to determine the rate of domestic abuse and its relationship with demographic characteristics among elderly people referred to Primary Health Care (PHC) centers in Shiraz, Iran, 2018.MethodsThis descriptive and cross-sectional study was conducted on 400 older people aged 60 years old and above who referred to 22 PHC centers of Shiraz. The data were collected using demographic characteristics questionnaire, Katz index, the domestic elder abuse questionnaire, and elder neglect checklist through face-to-face interview and observation methods. Backward linear regression model was used for analyzing the data.ResultsThe results indicated that 52.5% of the participants were female and 51.8% aged 60–69 years old. A total of 159 cases (39.8%) reflected at least one form of elder abuse or neglect. The results indicated that 21% of the participants (n = 84) were abused by their own children. Care neglect was the most reported form (42.8%), followed by psychological abuse (41.3%), emotional neglect (38.8%), and financial abuse (34.3%). The most common types of neglect were motion limitations (25%) followed by the dental problems (23.8%). The results also showed a significant relationship between domestic elder abuse and level of income (p = 0.017), having a house (p = 0.028), type of perpetrator (< 0.001), and insurance status (p = 0.027).ConclusionsThe results revealed a considerable rate of domestic abuse against elderly people, causing a serious risk for their health and security.

The effects of education on nurses' ability to recognize elder abuse induced by family members

Background: Nurses' lack of knowledge about domestic elder abuse and their limited ability to recognize it can result in negative consequences. Education has the potential to improve nurses' ability to recognize elder abuse. Yet, there is no conclusive result about its effectiveness. Objectives: The main objective of the present study was to assess the effects of education on nurses' ability to recognize elder abuse. Methods: This randomized controlled trial was conducted in two public hospitals in Ramsar and Tonekabon, Iran. Participants were 120 nurses who were randomly recruited and allocated to an intervention (n = 60) and a control (n = 60) group. The study intervention was an educational program implemented in two successive 2-h sessions in 1 day. Data were collected using a demographic questionnaire and The Nurses' Recognition of Elder Abuse by Family Caregiver Questionnaire. The possible total score of the latter questionnaire was 67–335. The data were analyzed using the Chi-square, the Fisher's exact, and the paired- and the independent-samples t-tests as well as the one-way and the repeated-measures analyses of variance. Results: The mean score of elder abuse recognition ability significantly increased in the intervention group (P

Development and Validity Testing of an Assessment Tool for Domestic Elder Abuse.

The older adult population is increasing in number, and elder abuse is expected to become a more pressing problem. Developing tools to assess the presence and severity of elder abuse is important to both effectively prevent this abuse and provide increased support for families. This study was intended to test the validity of an Assessment Tool for Domestic Elder Abuse (ATDEA). The items that constitute this tool were derived from a literature review. Two rounds of self-administered questionnaire surveys were conducted with nurses working at home-visit nursing stations. Round 1 was used to evaluate the face validity, and Round 2 was used to test the content using the content validity index (CVI). Two hundred forty nurses participated in the two studies. In Round 1, 56 nurses evaluated 38 items derived from a literature review, resulting in the development of a 36-item ATDEA. In Round 2, 184 nurses evaluated the content validity of the 36-item ATDEA. The Item-CVI (I-CVI) scores ranged from .61 to 1. Twenty-eight of the items met or exceeded the I-CVI threshold of .78, whereas the eight items assessing self-neglect did not. The overall Scale-CVI score for the assessment tool was .90, which met the threshold of .90. The results of validity testing established the preliminary validity of this assessment tool. In addition, as self-neglect is known to damage the well-being of older adults, six of the eight items assessing self-neglect were retained in the ATDEA despite their failure to meet the threshold I-CVI of .78. The remaining two self-neglect items were not included in the ATDEA because of excessively low I-CVI scores (< .70). Thus, the final version of the ATDEA includes 34 items. The authors recommend that nursing professionals use the ATDEA as a checklist to assess the presence of elder abuse and to discern the subtypes and severity of this abuse. When evaluating elder abuse, the higher the degree of severity, the greater the urgency to provide support.

Domestic elder abuse and associated factors in elderly women in Tehran, Iran.

OBJECTIVESElderly people are often abused in many ways, with serious and lasting consequences. Elder abuse remains one of the most hidden forms of family conflict, and its frequency is anticipated to be rising in many countries that are rapidly experiencing population aging. The purpose of this study was to investigate the status of domestic elder abuse in elderly women in Tehran, Iran and to identify associated factors.METHODSThis cross-sectional study was conducted in 2017 among 260 women aged 60 and over, selected through multistage random sampling. Information on abuse and its risk factors was collected through interviews with the elderly in their homes. In order to measure domestic elder abuse, the validated Domestic Elderly Abuse Questionnaire was used. The ordinal logistic test was used in Stata version 12 to identify factors related to elder abuse.RESULTSOverall, 90.4% of the subjects had experienced at least 1 type of abuse, among which authority deprivation (68.5%) was the most common and rejection (11.2%) the least common. The ordinal logistic analysis showed that the likelihood of experiencing more severe severe abuse was significantly higher in elderly people over 72 than in those aged 60-62 years (odds ratio, 2.07; 95% confidence interval, 1.03 to 4.17).CONCLUSIONSDomestic elder abuse was found to be common in older women. Old age was an important risk factor for domestic elder abuse in elderly women in Tehran. Managing and preventing elder abuse is an important issue that needs to be addressed.

Risk factors for domestic elder abuse and cognitive decline: A comparative study with a Spanish sample

ABSTRACTThe purpose of this study is threefold: (1) to ascertain the relationship between elder abuse and cognitive decline; (2) to compare the variables associated with the risk of abuse in a group of people with cognitive decline and another group without cognitive decline; and (3) to study whether cognitive decline and three other variables are related to the caregiver predicted risk of abuse. The cases of 200 elders and their caregivers were assessed by social service professionals. The results identified a relationship between cognitive decline and abuse. Although some variables were associated with a risk of abuse in both groups, others were observed to be specific to the group of elders with cognitive decline. Other predictors of abuse included the quality of the past relationship, the perceived burden of care, the caregiver’s willingness to assume the caregiving role, and the ability of the caregiver to manage difficult situations.

Elder Abuse in Shiraz, Iran

Background: Aging is an inevitable biological phenomenon. Today, the elderly have a more active life, better life expectancy, and health status than in the past in Iran. However, there are still a lot of related hidden problems such as the elderly abuse. Objectives: The current study aimed at determining different types of the elder abuse in Shiraz, Iran. Methods: The current cross sectional study was conducted in 2012. The study population included the elderly in Shiraz, Iran. A sample of 226 elderly was randomly selected from 7 urban health centers. Data were collected using domestic elder abuse questionnaire. Data were analyzed by performing descriptive statistics (mean, frequency percentage, and standard deviation), the Pearson correlation, and the Mann-Whitney test by SPSS. Results: Overall, 226 elderly, 72.6% females and 27.4% males, were recruited. The mean± SD age of the sample was 68.55 ± 6.28 years. The incidence rates of abuse for the elderly participants were as follows: emotional negligence (43.8%), psychological abuse (41.2%), negligence in healthcare (31.9%), financial abuse (23%), and curtailment of personal autonomy (20.8%), as well as financial negligence (28.8%), physical abuse (7%), and abandonment (4%). According to the results of the current study, there were significant relationships between financial negligence and occupation (P value = 0.02), financial negligence and gender (P value = 0.06); between negligence in healthcare and gender (P value = 0.04); and between financial abuse and gender (P value = 0.04). According to the results of the study, there was a significant relationship between financial negligence and Occupational negligence, gender and negligence in healthcare, and financial abuse and gender. Conclusions: The results of the study indicated that a high percentage of the elderly participants were abused differently. Therefore, recognizing the prevalence and types of abuse is important to inform the health policy makers and legal authorities, especially families. In this way, better and more desirable care can be provided to the elderly and measures can be taken to improve their lives.

Domestic elder abuse in Yazd, Iran: a cross-sectional study.

Background: Social changes due to urbanism, acculturation, and fading of values have led to some challenges in family relationships, including domestic elder abuse. This study was conducted to determine elder abuse status in Yazd, Iran. Methods: This cross-sectional study was conducted on 250 elderly people over 60 years in Yazd in 2014-2015. Clustered random sampling was used to recruit the participants from 10 clusters in Yazd (25 individuals from each cluster). The data were gathered by the 49-item,Iranian Domestic Elder Abuse Questionnaire which was filled out through private interviews with the participants. Results: Mean score of elder abuse was 11.84 (SD: 12.70) of total 100. Of the participants,79.6% (95% CI: 74.5-84.6) experienced at least one type of abuse. Emotional neglect was the most reported abuse and physical abuse was the least reported. Abuse score was associated with age, education level, living status, and insurance status of elders. Further, those who reported history of gastrointestinal problems, dyslipidemia, respiratory diseases, sleep disorders, audiovisual problems, joints pain, hypertension, dental/oral problems, cardiovascular disease,urinary incontinence and disability, reported a statistically significant higher abuse score. Conclusion: Despite overall low rate of domestic elder abuse, its high prevalence indicates that some interventions are necessary to decrease domestic elder abuse. Emotional neglect of elders should be addressed more than other abuse types.