Victims Of Elder Abuse Research Articles

Elder Abuse Around the World: An International Perspective

Elder abuse is a hidden epidemic, with millions of older adults experiencing physical, psychological, or financial harm each year. However, the true extent of the problem is unknown due to under-reporting and lack of reliable data. This paper aims to provide an international perspective on the hidden epidemic of elder abuse, exploring the prevalence, risk factors, and consequences of this global issue. A systematic review of the literature was conducted using multiple databases. Studies from various countries were included to overview the problem comprehensively. The prevalence of elder abuse varies widely across countries, but it is estimated that at least 1 in 6 older adults experience some form of abuse. Risk factors include female gender, advanced age, cognitive impairment, and social isolation. Consequences of elder abuse include physical and psychological harm, premature death, and reduced quality of life. Elder abuse is a severe and pervasive global problem. The lack of reliable data and under-reporting makes it difficult to assess its prevalence and impact accurately. The review underscores the urgent need for a worldwide response to elder abuse tailored to consider cultural contexts and local resources. Collaborative efforts between governmental and non-governmental organizations are essential to raise awareness, provide education on elder rights, and implement effective prevention strategies. Establishing robust reporting mechanisms and support frameworks for victims of elder abuse is crucial for safeguarding the wellbeing of older adults worldwide.

Lifetime Revictimization: Evidence From the Wisconsin Longitudinal Study.

Despite the documented increasing prevalence of elder abuse victimization and its devastating health effects, a life-course view of the victimization experiences of older adults has rarely been adopted in the elder abuse literature. The current study investigated lifetime links between victimization experiences by examining the indirect effect of adverse childhood experiences (ACE) on elder abuse victimization via intimate partner violence (IPV) victimization in middle adulthood, and whether this indirect association would differ by gender. Using data from the Wisconsin Longitudinal Study, we analyzed the previous and current victimization experiences of a total of 5,391 older adults in their early 70s and estimated mediational and moderated mediation models. The key results indicated that a higher ACE score was associated with exposure to IPV victimization in middle adulthood, which was in turn associated with exposure to elder abuse victimization. This indirect association was stronger for women than for men. Regarding specific types of childhood victimization, parental physical abuse, sexual abuse, and witnessing domestic violence significantly predicted elder abuse victimization via IPV victimization. Our results support the phenomenon of lifetime victimization, whereby an individual experiences reoccurring forms of victimization across the life course from childhood to late adulthood. Findings highlight the compelling need for the assessment of cumulative victimization experiences and their impact on elder abuse victims. A life-course-based, trauma-informed approach would greatly enhance prevention and intervention services for elder abuse.

Utilization of Healthcare Resources by Elder Abuse Victims in Emergency

Utilization of Healthcare Resources by Elder Abuse Victims in Emergency

Change in Depression Severity Among Depressed Older Crime Victims.

The crime rates in urban centers are rising. The psychological impact of crime can range from distress to longstanding mental health impairment. Despite the rising crime rates and psychological impact on victims, little research has been conducted on older adult crime victims' mental health. In this manuscript we describe the profile of older adult crime victims in New York City referred for mental health services, their rates of depression, and the preliminary outcome data from a brief therapy intervention (PROTECT) targeting depression among victims. Building on prior research demonstrating the efficacy of PROTECT for depressive symptom reduction in elder abuse victims, the present study hypothesized elder crime victims who completed PROTECT therapy would demonstrate clinically meaningful depression symptom reduction as measured by the Patient Health Questionnaire-9 (PHQ-9). Additionally, it was hypothesized that these clinically significant depression symptom reductions would be demonstrated regardless of sex, gender, victimization type, victimization frequency, or living status. The results demonstrate that 67.7% (21/31) of participants had a clinically significant reduction in PHQ-9 scores (≥5 points) upon completion of PROTECT. There were no significant group differences in clinically significant depression symptom reduction, suggesting that PROTECT is an effective intervention for a diverse sample of elder crime victims. Future research should focus on the mental health impact of crime against older adults and explore reductions in anxiety and PTSD symptoms among crime victims. Through our partnerships we aim to bridge the divide between victim service providers, and mental health service providers to assist victims to recover, heal, and thrive.

Suicidal Ideation and Treatment Response Among Depressed Elder Abuse Victims

Suicidal Ideation and Treatment Response Among Depressed Elder Abuse Victims

노인 재학대 예방 프로그램의 효과성에 대한 연구

This study developed an elder re-abuse prevention program targeting perpetrators and assessed its effectiveness through a mixed-method approach. Thirteen perpetrators participated in eight sessions, and quantitative results revealed positive effects on emotional control and reduction of depressive symptoms. However, no significant change was observed in self-esteem. Qualitative findings indicated notable shifts in perpetrators’ emotions, perceptions, actions, and their relationship with elder abuse victims. The trust relationship with social workers in charge, and the negative conditions of perpetrators emerged as influencing factors for these changes. The results suggest the need for enhanced follow-up monitoring of elder abuse cases, interdisciplinary or multi-systematic interventions based on family systems, and strategic workforce deployment for elder abuse prevention programs.

Comparative Study on Elder Abuse and Neglect Among Geriatric Population in the Rural and Urban Field Practice Areas of a Medical College.

Elder abuse is a multidimensional problem of public importance. According to the World Health Organization (WHO), 16% of older people were victims of elder abuse. A study conducted by HelpAge India in 2018 showed that Mangaluru ranks the highest in elder abuse (47%). Given the scarce literature, this study sought to determine the prevalence of elder abuse and its associated sociodemographic factors. A community-based cross-sectional study was conducted among the senior population in the rural and urban field practice a medical college in Mangaluru for one and a half years. The sample size was 280. Most of the study population was in the age group of fewer than 75 years (75.4%), with 50.4% females, 60% Hindus, 56.4% married, 39.3% illiterate, and 88.9% of them retired. The prevalence of elder abuse was 44.6% (rural = 50.7% and urban = 38.6%). Binary logistic regression showed that elder abuse was statistically significant among the unemployed, extended family members, and staying with children. The study brings to light the sociodemographic factors that play a role in detecting elder abuse. It also shows the importance of awareness of elder mistreatment among older people. These elements must be considered for implementing and enforcing laws and legislation to help curb elder abuse.

Situation, Risks and Prevention Strategies of Elder Abuse: A Lesson for Nepal

The purpose of this paper is to identify and summarize the body of research on elder abuse in order to offer a more thorough understanding of the topic. Specifically, the goal is to identify and discuss the situation, risks and preventive measures related to elder abuse in light of Nepal's aging population. This narrative review was conducted after searching the article databases including Google Scholar, PubMed and Nepjol. A total of twenty seven journal articles, four systematic review articles, five books, five reports, one dissertation, two national acts of Nepal, four webpage articles and one methodological journal article were reviewed during a period from September 2022 to June 2023. The narrative review in the area of elder abuse is reflected in this article. Studies have shown that several misuse hazards are higher for senior citizens. Elder abuse is any single or recurrent act that hurts or distresses an older person and takes place in any relationship where there is an expectation of trust. The aging populations of many nations, including Nepal, are growing quickly, as are the number of senior abuse incidents. There are numerous government organizations, international and national non-governmental organizations, and local bodies doing admirable work concerning the investigation of elder abuse and the provision of assistance to elder abuse victims through the sharing of research experiences and the practical implementation of various prevention strategies. However, much more needs to be done for this at-risk population group in our society. In addition to raising social security for all seniors, it is recommended that each municipality in Nepal build an Elderly Service Center.

INNOVATIVE APPROACHES TO MENTAL HEALTH SERVICES FOR DIVERSE COMMUNITY OLDER ADULTS

Abstract Addressing the triple stigma (age, mental health, race) faced by older adults in need of mental health services has necessitated innovations that move the service provision needle. Co-located services within community settings, mental health interventions addressing those with nutritional needs, and victims of elder abuse and elder crime benefit from innovative services. The following session will highlight research outcomes from innovative treatment models: (a) In a sample of 138 diverse individuals participating in PROTECT (a brief behavioral intervention for late-life depression among elder abuse/crime victims) showed 5.15 point reductions in PhQ-9 scores across the sample and found video-delivery was non-inferior to traditional in-person therapy. Those receiving video therapy completed treatment faster, with more rapid rate of symptom reduction. (b) Do More Feel Better (a 9-week peer-led manualized intervention for those with depression and nutritional needs) found 78% experienced clinically significant reduction in depressive symptoms and over two-thirds (66%) reported satisfaction with the program. (c) DGMH (mental health services co-located in older adult centers) data indicate that of the 4,118 clients assessed, 3,373 endorsed at least one mental health need (81.9%), significantly higher than the mental health literature indicates. Over 2,133 clients have been treated in 67,597 sessions since program inception in 2018. Within 3-months of treatment, 60.8% and 52% showed clinically significant improvements in depression and anxiety, respectively. A third reported decreased loneliness and 39.4% indicated feeling less socially isolated. Further data will be presented (demographic, racial, ethnic differences). Data supported efficacy lend support to innovative mental health treatment approaches.

HOW FILIAL PIETY INFLUENCES THE LINKS BETWEEN ELDER ABUSE, SOCIAL WELL-BEING, AND DEPRESSION AMONG CHINESE SENIORS

Abstract Objectives Based on Interactive Biopsychological Model, this study examined how multi-dimensional social well-being and filial piety influence the association between elder abuse and depression among older adults in China. Methods The participants were 7,700 older adults (aged 60 years or older) enrolled in the 2018 China Longitudinal Aging Social Survey, a national population-based study of older adults. Moderated mediation models were applied to test the mediating effects of multidimensional social well-being (social isolation, loneliness, social network, and social participation) and the moderating effect of filial piety. All mediation and moderated mediation effects were estimated using SPSS.26. Results: Different dimensions of social well-being have a partial mediating effect on the association between elder abuse and depression. Traditional attitudes towards filial piety exacerbated the effects of elder abuse on depression by improving social isolation and loneliness while reversing the negative effects of elder abuse on depression through improving the social network. The interaction of elder abuse and filial piety has no significant influence on social participation. Conclusions: Although particular sociodemographic factors are associated with a greater risk of depression for elder abuse victims, our findings suggested that victims with traditional attitudes towards filial piety are more likely to feel isolated subjectively (lonely, worse social adaptation) and more depressed. This should be taken into consideration when developing culturally sensitive identification, prevention, and intervention services for older adults.

Improved outcomes for depressed elder abuse victims with video-delivered psychotherapy during COVID-19

Objective: There is a lack of evidence-based scalable therapies for elder abuse victims, with no current remotely delivered tailored psychotherapy. The purpose of this manuscript is to (a) examine the effectiveness of a brief therapy for depression for elder abuse victims, and (b) to compare remote intervention delivery via phone or video to the traditional in-person delivery. Method: PROTECT, Providing Options to Elderly Clients Together, is a brief therapy developed in collaboration with partners at the Department for the Aging (DFTA) of New York City. During the COVID-19 outbreak, PROTECT delivery shifted from in-person to phone or video delivery. Depression severity was tracked using the Patient Health Questionaire-9 (PHQ-9). Reduction in depression severity was evaluated using a linear mixed effects model with non-inferiority test to compare the effectiveness of video vs in-person delivery of PROTECT. Results: PROTECT reduced depression (average 5.15 PHQ-9 points). Video and phone delivery were non-inferior to in-person delivery. The video group completed therapy more quickly than the in-person group and had a more rapid improvement in depression symptoms. Conclusions: PROTECT therapy delivered remotely reduces depression among diverse elder abuse victims. Video delivery of PROTECT could increase reach and scalability to serve more vulnerable older depressed victims.

Mechanisms and weapons in physical elder abuse injuries: Findings from legally adjudicated cases

IntroductionElder abuse is common, but many characteristics have not been well-described, including injury mechanisms and weapons in physical abuse. Better understanding of these may improve identification of elder abuse among purportedly unintentional injuries. Our goal was to describe mechanisms of injury and weapons used and their relation to injury patterns. MethodsWe partnered with District Attorney's offices in 3 counties and systematically examined medical, police, and legal records from 164 successfully prosecuted physical abuse cases of victims aged ≥60 from 2001 to 2014. ResultsVictims sustained 680 injuries (mean 4.1, median 2.0, range 1–35). Most common mechanisms were: blunt assault with hand/fist (44.5%), push/shove, fall during altercation (27.4%), and blunt assault with object (15.2%). Perpetrators more commonly used body parts as weapons (72.6%) than objects (23.8%). Most commonly used body parts were: open hands (55.5% of victims sustaining injuries from body parts), closed fists (53.8%), and feet (16.0%). Most commonly used objects were: knives (35.9% of victims sustaining injuries from objects) and telephones (10.3%). The most frequent mechanism/injury location pair was maxillofacial/dental/neck injury by blunt assault with hand/fist (20.0% of all injuries). The most frequent mechanism/injury type pair was bruising by blunt assault with hand/fist (15.1% of all injuries). Blunt assault with hand/fist injury was positively associated with victim female sex (OR: 2.27, CI: [1.08 – 4.95]; p = 0.031), while blunt assault with object mechanisms was inversely associated with victim female sex (OR: 0.32, CI: [0.12 - 0.81]; p = 0.017). ConclusionPhysical elder abuse victims are more commonly assaulted with an abuser's body part than an object, and the mechanisms and weapons used impact patterns of injury.

Addressing Vicarious Trauma in the Legal Profession through a Webinar-Based Format

Objective: This article describes a multiple session training on vicarious trauma which were delivered to groups of professionals (N = 2 to 24) working as legal advocates for domestic violence, elder abuse victims and adults in long term care. Hypothesis: Addressing vicarious trauma of legal professionals through a webinar-based format will lower trauma exposure responses and lead to better self-care and well-being. Methods: The training participants were mostly lawyers employed with legal aid and state entities and were regularly exposed to details of traumatic experiences of their clients. They also experienced challenges in dealing with systems that may not be acting in their client’s best interests. Many of the participants were working with less than adequate resources. The training took place mainly over video conference and addressed issues such as: understanding neurobiology of trauma, providing trauma-informed services, vicarious trauma, assessing professional quality of life, exploring one’s trauma exposure response, and developing adequate self-care strategies. To evaluate the program a mixed method, post-test survey was conducted via Survey Monkey (N = 16) that assessed the level of trauma exposure response before and after the training, the likelihood of engaging in self-care strategies, and qualitative data was used to evaluate the relevance of various training topics. Results: Results indicated a statistically significant reduction in trauma exposure response, willingness to engage in several types of self-care, and specific suggestions for their organization to engage in further Trauma Stewardship activities. Conclusion: Using a webinar-based format was an effective approach to addressing vicarious trauma in legal professionals. A detailed description of the training will be provided and suggestions for ongoing education on trauma stewardship, vicarious trauma, trauma exposure response, and self-care strategies will be offered.

USE OF MOTIVATIONAL INTERVIEWING IN THE CONTEXT OF ELDER ABUSE INTERVENTION: THE RISE PROJECT

Abstract Despite the increasing number of elder abuse (EA) cases, many EA victims are reluctant to engage with formal support services, such as Adult Protective Services (APS). For EA interventions to be effective, it is important to overcome this client reluctance. This study examined the use of motivational interviewing (MI) by elder advocates, as a component of a larger EA intervention model, RISE (Repair Harm, Inspire Change, Support Connection, Empower Choice), developed in partnership with Maine APS and the Elder Abuse Institute of Maine. The advocate role was developed, in part, to increase service acceptance/utilization among EA victims. Advocates are trained in MI, a collaborative, client-centered approach designed to help individuals explore and resolve ambivalence around making a change. This study conducted qualitative interviews and a focus group interview with all advocates (n = 4) working within the RISE model to understand how MI is applied in the context of an EA intervention. Three domains were identified: (1) therapeutic relationship, which describes the importance of foundational relationship building to support EA victims; (2) techniques, which refers to the MI strategies that advocates apply and adapt in the context of EA intervention; and (3) implementation challenges, which discusses the difficulties that advocates encounter when using MI with victims of EA. Overall, the experiences of advocates suggest MI is a beneficial and amenable approach to help EA victims navigate feelings of ambivalence and explore their motivation for change. This study represents the first in-depth exploration of MI in the context of EA intervention.

A SCOPING REVIEW OF OUTCOMES IN ELDER ABUSE INTERVENTION RESEARCH: THE CURRENT LANDSCAPE AND WHERE TO GO NEXT

Abstract Researchers, practitioners, and policy-makers worldwide recognize elder abuse (EA) as a major threat to the health and well-being of older adults, but rigorous intervention research has greatly lagged behind this interest. A major weakness is the lack of cohesive understanding of appropriate program outcomes to be measured. To address this knowledge gap, we conducted a scoping review of the EA intervention research literature to understand the range of outcomes considered to date and to provide guidance for future research. We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, Ovid Social Work Abstracts, Ebsco AgeLine, Ebsco CINAHL, Wiley Cochrane Central, and Proquest Sociological Abstracts for studies evaluating community-based EA response programs. Two independent reviewers completed record search, screening, and data extraction procedures. We identified 52 eligible studies (1986-2019) that employed a total of 184 outcomes (range: 1–16, mean = 3.5). This study revealed that a large range of outcomes has been employed in EA intervention studies to date, mostly attached to victims or the intervention process itself, with inconsistent operational definitions and measurement procedures. Several key recommendations for future EA intervention research are: 1) implementing intervention outcomes that reflect multiple levels of eco-systemic influence, 2) heightening the analysis of intervention process outcomes beyond description toward identifying factors that mediate or moderate successful case outcomes, 3) conducting qualitative research with EA victims and other relevant stakeholders to understand meaningful intervention outcomes from their perspectives, and 4) establishing common EA outcome measures for implementation across studies to facilitate greater data pooling and synthesis.

A STUDY COMPARING TRENDS IN NUMBER OF AND CONTENT IN ARTICLES ABOUT DOMESTIC VIOLENCE AND ELDER ABUSE IN JAPAN

Abstract Since enactment in 2000, Japan’s Domestic Violence (DV) Law has been amended four times. No amendments have been made to Japan’s Elder Abuse Prevention Law, despite awareness of its imperfections. This study examined trends in the number of journal articles, and titles by content of those articles, using a KJ Method, to determine how the research literature has informed DV law, and to identify gaps in knowledge and further research needs related to elder abuse that could inform policy change. Using the CiNii database, in 2005-2021, we found1020 elder abuse articles (average 60 articles/year), and in 2001-2021, 836 DV articles (average 40 articles/year). Preliminary analyses revealed the per year annual average has been decreasing for each. Although the most used term was similar in both DV and elder abuse articles, which was “responses of professional personnel,” 15.4% for elder abuse and 13.4% for DV, title terms differed, with titles of elder abuse articles are more likely to be related to caregiving, such as “support for caregiver” (who are actually abusers) (4.7%) and “dementia” (3.6%), while terms found in DV but not in elder abuse articles included “supports for victims” (7.1%) and “responses to abusers” (5.3%). Our findings indicate that more research on supporting victims of elder abuse may be imperative to inform lder abuse law changes.

Elder abuse and life-course victimization in hospitalized older adults in Sweden: prevalence and associations with mental ill-health

BackgroundThe prevalence of elder abuse has only rarely been investigated in Sweden and never in a hospital setting. Therefore, the aims of this study were to: 1) Estimate the prevalence of elder abuse and life-course victimization among hospitalized older adults in Sweden, 2) Explore factors associated with elder abuse in the same sample, and 3) Explore the associations between life-course victimization and mental ill-health.MethodsThe study was conducted at a university hospital in Sweden. Adults over the age of 65 years admitted to a medical or geriatric acute care ward during spring 2018 were consecutively recruited. The participant rate was 44% (n = 135/306). Participants were assessed via a face-to-face interview about their experiences of elder abuse and abuse earlier in life. Mental ill-health was measured using a self-administered depression assessment (Patient Health Questionnaire-9), along with information about medications and diagnoses retrieved from medical records.ResultsAltogether, 40.7% (n = 55) of the participants reported some form of abusive experience during their life course. The prevalence of elder abuse was 17.8% (n = 24), and 58% (n = 14) of elder abuse victims also reported victimization earlier in life. Being abused before the age of 65 was the only background factor associated with elder abuse (OR = 5.4; 95% CI 1.9–15.7). Reporting abusive experiences both before and after the age of 65 was associated with current anti-depressant medication (OR = 6.6; 95% CI 1.1–39.2), a PHQ-9 result of 10 or more (OR = 10.4; 95% CI 2.1–51.0), and nine or more symptom diagnoses (OR = 4.0, 95% CI 1.0–16.1). Being abused only before or after the age of 65 was not significantly associated with any mental ill-health outcome measure.ConclusionsElder abuse and victimization earlier in life are highly prevalent among hospitalized older patients, and our findings underline the importance of a life-course perspective both in research on elder abuse and in clinical practice. Identifying and caring for older adults who have been subjected to abuse should be a priority in health care.

Social Isolation: Levels of Response for Nurse Practitioners

Although social isolation occurs across the lifespan, this article focuses on the unique challenges faced by the older adult population. Older adults are particularly sensitive to the health risks of social isolation. High-risk groups within the older adult population are minorities, immigrants, LGBTQ+, and victims of elder abuse. Nurse practitioners have the education and are poised to assess and intervene appropriately on social isolation at the primary, secondary, and tertiary levels of care. This article provides evidence-based assessment tools and resources for the nurse practitioner to use in clinical practice.

Testing an educational intervention to improve health care providers’ preparedness to care for victims of elder abuse: a mixed method pilot study

AabstractBackgroundElder abuse is prevalent and associated with ill-health. However, health care providers often lack education about elder abuse and older patients’ victimization often remains unknown to them. In this pilot study we performed initial testing of an educational model aiming at improving health care providers’ preparedness to care for older adults subjected to abuse, or more specifically their self-reported propensity to ask older patients questions about abuse and perceived ability to manage the response.MethodsThe educational model consisted of a full training day about elder abuse, including theory, group discussions and forum theatre. Forum theatre is an interactive form of drama in which participants are not only observers, but rather spect-actors, urged to participate in the scene. They are thereby given the opportunity to discuss and practise difficult health care encounters. Medical interns (intervention group n = 16, control group n = 14) in Sweden participated in the study and a mixed method convergent parallel design was used. Quantitative data was collected at baseline and 6 months post-intervention using a questionnaire (the REAGERA-P). Qualitative interviews were conducted with four of the participants in the intervention group and data was analysed using qualitative content analysis.ResultsThe reported frequency of asking older patients questions about abuse increased in the intervention group (p = 0.047), but not the control group (p = 0.38) post-intervention. Potential mediators for the improvement were an increased awareness of elder abuse and higher self-efficacy for asking questions about elder abuse. Participants also reported a higher perceived ability to manage cases of elder abuse, even though uncertainties concerning how to provide the best possible care remained. The qualitative interviews indicated that learning from each other in group discussions and forum theatre likely was an important contributor to the positive results.ConclusionThis pilot test indicated that the educational model may be effective in improving health care providers’ preparedness to care for older adults subjected to abuse. However, uncertainties about how to handle elder abuse cases remained post-intervention. In a future full-scale test of the model more focus needs to be put on how to manage cases of elder abuse.

Elder abuse and hospitalization in rural Malaysia.

Our study aims to describe and determine factors associated with hospitalization among victims of elder abuse and neglect (EAN) in rural Malaysia. A cross sectional study based on the baseline data of the Malaysian Elder Mistreatment Project (MAESTRO) collected from November 2013 until July 2014 involving 1927 older adults in Kuala Pilah, Negeri Sembilan was conducted. EAN was determined using the modified Conflict Tactics Scale (CTS) and hospitalization rates were determined based on self-report. The prevalence of overall EAN was 8.1% (95%CI 6.9–9.3). Among male respondents, 9.5% revealed history of abuse and among female respondents, 7.2% reported experiencing EAN. The annual hospitalization rates per 100 persons within the past one year among EAN victims and non-victims were 18 per 100 persons (SD = 46.1) and 15 per 100 persons (SD = 64.1) respectively. Among respondents with history of EAN, 16.0% (n = 21) had been hospitalized in the past 12 months while among respondents with no EAN experience, 10.2% (n = 153) were hospitalized. Multivariable analyses using Poisson regression did not show any significant association between EAN and hospitalization. This could be due to the complex interactions between medical and social circumstances that play a role in hospital admissions, factors affecting the health care system, and access to health care among EAN victims.