Elder Abuse Research Articles

Emancipatory Social Work: A Promising Practice to End Elder Abuse in Uganda

Emancipatory Social Work: A Promising Practice to End Elder Abuse in Uganda

Elder abuse in Flanders, Belgium: perspectives from home care nurses

ABSTRACT The present study focuses on elder abuse in the home care setting. The aim of this study was to explore home care nurses’ definition, general perspectives and experiences of elder abuse, and the barriers they experience to avoid elder abuse. Individual qualitative interviews were held with Flemish home care nurses (N = 17), employed by a Dutch home nursing organization. Data analysis was performed using reflexive thematic analysis. Results showed that (1) participants’ understanding of elder abuse was based on intuition and daily practice. (2) Participants highlighted several institutional barriers to avoid elder abuse. (3) The participating home care organizations did not have a standard protocol to report or handle elder abuse. Institutional structures, procedures and decisions should be critically reviewed as to how they lead to staff abusing older adults.

Analysis of Underlying Factors in Financial Neglect and Abuse in Older Adults: A Qualitative Content Analysis

Objectives: To analyze underlying factors in financial neglect and abuse to enhance understanding and inform interventions that can protect the financial well-being of older adults. Design: A qualitative content analysis approach. Setting(s): Borujen, Shahrekord, Iran. Participants: A sample of 15 older adults (8 females and 7 males) aged 60 and above was selected through a purposeful sampling method from healthcare centres in Borujen, based on specific inclusion criteria. Outcome measures: Data were collected through semi-structured, in-depth individual face-to-face interviews. Results: The findings displayed one overarching category, which is lost property, along with four subcategories, including forced reluctance to pursue the recovery of lent money, deprivation of financial independence, distress due to an inability to recover lent money, and children’s financial evasions in repaying the lent money. Collectively, these factors contributed to older adults perceiving their property as lost. Conclusions: Addressing the burden imposed by financial neglect and abuse necessitates coordinated efforts from authorities, ensuring that policymakers and planners in the fields of health and aging implement concrete measures to raise awareness among families, older adults, and service providers regarding elder abuse. Ultimately, these efforts should aim to improve the quality of life for older adults.

Silver Rainbows in The Information Society: Aging-Related Information Needs and Barriers of LGBT+ Older Adults

Abstract Society is experiencing a global shift in which older people now outnumber children five years and younger in many countries. This demographic aging has profound implications for library and information professionals, and yet research into the information needs of older adults – especially from diverse backgrounds – remains underdeveloped. This study seeks to help address this gap by studying the aging-related information needs and barriers of LGBT+ older adults. Interviews with 25 LGBT+ older adults in East Tennessee were analyzed using thematic analysis to identify five need (e.g., culturally competent care, LGBT+ specific services, social support, planning, and caregiver services) and seven barrier (e.g., stigma, discrimination, fewer personal resources, identity concealment, staff limitations, personality, ageism and elder abuse) themes. Beyond the aging focus, the study brings attention to the need for more research on intersectional populations in general and offers one of the first – perhaps only – studies of the information needs of LGBT+ older adults. It also presents a challenge to librarians and other information professionals in considering how to fight inequities for intersectional populations. Future research will consider how to meet needs and address the barriers LGBT+ older adults face.

Relative-to-resident abuse in Norwegian nursing homes: a cross-sectional exploratory study.

In community settings, relatives often provide care to their older family members, which is sometimes perceived as a high burden, overwhelming and stressful, contributing to an increased risk of elder abuse. In most countries, relatives have no legal obligation to provide care when family members are admitted to nursing homes; nevertheless, studies have shown that relatives continue to provide emotional, instrumental, and personal care after admission, often related to the understaffing and high workload of nursing staff. Despite the growing interest in elder abuse in nursing homes, most studies have concentrated on the abuse perpetrated by nursing staff or co-residents, but few studies have explored the abuse that relatives may perpetrate. This study was a cross-sectional survey of 3,693 nursing staff members recruited from 100 nursing homes in Norway, to examine the extent of relative-to-resident abuse in Norwegian nursing homes, as observed by nursing staff. The findings indicate that 45.6% of the nursing staff had observed one or more episodes of relative-to-resident abuse during the past year. Among the subtypes of abuse, 44.8% of the nursing staff had observed psychological abuse, 8.4% had observed physical abuse, 2.7% had observed financial/material abuse, and 0.7% had observed sexual abuse at least once during the past year. This is the first large study exploring the extent of relative-to-resident abuse in nursing homes, which is a phenomenon that is significantly less addressed than abuse committed by staff and co-residents. The findings in our study illustrate that abuse committed by relatives needs more awareness and attention to improve the well-being of nursing home residents. Further research is recommended to enhance our understanding of such abuse and should include other approaches measuring the proportion of relative-to-resident abuse, as relying solely on staff observations is insufficient for determining the prevalence in this case. Future studies should also examine the cumulative impact of victimization in nursing homes and should include an analysis of how cases of abuse are reported and handled.

Elder Abuse between EAG and non-EAG States in India: A Decomposition Analysis Approach

Objective: The primary aim of this study is to identify the key factors contributing to the differences in the prevalence of elder abuse between Empowered Action Group (EAG) states and non-EAG states. Methods: The data for this study was sourced from the Longitudinal Ageing Study in India (LASI) Wave 1, conducted in 2017-18. The study focused on older adults aged 60+ from a sample of 10,686 from EAG states and 20,166 from non-EAG states. A multivariate nonlinear decomposition analysis was conducted to identify the key factors contributing to the gap in elder abuse prevalence between EAG and non-EAG states in India. The main goal was to determine the covariates driving these variations. Results: The decomposition analysis revealed a significant rise in elder abuse rates among EAG states compared to non-EAG states, driven largely by changes in behavioral responses.

Codesigning training for health providers to improve detection and response to elder abuse.

Screening for elder abuse can improve detection, but many health providers lack the necessary skills and confidence. To address this, training for health providers on elder abuse screening was co-designed as part of a trial aimed at improving elder abuse detection and response. Between March and April 2023, 7 health providers and 10 older people and family carers participated in two national Australian online codesign workshops. Using the World Café method, discussions focused on what knowledge and skills health providers needed for screening; clinical and social issues affecting screening and referral; and support older people needed throughout the process. Data were thematically analyzed. Participants said health providers should take a trauma-informed, person-centered approach to screening, and explain the limits of confidentiality to older people. Clinical, social, and systemic issues such as dementia, ethnic diversity, and housing availability complicated screening and referrals. To facilitate disclosure, participants said health providers needed to reflect on whether they held ageist views. There were differing opinions on the length of the training and if all health providers or only social workers should screen for abuse. Participants' feedback on trauma-informed care, consent, and cognitive impairment concorded with evidence on best practice responses to elder abuse and were integrated in the training. Given operational constraints in health services, feedback from health providers about the training length and the inclusion of all health providers in screening were prioritized. The training is being evaluated in a national trial.

The Implementation of the Advocacy Intervention for Midlife and Older Women Who Have Experienced Intimate Partner Violence: Protocol for a Randomized Controlled Trial.

Midlife and older women who experience intimate partner violence (IPV) often have less access to supports and services than younger women. There is far less focus on research and supports for midlife and older women compared to younger women experiencing IPV, and often, neither elder abuse nor IPV services meet their needs. Few interventions are available to meet the needs of midlife and older women. The goal of this randomized controlled trial is to test the effectiveness of an advocacy intervention for midlife and older women who experience IPV and to learn from the experiences of those who implement and participate in the program. This trial is a 2-arm, unblinded, parallel, pragmatic randomized controlled trial with a qualitative component. Eligible participants will be women who live in the Maritime provinces of Canada (New Brunswick, Nova Scotia, and Prince Edward Island), who are in midlife and older (aged approximately ≥50 years), and who are currently in a relationship with an abusive partner or have recently left an abusive partner. Facilitators will be trained to deliver the intervention. The intervention will be entirely virtual and will consist of 2 components: (1) an empowerment component, which will involve sharing resources and information with the women; and (2) a social support component, which will include providing support and encouragement to women for 12 weeks. Quantitative effectiveness data will be collected from all trial participants at baseline, 3 months after the intervention, and 9 months after the intervention about the incidence and severity of IPV, physical and mental health, and safety behaviors and strategies. Qualitative interviews will be conducted with the facilitators and intervention group participants. Control group participants will receive a static, nontailored version of the advocacy intervention for midlife and older women (AIM) intervention materials after baseline data collection. A total of 12 facilitators have been trained to deliver the AIM intervention to trial participants. Participant recruitment and data collection will be completed in January 2025. Data analysis will continue throughout the data collection period, and the results will be disseminated by December 2025. This research will result in the adaptation and testing of a program to support and empower midlife and older women in the Maritime provinces of Canada who experience IPV. International Standard Randomized Controlled Trial Registry ISRCTN30646991; https://doi.org/10.1186/ISRCTN30646991. DERR1-10.2196/57886.

Impact of caregiving stressors on elder abuse—examining the mediating role of caregiver coping strategies

Objectives Based on the Caregiving Stress Theory and Cognitive Theory of Stress and Coping, this study examined whether increase in caregiving stressors had an impact on subsequent increase in different forms of elder abuse. Additionally, this study evaluated how these relationships were influenced by caregiver (CG) coping strategies. Method A group of 800 Chinese primary family CGs and their care recipients (CRs) with mild cognitive impairment or mild-to-moderate dementia were analyzed. Participatory dyads were assessed and followed for 2 years. Structural Equation Models were used to test the associations among caregiving stressors, CG coping strategies, and elder abuse. Results Increase in caregiving stressors (ie CR decreased cognitive function, neuropsychiatric symptoms, and functional impairment) significantly increased the level of subsequent physical abuse, psychological abuse, and neglect. In addition, the associations between caregiving stressors and different forms of elder abuse as stated above was mediated by CG dysfunctional coping strategies. Conclusion This study highlights the varying impact of caregiving stressors on different types of elder abuse and emphasizes the role of CG coping strategies in mediating these relationships. The findings provide valuable insights for the development of intervention protocols targeting both caregiving stressors and CG coping strategies to prevent elder abuse.

An Exploration of the Knowledge and Current Practices of Frontline Workers Regarding Elder Abuse.

Annually, approximately 16% of adults aged 60 and older are victims of abuse in community settings. A critical first step toward effectively intervening and reducing the prevalence of elder abuse is to better understand the current state of knowledge, beliefs, and practices. This qualitative descriptive study explored the perceptions of US frontline community workers regarding elder abuse through focus groups and interviews conducted in the spring and summer of 2021. Participants represented various aging and victim services (n = 9), healthcare (n = 7), and law enforcement (n = 8). Thematic data analysis led to the emergence of three major themes in our data: societal influence, individual circumstances, and nature of abuse. Our findings point out several directions in which researchers and policymakers can begin moving the field forward. These include the need to focus on prevention strategies as well as the need to reduce ageist beliefs and attitudes.

Elder mistreatment and psychological resilience: the moderating role of social support

ABSTRACT This study examines the possible consequence of elder mistreatment on resilience and whether social support moderates this posited association, using a rural sample of 432 community-dwelling older Chinese adults aged 60 to 79 years. Elder abuse included verbal abuse, physical abuse, or financial exploitation. Social support was measured by The Multidimensional Scale of Perceived Social Support (MSPSS). Resilience was represented by a seven-item scale. Hierarchical regression models indicated that mistreatment is significantly related to low levels of resilience when confounding factors are adjusted. A significant interaction term (abuse × social support) was also detected. Mistreated respondents who reported higher levels of social support were less likely to experience low resilience compared to those with lower levels of social support. Social support buffers against the undesirable effect of mistreatment on resilience, especially for those who were abused.

Association between Multimorbidity and Psychological Distress among Older Adults in India: The Moderating Role of Elder Abuse

ABSTRACT Objectives In this study, we examine the association between multimorbidity and psychological distress and to what extent elder abuse mediates the association. Methods We analyzed cross-sectional nationally representative data from the “Building Knowledge Base on Population Ageing in India (BKPAI).” Multivariate logistic regression was used to understand the association between multimorbidity and psychological distress. We used Karlson–Holm– Breen (KHB) method to understand the role of elder abuse in mediating the association between multimorbidity and psychological distress. Results Older adults who ever experienced abuse (OR = 1.92 95%CI = 1.62, 2.26, p < .001) or in last one month (OR = 2.09 95%CI = 1.65, 2.64, p < .001) reported higher odds of psychological distress. Further, older adults with four or more chronic diseases are thrice more likely to report psychological distress (OR = 3.03 95%CI = 2.38, 3.82, p < .001). The results further suggest the mediating role of abuse on the association between multimorbidity and psychological distress. Conclusions The results suggest the role of elder abuse on the association between multimorbidity and psychological distress among older population in India. Clinical implications Creating an environment to reduce the abuse among older adults who have multimorbidity will be essential to reducing the psychological distress among older adults in India

The evolutionary paths of clinical psychology studies in the United States: A bibliometrics illustration of 69k publications.

We aim to uncover the hot topics and development trends in clinical psychology research in the United States. Utilizing bibliometric analysis, we examined clinical psychology papers published in the United States from 2010 to 2022 in the Web of Science database, employing citation analysis, content analysis, author analysis, and journal analysis. Our analysis revealed a significant increase in clinical psychology research, notably catalyzed by the 2019 COVID-19 pandemic. This surge was particularly evident in studies addressing mental disorders such as PTSD, anxiety, and suicidal behaviors, as well as psychological trauma related to issues like family conflict, elder abuse, and collective trauma. Furthermore, there was a distinct shift towards studying diverse populations, including gender and racial minorities, mothers, and adolescents. Therapeutic approaches, such as mindfulness-based practices and AI-assisted technologies, also gained prominence. This study represents the first large-scale bibliometric analysis in the field of clinical psychology in the United States. Our findings suggest that the COVID-19 pandemic highlights the importance of studying psychological issues linked to major events. Also, researchers are increasingly focusing on minority groups. This trend, along with the use of new technologies like big data and artificial intelligence, guides future research in clinical psychology. The works in this review suggest that the changing landscape of clinical psychology, especially post-COVID-19. The increased research post-pandemic emphasizes addressing psychological trauma arising from societal issues like family conflicts, elder abuse, and collective trauma. A positive shift towards inclusivity is evident in research, focusing on diverse groups like gender minorities, racial minorities, mothers, and adolescents. Additionally, the amplified focus on mental disorders like PTSD, anxiety, and suicidal behaviors during the pandemic stresses the need for tailored interventions and support systems. Exploring innovative methods such as mindfulness-based practices and AI-assisted technologies showcases the field's adaptability in mental health interventions.

Elder abuse in the transgender community of Pakistan: A clandestine issue

Elder abuse in the transgender community of Pakistan: A clandestine issue

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.

Adult-Child to Older-Parent Coercive Control: A Hybrid Co-constructed Concept Analysis

Abstract Background In the absence of an established definition, the term filial coercive control is used to denote a relationship between an adult-child and their older-parent(s) which is characterised by a persistent pattern of controlling and abusive behaviour. This study explores how this phenomenon is understood in the literature by identifying and synthesizing the current state of knowledge of in this field of research. The knowledge generated from this concept analysis, along with the tacit knowledge of the author as a practitioner- researcher, was synthesised to produce a tentative conceptual framework. The distinctions between filial coercive control from psychological elder abuse are explained with the use of models and contrary cases. The hypotheses generated from this study will be used to guide semi-structured interviews with safeguarding social workers in a later qualitative study. Methods A scoping review methodology was adopted to guide the literature review, while a concept analysis methodology guided data extraction and analysis. Drwing on Rodgers’ evolutionary concept analysis method, a co-constructed research methodology was developed for this study. Results The concept of filial coercive control is understood in the context of the following antecedents: ageist norms, a parental relationship (both biological and non-biological), physical proximity and spatiality, along with the controlling characteristics and tendencies of the abusive adult-child. The defining attributes include the exercise of power through control, dependency and entrapment, isolation and confinement, and fear and intimidation. Through a process of reflective thematic analysis, the defining attributes were used to guide the construction of models and contrary cases to illustrate the findings. Conclusion Existing bodies of theory fail to adequately describe the phenomenon of filial coercive control. A tentative operational definition and a conceptual model are proposed that provide a starting point for future research and to help to inform professional practice and education.

Institutional, humane, therapeutic: Towards an understanding of caregiver violence through third sector violence prevention discourse in Finland.

Violence in family caregiving, once a social taboo, is now emerging as a topic of scientific inquiry. Engaging with a non-normative approach to care and critical reflection on research of abusive caregiver behaviour and elder abuse, this study argues that as caregiver violence is increasingly addressed in research, it is crucial to understand it as a complex issue within its social context. The study adds to this understanding by conducting a discourse analysis of violence prevention programmes in Finland, where third sector organisations have taken the initiative in addressing caregiver violence. Based on analysis of project materials, media texts and expert interviews related to two such violence prevention programmes, the study illuminates how caregiver violence is made intelligible through a combination of three kinds of understanding: institutional, humane and therapeutic. It is suggested that these understandings offer a way forward in thinking about the complex, sensitive topic of caregiver violence in sociological research on care.

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.

Trauma Theory and Abuse, Neglect and Violence Across the Life Course.

A literature review of recent prevalence and prospective studies on interpersonal violence (IPV) identifies a link among child abuse, intimate partner violence, and elder abuse that had not emerged from life-stage-specific studies on abuse, neglect, and violence against older persons. In line with a developmental understanding of IPV from a life course perspective, early life trauma is emerging as an explanatory theory of IPV across the life course. This paradigm shift in the field of elder abuse challenges more traditional explanations of IPV in old age, such as ageism, but opens up new opportunities for interventions leading to prevention and treatment of abuse, neglect, and violence against older adults. Prevalence studies that include older subjects and questions about violence experienced as children and younger adults consistently identify child abuse as a risk factor for IPV experienced in old age. Similarly, prospective studies on IPV that follow subjects from childhood to old age identify lifetime patterns of abuse. Qualitative studies of IPV in old age that include retrospective data suggest a link as well. IPV perpetrated against children and adults of all ages by persons in positions of trust can lead to trauma that has adverse lifelong behavioral and relational implications. This provides a link between trauma theory and violence against older people. Until recently, abuse, neglect, and violence were conceptualized differently based on the life stage of the victim. While historically the definitions for partner and non-partner violence diverged based on the life stage of victims, more recently this has begun to converge. Understanding violence from a life course and trauma-informed perspective better identifies risk factors and interventions for IPV against older adults. Intersectionality of age and gender variables demonstrate differences and similarities among populations studied.

Unravelling elder abuse through a human rights lens: a case study.

This article examines the connection between human rights and elder abuse, employing a human rights-based approach. Through a critical examination of a fictional case study on elder abuse, the discussion highlights the vital role of nurses when safeguarding the rights of older individuals in residential care settings. The PANEL framework - encompassing Participation, Accountability, Non-discrimination, Empowerment and Legality - is a comprehensive guide for safeguarding practice and is applied to the example provided. By applying this human rights-based approach, nurses can proactively address elder abuse, ensuring individuals' rights are protected, promoted and supported. Through accountability measures, non-discriminatory practices, empowerment strategies and adherence to legal standards, the authors advocate for a holistic approach to enhance the quality of care and foster a safe environment for older adults.