Forms Of Elder Abuse Research Articles

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.

Technology-facilitated abuse among Americans age 50 and older: a latent class analysis

ABSTRACT Technology-facilitated abuse (TFA) is of growing concern and is a form of elder abuse. There is limited TFA research in general population samples in the U.S. among older adults. Researchers conducted a survey of behavior-based forms of TFA experiences in a nationally representative sample of n = 1,011 U.S. adults ages 50 and older. Within this sample, 63.8% of respondents reported some experience of TFA during their lifetime. Latent class analyses were applied to understand the pattern of older adults’ exposure to ten different forms of TFA resulting in three classes distinguished by the number of different TFA types experienced: low TFA (55%), low-mid TFA (40%) and high TFA (5%). Socio-economic characteristics associated with these TFA profiles, as well as perpetrator relationship, post-TFA behaviors, and resulting harms associated with the TFA experiences, were examined to inform research, prevention, and intervention activities. Attention across different sectors to TFA among older adults is needed.

ANALYSIS OF SOCIAL PARTICIPATION, ELDER ABUSE, AND CORRESPONDING BEHAVIOR OF THE ELDERLY IN CHINA

Abstract Introduction Ancient Chinese wisdom under the Confucian culture show that “Parents raise children who in turn support them in old age” and "Don't wash one's dirty linen in public". The elderly in China brings up children with the aim to guard against troubles in their late years, but many older people with sons also suffer from various forms of elder abuse, and often choose to submit to humiliation when facing abuse from family members. Data: The Survey on the living conditions of the elderly in urban and rural China（SSAPUR）, four waves: 2015, 2016, 2017 and 2018 followed samples(N=224360) Methods The hierarchical Logit model was used to analyze the influence of social participation on elder abuse in China, and the risk of the elderly's choice to submit to humiliation. Results and conclusion The results showed that the annual incidence of elderly abuse (include physical abuse, emotional abuse, financial abuse, and neglect of care) among the elderly in China was 5.36%, and 35.77% of them chose to submit to humiliation. The more the elder participate in society involvement outside the home, the less likely they are to be abused from family members, the less likely they submit to humiliation. The more sons, the higher the risk of elder abuse. Therefore，the relevant government and the grass-roots social organizations should strengthen the construction of social organizations for the elderly.

Resilience as a protective factor against elder abuse by family caregivers: findings from a cross-sectional study in Hong Kong

PurposeThis study aims to explore the risk and protective factors of abuse on older adults by family caregivers, with a special focus on the protective role of caregiver resilience in elder abuse.Design/methodology/approachThis cross-sectional survey was conducted on a purposive sample of 600 family caregivers of community-dwelling older adults in Hong Kong (mean age = 71.04 and female = 67.2%). Caregivers reported in a guided interview about elder abuse behaviours, caregiver burden, care recipients’ agitated behaviours, caregiver resilience, self-efficacy, social support and basic demographic characteristics. Hierarchical linear regression analyses were conducted to examine the predictors of different forms of elder abuse.FindingsCaregiver resilience was predictive of lower levels of verbal abuse, physical abuse, injury and financial exploitation but not potentially harmful behaviour (PHB). Social support was independent with all forms of elder abuse, while self-efficacy predicted greater physical abuse after the adjustment of confounding variables. Caregiver burden and agitated behaviours by care recipients remained as significant risk factors in the final models when protective factors were considered.Research limitations/implicationsThis study extends current knowledge on the protecting role of resilience in elder abuse in family caregiving. Mixed findings revealed on social support and self-efficacy also highlight the complexity of the prediction of caregiver abuse. Further research should address this area.Practical implicationsThe findings of this study warrant the inclusion of caregiver resilience as a key component in developing interventions to prevent elder abuse. Addressing caregiver burden and agitated behaviours have the potential in preventing elder abuse.Social implicationsThe findings raise awareness of the importance of supporting caregivers in the community to prevent elder abuse.Originality/valueResearch concerning the protective factors of elder abuse is in a preliminary stage. To the best of the authors’ knowledge, this study is among the first which successfully demonstrates the protective role of resilience in caregiver abuse on older adults. The findings shed invaluable light on the design of effective interventions.

Predictors of Physical Abuse in Elder Patients With Fracture.

Introduction:Elder abuse is a public health issue requiring attention. Unlike abuse in the pediatric population, predictors of elder abuse in patients with fracture have not been well defined.Methods:Elderly patients with physical abuse and fracture were abstracted using the 2007 to 2017 National Emergency Department Sample database. Univariate comparisons, multivariate regression, and adjusted odds ratios were used to determine independent predictors of elder abuse compared with nonabuse fracture controls.Results:Thirteen percent of elder physical abuse patients presenting to the emergency department had fracture. Of all patients with fracture, elder abuse patients tended to be younger; be female; belong to lower income quartiles; and have codiagnoses of volume depletion, mental disorders, dementia, and intellectual disability. Presentation with other forms of elder abuse, such as psychological abuse, neglect, and sexual abuse, and multiple fractures were also associated with elder physical abuse. Multivariate regression found elder abuse to be more likely in the setting of skull and rib fractures and less likely in the setting of femur and foot and ankle fractures.Discussion:This study identified predictors of elder physical abuse in fracture patients older than 60 years. As with pediatric abuse, heightened awareness of potential physical abuse should be considered, especially in higher risk patients.

Associated factors of discrepancy between older adults and their family caregivers in reporting elder abuse.

This study focuses on elder abuse against older adults with mild-to-moderate cognitive and physical impairment who were receiving family care in Chinese context. Specifically, the study examined the associated factors of discrepancy between family caregiver and care recipient reports of elder abuse committed by the caregivers. Many studies identified the discrepancies between caregivers and care recipients reports of elder abuse, but they did not examine factors contributing to such discrepancies. Various cultural factors may contribute to the accuracy of elder abuse reports. A consecutive sample of 1,002 older adults with mild-to-moderate cognitive and physical impairment and their family caregivers was surveyed. Quantitative study with cross-sectional design. Moderate-to-substantial agreement in caregiver and care recipient reports was found for all forms of abuse (Cohen's kappa = 0.39 to 0.76). Care recipient reports consistently generated higher rates than caregiver reports for psychological abuse (51.1% vs. 42.8%), physical abuse (1.2% vs. 1.0%), caregiver neglect (65.0% vs. 50.2%) and financial exploitation (40.8% vs. 34.2%). Similar factors were found for dyadic discrepancy in the reporting of various forms of elder abuse, which included desire to gain face, fear of losing face and sense of familism in the caregivers, as well as older age, cognitive impairment and female gender of the care recipient. This study was presented in adherence to the Strobe Checklist. The results suggest that family caregivers might not be reliable as the sole informants to report their care recipients' victimization experiences. Information from multiple parties should be gathered and synthesized to obtain more accurate reporting of the frequency and severity of elder abuse. Meanwhile, cultural factors should be taken into account when seeking information related to elder abuse. There is a need for multiple parties to provide and report information about the elder abuse. It is also need to consider cultural factors when detecting and intervening elder abuse.

The Impact of an Educational Program on Medical Students' Knowledge and Awareness of Elder Abuse.

Objective:Approximately 1 in 6 adults 60 and older have experienced a form of abuse in the past year. Many cases remain under-reported due to lack of knowledge and awareness. This study created an educational program on elder abuse for medical students to determine if participation would increase knowledge and awareness of elder abuse.Methods:This study used a pre and post survey methodology to evaluate students’ knowledge and awareness of elder abuse before and after participating in this educational program. Sixty first and second year osteopathic medical students at the Edward Via College of Osteopathic Medicine, Carolinas Campus participated in this study. Students were emailed a pre-survey to evaluate their pre-existing knowledge and awareness. The survey was, previously created by the Student Training on Preventing Domestic Violence (STOP-DV) team using validated measures. Participants then attended educational events about various forms of elder abuse and recognizing its associated signs, and afterward completed the post-survey. The results were compared using t-tests to determine if there was a significant difference.Results:First and second year students differed significantly in pre-survey results of knowledge but not post-survey results. The results showed a significant difference in overall mean knowledge (P-value < .001) and awareness scores (P-value < .001) in all students.Conclusion:These results suggest education on elder abuse can enable future physicians to better recognize, understand, and support older adults regarding elder maltreatment.

Caregiver Resilience as a Protective Factor for Elder Abuse

This study examines the protective function of caregiving resilience and caregiving self-efficacy for elder abuse. A convenient sample of 600 family caregivers of community dwelling older Chinese in Hong Kong were individually interviewed. Participants were assessed on the caregiving context, care recipient physical functioning and behavioral problems, perceived caregiver stress, neurotic personality, caregiving self-efficacy and resilience. Past year elder abuse was assessed using Revised Conflict Tactic Scale and Older Adult Financial Exploitation. Elder abuse is common in this sample: 7.5, 11.5, 24 per cent reported physical, psychological, and financial abuse respectively. Injuries were reported in 2.3% of the sample. Hierarchical linear regression analysis was conducted. Number of co-residing days and hours of care provided per week were entered into Model One; Care recipient physical functioning, behavioral problems, and caregiver stress were entered into Model Two; Caregiver resilience and caregiving self-efficacy were entered into Model Three. Care recipient behavioral problems and caregiver stress were prominent factors associated with abuse across all models. With the exception of physical abuse, caregiver resilience buffered the effects of care recipient behavioral problems and caregiver stress on all forms of elder abuse. No such effect was observed for caregiving self-efficacy. Intervention efforts aiming at fostering caregiver resilience could potentially prevent elder abuse.

Substance Use Is Common in Elder Abuse Cases: Qualitative Findings From a Multi-Disciplinary Team

Elder abuse is mistreatment of an older adult by a caregiver or another person in a position with an expectation of trust. Adversely affecting as many as 10% of community-dwelling older adults in the US, it may include physical abuse, sexual abuse, psychological abuse, financial exploitation and neglect. Mental illness and substance use by caregivers, family members and victims themselves have been described as risk factors for multiple forms of elder abuse in prior cross-sectional analyses but the impact on these cases is poorly understood. To explore this association we conducted a focus group using a semi-structured format involving an inter-disciplinary group of elder abuse professionals that are part of the New York City Elder Abuse Center enhanced multi-disciplinary team (EMDT) in Staten Island, New York. Focus group participants reported that opioid, cocaine, cannabis and alcohol use is common among perpetrators of elder abuse, especially in cases of financial mistreatment, verbal and physical abuse. Other potential consequences included eviction of the older adult victim, co-dependency and involvement of the older adult in the procurement of illicit substances, and substance use by the older adult. Respondents specifically expressed concerns that the opioid epidemic, including rising heroin use, may be changing the frequency and nature of elder abuse, and that case investigations offer an opportunity to facilitate referrals for formal substance use disorder assessment and treatment. Future work includes additional focus groups and quantitative analysis to clarify the intersection between substance use and elder abuse and inform intervention and prevention strategies.

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.

Pent-up demand for care among dual-eligible victims of elder financial exploitation in Maine

ABSTRACT Elder financial exploitation (EFE), the misuse of a vulnerable adult’s property or resources for personal gain, is a form of elder abuse. This study addresses whether dual-eligible EFE victims were experiencing pent-up demand for health services alleviated through investigation by Adult Protective Services (APS). A quasi-experimental design addressed health service utilization and costs for 131 dual-eligible Maine APS clients over age 60 with substantiated allegations of EFE relative to comparable non-APS controls. APS case files spanning 2007–2012 were linked to 2006–2014 Medicare and Medicaid claims data. Service utilization and costs were analyzed 1 year prior, during, and 2 years after the initial APS investigation. Difference in differences logistic regression and generalized linear models addressed the likelihood of incurring costs and expenditure levels relative to matched controls, respectively. Victims of EFE had higher overall odds of using inpatient and long-term services and supports (LTSS) and higher odds of using LTSS post-investigation than controls. Higher overall levels of outpatient and prescriptions expenditures and higher inpatient expenditures during the APS event year contributed toward APS clients incurring $1,142 higher PMPM total costs than controls. Victims of EFE were experiencing significant pent-up demand for health services post-APS involvement.

Association between personality traits and elder abuse in a community-dwelling Chinese population: findings from the PINE study

ABSTRACT Elder abuse is a pervasive public health issue. The relationship between personality traits and elder abuse remains unclear. This study aims to examine the associations between neuroticism, conscientiousness, and elder abuse. Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged study of 3,157 US Chinese older adults in the greater Chicago area from 2011–2013. Elder abuse included psychological, physical, and sexual abuse, financial exploitation, and caregiver neglect. The assessments of neuroticism and conscientiousness were derived from the NEO Five-Factor Inventory. Logistic regression was used. Higher neuroticism (score range: 6–30, OR = 1.14, CI = 1.11–1.18) and lower conscientiousness (score range: 16–60, OR = 0.97, CI = 0.96–0.99) were associated with a higher risk of elder abuse. With respect to different forms of elder abuse, higher neuroticism was associated with an increased risk of psychological abuse (OR = 1.14, CI = 1.10–1.17), financial exploitation (OR = 1.03, CI = 1.00–1.07), and caregiver neglect (OR = 1.06, CI = 1.03–1.09). Higher conscientiousness was associated with a higher risk of financial exploitation (OR = 1.02, CI = 1.00–1.05). Intervention programs could reduce neuroticism and raise conscientiousness of elder abuse victims.

Social Justice Games: Building an Escape Room on Elder Abuse through Participatory Action Research

This paper discusses the creation of an escape room on older adult mistreatment (or elder abuse). The game, titled Sandra's Keys, invited players to engage with the story of a fictional older woman dealing with a situation of abuse through a series puzzles. The escape room sought to bring players into a conversation about the different forms of elder abuse, and to give them a greater understanding of their role as bystanders and of the potential ways to intervene. The escape room game was co-designed by researchers, a group of older adults activists in Montreal and a social worker. This paper focuses on how we made this game and the methodological principles and values behind the design process. This design process is grounded in Participatory Action Research and is inspired by the writings of radical theatre activist Augusto Boal. One of its aims was to consolidate long standing relationships between the members of the design team around a common social justice goal. We map out the potential of games to become tools in the ‘arsenal’ of community-based activism and to playfully contradict dominant societal norms related to age. Finally, we introduce the term ‘social justice game’ to assert the connections between activism, social justice and games studies.

Me Too? The Invisible Older Victims of Sexual Violence

A review of legal research on violence against women and elder abuse reveals a disturbing picture. There is hardly any American legal research examining sexual abuse of older women and its conceptualization in legal literature and treatment in the legal system. This Article attempts to fill the abovementioned gap and to bring the hidden issue of sexual violence against older women to light. Scholars writing on rape, violence against women, and elder abuse tend to analyze age and gendered sexual violence separately from each other, without accounting for their interplay. This Article proposes a conceptual framework of sexual abuse of older women that integrates age and gender in the analysis. To achieve this end, this Article examines 109 publicly available American cases involving sexual violence against women over the age of 60, between the years 2000 and 2018, which are based on a search of 1,308 American cases. Based on this new empirical database, this Article offers an opportunity for analyzing the social and legal “taboo” regarding sexual abuse of older women. Despite findings indicating that sexual abuse of older women (and older people in general) is a significant issue creating serious consequences for victims, the Article shows that legal actors, social workers, health professionals, family members, and society miss its signs. Sexual abuse of older women is being noticed and treated by the criminal justice system only when it reflects a “real rape” 1 scenario. The obstacles to effective prosecution and to full access to the criminal justice system are distinctive in the case of older victims because of the effect of age, the way age shapes the experience of older victims of sexual violence, the effects of sexual violence on the victims, and its interplay with gender. Although sexual violence against older women is a form of elder abuse, it should be viewed separately from other forms of elder abuse and should be understood as part of a wider context of gender-based violence. There is a need for a holistic approach to sexual violence of older women, which perceives the sexual violence as a unique phenomenon and provides older women with legal and social mechanisms that fit their needs and experience both as women and elderly people.

Frequency and forms of elder abuse in Serbia

This paper aims at presenting findings of the research that aimed at exploring the frequency of abuse targeting older persons, frequency of individual types of elder abuse, as well as the frequency of elder abuse targeting two different types of older persons. The research took place in 2016 in 9 Serbian municipalities and was designed as a cross-section study. It was conducted on a sample of 616 older persons of whom 58.1% (358) are socially less active and have some kind of support in daily life activities and 41.9% (258) are active in their communities and are socially included. The starting assumption of the research is that the frequency of elder abuse is more often in socially excluded persons than it is in socially included and more active ones. The research confirmed the correlation between the level of social activity and the risk of elder abuse and this correlation can be clearly explained by exploring other protective factors and risk factors such as income and education level or chronic diseases and disability.

CO-OCCURRENCE OF ABUSE AND NEGLECT AS REPORTED BY DEMENTIA FAMILY CAREGIVERS

Understanding the co-occurrence or overlap among multiple forms of elder abuse and neglect (EAN) is important for designing effective interventions. This paper reports patterns of family caregiver’s daily behaviors related to physical assault, psychological mistreatment, and neglect. Majority of participants self-reported at least one EAN behavior (74%), with most reporting using multiple forms of EAN over the 21-day period (52%). On a given day, psychological mistreatment and neglect were more likely to happen in isolation, while physical assault was more likely to co-occur with psychological mistreatment. The mixed model’s intra-class coefficient suggests the daily context, rather than personal characteristics, explain the variance in the use of EAN. These findings highlight the importance of never minimizing a single event of EAN reported in clinical practice, give the high rate of polyvictimization, and reinforces the need to understand why caregivers use one form of EAN over another on a given day.

ELDER SELF-NEGLECT: REPORTING AND RESPONSE WITHOUT APS OVERSIGHT

Self-neglect is generally considered a geriatric phenomenon and subsumed within the category of elder abuse and neglect. In the U.S., self-neglect is the most commonly reported form of elder abuse and neglect and has been linked to decreased physical and psychological well-being, higher mortality rate, and increase health care services utilization. While self-neglect typically falls under the purview of a state’s adult protective service (APS) system, there are several states where this is not codified and/or practiced. This study examined the state of existing laws, policies and programs that address elder self-neglect in the U.S. in an effort to better understand how self-neglect reporting and response is handled, particularly in states where APS does not have oversight. A 50-state review of existing policies and laws addressing elder self-neglect was followed by key stakeholder interviews with those who oversee self-neglect reporting and response in states where APS does not have oversight. Findings indicate that a range of rationales explain variation in responsibility for self-neglect cases, including a lack of specificity in statutes, concerns that self-neglect does not fit into legal/criminal models due to the lack of perpetrator/victim relationship, and strong sentiments that those engaging in self-neglect need human services and support rather than investigatory or legal approaches. While the inclusion of self-neglect into the broad category of elder abuse and neglect is often perceived as vital for the provision of services, findings indicate it may exacerbate the complex challenges inherent in defining and conceptualizing both the term and its response.

ASSOCIATION BETWEEN PERSONALITY OF VICTIM AND ELDER ABUSE

AbstractElder abuse is a pervasive and significant public health issue. The relationship between personality of victims and elder abuse remains unclear in literature. This study aims to examine the association between neuroticism, conscientiousness, and elder abuse. Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of 3,157 US Chinese older adults aged 60 and above in the greater Chicago area. Elder abuse was assessed by a ten-item instrument modified from the Hwalek-Sengstok Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Subtypes of elder abuse include psychological, physical, financial and sexual abuse, and caregiver neglect. The assessments of neuroticism and conscientiousness were derived from the NEO Five-Factor Inventory. Logistic regression models were used. Higher neuroticism (OR: 1.18, 1.15–1.21) and lower conscientiousness (OR: 0.96, 0.95–0.98) were associated with higher risk of elder abuse. With respect to different forms of elder abuse, higher neuroticism was associated with increased risk of psychological abuse (OR: 1.17, 1.14–1.21), financial exploitation (OR: 1.04, 1.00–1.07), and caregiver neglect (OR: 1.08, 1.05–1.12). Higher conscientiousness was associated with higher risk of financial exploitation (OR: 1.02, 1.00–1.05) and lower risk of caregiver neglect (OR: 0.98, 0.96–1.00). This study added new insights to interventions on elder abuse by testing personality traits of victims. Intervention programs could modulate neuroticism and conscientiousness of elder abuse victims.

Elder abuse: The role of general practitioners in community-based screening and multidisciplinary action

There are growing calls for elder abuse screening to be conducted by a range of community-based service providers, including general practitioners (GPs), practice nurses, home care workers and lawyers. Improved screening may be a valuable first step towards improving elder abuse detection and response; however, practitioners need evidence-based strategies for screening and follow-up. This article summarises several brief screening tools for various forms of elder abuse. Screening tool properties and evidence gaps are noted. As elder abuse often requires multidisciplinary responses, initiatives to connect health, legal and other service providers are highlighted. GPs are trusted professionals who are well placed to identify older patients at risk of, or experiencing, various forms of abuse. They should be aware of available screening tools and consider how best to incorporate them into their own practice. They also play an important role in multidisciplinary action to address elder abuse. <div class="hor-line">&nbsp;</div>.

The Need for a Stronger Definition: Recognizing Abandonment as a form of Elder Abuse Across the United States

Elder abuse is a growing public health problem in the United States and statistics show that each year, hundreds of thousands of elders are abused in some manner. This Note discusses elder abuse while focusing specifically on the occurrence of elder abandonment and how the majority of states do not recognize elder abandonment as a form of elder abuse in their statutes. Moreover, this Note proposes a model statute to be adopted by every state in an effort for elder abandonment to become more widely reported. Elder abandonment is an unfortunate phenomenon and those who contribute to elder abandonment should face criminal liability similar to those abusers who engage in elder neglect or other types of elder abuse. Furthermore, this Note emphasizes that there should be a greater focus on how caregivers can seek assistance in order to prevent elder abuse in the United States.