Prevalence Of Elder Abuse Research Articles

ADDRESSING OLDER ADULT SOCIAL ISOLATION AND ABUSE THROUGH RURAL OUTREACH AND INTER-ORGANIZATIONAL COLLABORATION

Elder abuse is commonly linked with social isolation and in a rural state, such as Iowa, older adults may be at increased risk of social isolation and elder abuse. A community-based needs assessment aimed to record the first-hand perspectives of service providers regarding the needs of older adults in rural areas across the state of Iowa, covering 54 of the 99 counties. Through a survey (N=202) and focus groups (N=24), service providers, including direct care, Area Agencies on Aging, law enforcement, and attorneys, offered ways in which to address the gaps in service provision and prevention of elder abuse. Based on survey and focus groups, suggestions included ways to decrease social isolation among older adults by improving service outreach, provider training, and inter-organization communication. Discussion will outline gaps in service outreach and address future inter-organizational collaboration and strategies to prevent social isolation and elder abuse in rural communities.

INTEREST GROUP SESSION—ABUSE, NEGLECT AND EXPLOITATION OF ELDERLY PEOPLE: DAILY REFLECTIONS OF DEMENTIA CAREGIVERS: MICRO-LONGITUDINAL APPROACHES TO UNDERSTANDING ELDER ABUSE AND NEGLECT

Studies with clinic samples have found approximately 50% of family caregivers self-report engaging in abusive and neglectful acts towards the person with dementia whom they assist. Despite this, interventions to reduce and prevent elder abuse and neglect in dementia caregiving are lacking. To develop targeted interventions, the field still has much to learn about what happens during single incidents of elder abuse and neglect including (1) the types of tactics used (2) contextually-based risk/protective factors and (3) circumstances surrounding acts. This symposium will advance discussions on these topics through presentation of pilot data from a micro-longitudinal study on abuse and neglect within dementia family caregiving. Micro-longitudinal methods, such as daily diary studies, rely on intensive longitudinal measures over shorter periods of time. This approach can better ascertain ecologically-valid factors and identify temporal patterning between variables than traditional longitudinal and cross-sectional methods. First, we will provide an overview of the pilot project with family caregivers (N=50) completing diaries for 21 days. The second presenter will discuss data on the co-occurrence of different types of elder abuse and neglect as they manifest in daily lives of family caregivers, and lead discussion on measurement considerations. The next presenter will discuss data on contextually-based risk and protective factors for abuse and neglect that occur during daily caregiving activities. The final presentation will discuss findings on caregivers’ perceptions of the circumstances surrounding abusive and neglectful behaviors. Discussion will focus on how these findings, and methods, can be used to advance intervention development for the field.

ELDER ABUSE BY FAMILY CAREGIVER: DOES COGNITIVE IMPAIRMENT REALLY MATTER?

Previous research suggested that cognitive impairment is a risk factor for elder abuse. Persons with dementia experience elevated risk of abuse as compared to the general aging population. The present study compared rates of abuse reported by family caregivers of older persons with and without dementia. A total of 693 family caregivers participated, among which 592 were providing care older persons with dementia and 101 were providing care to older persons without. Participants provided information on their demographic characteristics, care recipient physical functioning (Instrumental Activities of Daily Living), behavioral problems (Cohen Mansfield Agitation Inventory), caregiver stress (Zarit Burden Interview), emotional and instrumental social support, and abusive behaviors directed at the care recipients (Conflict Tactics Scale and Potentially Harmful Behaviors). Abuse is common in this sample: 46.8% reported potentially harmful behaviors, 52.7% reported psychological aggression, 11% physical assault, and 1.3% injury. No significant difference was observed between caregivers providing care to older persons with or without dementia (p>.05). A series of logistic regression was conducted to determine factors associated with abuse. Care recipient behavioral problems and caregiver burden were two prominent factors associated with potentially harmful behaviors and all forms of abuse. Behavioral problems are common in persons with cognitive impairment and many caregivers feel stressful managing them. It is plausible that cognitive impairments per sec do not increases risk of abuse, but the associated characteristics do. Helping family caregivers manage the caregiving situation and their expectation, positive appraisal and cognitive restructuring may help prevent elder abuse.

CHALLENGES AND BARRIERS FOR SERVICE PROVIDERS IN RURAL SETTINGS: AN ELDER-ABUSE NEEDS ASSESSMENT

There has been concern about the increasing prevalence of elder abuse in the rural settings. This trend has called for more coordinated efforts to address elder abuse in the rural community. The current literature regarding elder abuse suggest there is more to learn about systematic obstacles service providers face. The framework applied in this study include elements of Bronfenbrenner’s Bioecological model, showing a multilevel application to the obstacles agencies encounter when supporting else abuse victims. Little research has been conducted on the providers who work with elders in the rural context. In this study, based on the needs assessment of Iowa, we have examined the perceived barriers service providers face. Our sample included 222 providers across Iowa who took an online survey. The survey was initially sent to members of the Coordinated Community Response team of Iowa. Our findings indicated that service providers revealed multilevel challenges (i.e., individual vs. organization level) in working with elder abuse cases. Service providers’ perceived effectiveness training was negatively associated with the quality of training they evaluated (β=.24, p<.05). The data also showed us that a large portion of agencies offered no training and education on elder abuse. Common themes described by the providers as barriers to addressing abuse was lack of education, social isolation, low awareness and ageism. These results highlight that training for elder abuse in the rural setting needs multilevel systematic efforts.

IMPROVEMENTS NEEDED FOR JAPANESE ELDER ABUSE PREVENTION LAW: COMPARISONS WITH OTHER ABUSE PREVENTION LAWS

Japan has four stand alone abuse prevention laws, including child abuse (enforced in 2000), domestic abuse (2001), elder abuse (2006) and abuse for people with disabilities (2011). These laws are distinctive in that they aim to prevent abuse, not merely to address abuse after it occurs. This paper compares components of these four abuse prevention laws, delineating major strengths and weaknesses of the elder abuse prevention law in comparison to the other three. The analysis considers both institutional and domestic settings and suggests possible improvements of elder abuse prevention law that need to be made. Evidence for this analysis is supplied through examination of trends abuse using longitudinal data (2012-2017) collected by Japan’s Ministry of Health, Labour and Welfare. The analysis shows commonalities in trends in the four abuse categories. For example, the number of abuse cases has risen over time despite the dissemination and implementation of abuse prevention training, program implementation, and public outreach. Differences include reporting – police more often report abuse cases of children and people with disabilities, while elder abuse cases are more often reported by professional staff members responsible for dealing with elder abuse cases. Although some amendments have been made to the child abuse and domestic abuse prevention laws, no amendments have been made to the elder abuse prevention law despite the requirement to review its success. Needed revisions include provisions of protection orders and temporary shelters to protect elder victims from abusers as soon as possible.

RURALITY, ALCOHOL, AND OPIOID USE AS PRECURSOR TO ELDER ABUSE

Pain, alcohol, and opioid risk management is an increasingly important issue in the care of the older adult population. Older adults are at higher risk for pain and the negative outcomes associated with opioid and alcohol use due to higher prevalence of multimorbidity, polypharmacy, and the age-associated changes in metabolism and elimination. Evidence-based approaches for pain and substance use management exist and are effective for older adults, but underutilized and have limited availability in rural areas. Therein, undermanagement of pain and substance use becomes a risk factor for elder abuse. Improved dissemination and implementation in practice, as well as training for health professionals and the community is needed to better realize and prevent negative health outcomes from pain, alcohol, and opioid use. Community education and training tools for health professionals will be discussed, with suggestions for community initiatives to address pain, alcohol, and opioid risk management to prevent elder abuse.

Prevalence of elder abuse and associated factors among community-dwelling older adults in Iran

ABSTRACT The aim of this study was to investigate the prevalence of elder abuse and associated factors among community-dwelling older adults Kerman province, Iran. In this cross-sectional descriptive study, 200 elderly people in Kerman were included using multi-stage sampling. 51.4% of the elderly reported abuse. 17.5% reported physical abuse, 20.9% reported verbal abuse, and 26.4% reported non-verbal abuse. Also, 11.5% reported self-neglect and 6.5% were neglected by others. 11.4% of the elderly reported abandonment and 14.9% reported financial abuse. There was a significant relationship between economic stress and neglect (P = .01), the risk of abuse in the elderly with a very good health status was about 50% less than that in others (P < .001). Elderly experience different types of abuse. Therefore, proper knowledge of elder abuse, especially emotional abuse and its related factors, including economic stress and health status, can increase knowledge and sensitivity of society, in order to avoid this dilemma.

Elder Abuse and Social Capital in Older Adults: The Japan Gerontological Evaluation Study

Background: Elder abuse is a serious public health issue worldwide, but large-scale epidemiologic studies remain sparse. Although social factors in human relations such as social support and social isolation have been proposed as the factors related to elder abuse, cognitive social capital has not been examined. Objective: This study aims to clarify the prevalence of and the factors associated with elder abuse among independent older adults in Japan. Methods: The study design is a retrospective observational study. The data were derived from the Japan Gerontological Evaluation Study (JAGES). These self-report data were collected from 26,229 people aged 65 years or older living in 28 municipalities in 2013. The types of elder abuse and factors associated with them were examined using logistic regression analysis. Results: The prevalence of elder abuse among the sample was 12.3% (11.1% in males and 13.3 in females). In the entire sample, physical, psychological, and financial abuses were reported to be 1.26, 11.12, and 1.45%, respectively. Factors associated with increased odds of experiencing abuse were being a woman, living with family members, having poor self-rated health, and having mild or severe depression. By contrast, age ≥85 years, being widowed, or unmarried, and having a positive view of community trust were associated with a lower risk of experiencing abuse. Conclusion: While particular demographic factors and health are associated with a greater risk of elder abuse, our findings that trust within the community lessens the risk indicates the importance of social capital. This should be taken into consideration when developing population-based strategies to prevent elder abuse.

Prevalence of elder abuse and neglect: screening in Poland families.

Elder abuse and neglect is one of the most important problems of social and health policy among countries around the world. Making a real and reliable assessment of the occurrence of abuse is difficult to implement. The aim of this work is to show the frequency of physical, psychological, sexual abuse and financial exploitation among older adults. Older adults, who were aged ≥ 60years (N = 200) were qualified for the study. The studied population consisted of 112 women (56.0%) and 88 men (44.0%). The whole project procedure only included filling in the survey questionnaire. The verification of hypotheses was based on tests: Chi square test, Chi square test with continuity correction and logistic regression models. Within the obtained own results, out of 200 older adults, 77 respondents (38.5%) experienced abuse and neglect during the last 12months. Most of the respondents (68.8%) experienced various forms of abuse simultaneously. Among those who experienced abuse, 75.3% experienced psychological abuse, 68.8% financial exploitation, 48.1% physical abuse, and 22.1% experienced sexual abuse. The rate of physical (OR 2.48; 95% CI 1.13, 5.44; p = 0.02), verbal (OR 1.94; 95% CI 1.02, 3.67; p = 0.04), sexual (OR 4.05; 95% CI 1.13, 14.5; p = 0.03) and economic (OR 1.98; 95% CI 1.02, 3.83; p = 0.04) abuse is statistically significantly higher, respectively, in women than in men. The level of education is a risk fact for physical abuse (p = 0.02). It has also been shown that singles, people with the income < 233 EUR and people living in urban areas are most often victims of elder abuse and neglect. The results suggest that elder abuse and neglect is a fairly common phenomenon. Our data also provide confirmation of other researches conducted in this area.

Prevention of elder abuse in long-term care facilities

ABSTRACTThe objective of this study is to investigate the types of interventions used to prevent elder abuse in long-term care facilities. Eighteen English and Spanish articles published between 2015 and 2019 were reviewed systematically. The analysis indicated that the focus of proposed strategies has been to prevent staff-to-resident abuse and resident-to-resident aggression. The interventions targeting both staff-to-resident abuse and resident-to-resident aggression include training, changes in organizational and environmental factors, and changes in supervision and control. The results demonstrate the need for a comprehensive approach and creation of relevant social policies in developing these interventions.

PREVENTION OF ELDER ABUSE IN DOMESTIC SETTING: ISLAMIC APPROACH

Elder abuse is a malicious act prevalent in almost all over the world. In searching for solutions, many theories have been introduced and initiated. Despite numerous approaches and research carried out to find ways to prevent elder abuse case, only a few studies have examined the prevention of elder abuse from an Islamic perspective. The aims of this article are to discuss the status of the elderly and the concept of family life in Islam. The article further explores the concept of prevention of elder abuse in a domestic setting from an Islamic perspective. This article applies a qualitative approach. The verses from al-Quran and the Sunnah/ Hadith of the Prophet (PBUH) were gathered and analyzed using content analysis. Based on the analysis, this article found that Islam has laid down a very clear provision pertaining to managing the family relationship by prescribing every individual member in a family the specific rights and obligations. The strict obedience and adherence to these provisions can prevent the problem of abuse of elderly parents by family members.

Thai Elder Abuse Problems and Prevention

The present qualitative research aimed to study: 1) the nature of abuse experienced by Thai elders, 2) the causes of elder abuse, and 3) the prevention of elder abuse. The key informants were the Thai elders and directors of 9 Social Welfare Development Centers for Older Persons and old age homes in Buriram, Chiang Mai, Nakhon Pathom, Pathum Thani, Chonburi, Lopburi, Bangkok, Kanchanaburi, and Phra Nakhon Si Ayutthaya. The in-depth interview technique was applied to collect data. The results suggested that the abuse of older people in Thailand could be categorized into 4 main groups, which were neglect, financial abuse, verbal abuse, and physical assault. The occurrence of elder abuse resulted from the individual factors of elders and abusers such as sons and daughters, sons-in-law, husband’s brothers, and grandchildren. The preventive measures to reduce elder abuse included driving Thai local administrative organizations to play a role in caring the elderly in each community, formulating a specific law on elder abuse, strictly complying with the elder abuse law, and encouraging community volunteers such as care-forthe- elderly-at-home volunteers and village health volunteers to pay attention to and look out for the elderly in communities.

Family-Centred Interventions for Elder Abuse: a Narrative Review.

Information about elder abuse has not only been sparse due to factors such as underreporting or lack of standardized research, but also in defining elder abuse. However elder abuse is commonly understood to be a single/repeated act, or lack of appropriate action, occurring within any relationship which embodies an expectation of trust, which causes harm or distress to elderly individual. In elder abuse, the relationship of trust usually entails the family, as it family members who are noted to be the most likely perpetrators of elder abuse With the increased prevalence of elder abuse in developed countries and a proclivity towards individualized interventions, this narrative review sought to explore family-centered interventions used to address elder abuse by using a RE-AIM framework.

An Exploration of Elder Abuse in a Rural Canadian Community

The Elder Abuse Awareness Committee of Chatham Kent, Ontario employed ten seniors (65 years of age or older) from this rural community to conduct an investigation of the knowledge and prevalence of elder abuse among their peers. The 236 study participants interviewed by the specifically trained elders were predominantly female ranging in age from 55 to over 90. The majority were still living in their own homes, had completed high school or post-secondary education, and reported relatively good health. These attributes predicted a rate of disclosed elder abuse within the lower end of the four to ten percent range typically reported in the literature. However, an incidence rate of 19.1% was reported nearly double the upper end of the range, with 137 separate acts of verbal, emotional, and financial abuse reported by participants to their peers. Formal paid caregivers were identified as the most frequent perpetrators though two thirds of the incidents were not reported to anyone at the time they occurred primarily due to embarrassment, fear, being dependent upon the abuser, or simply not knowing who to tell about the abuse. In the minority of instances when the abuse was reported the most common sources informed were the police, a family physician, or a helping professional in the community. &#x0D; KEYWORDS: Elder abuse, rural, Canada

Associations of Child Maltreatment and Intimate Partner Violence With Elder Abuse in a US Chinese Population

People who have experienced abuse as a child or violence with an intimate partner might have higher odds of being abused again, but this has been insufficiently investigated regarding elder abuse. More conclusive evidence might be critical to assessment and prevention strategies. To examine the associations of child maltreatment and intimate partner violence with elder abuse. Cross-sectional data of 3157 community-dwelling US Chinese older adults (60 years or older) in Chicago, Illinois, were collected during 2011 through 2013. Cases of child maltreatment and intimate partner violence. Cases of elder abuse. Of the 3157 US Chinese older adults included in the study, 1328 (42.1%) were men, and the mean (SD) age was 72.8 (8.3) years. The prevalence of elder abuse, child maltreatment, and intimate partner violence in the cohort was 15.2%, 11.4%, and 6.5%, respectively. After adjusting for sociodemographic variables, health status, quality of life, and health change, individuals reporting child maltreatment had increased odds of intimate partner violence (13.4% vs 5.6%; adjusted odds ratio [aOR], 2.57; 95% CI, 1.78-3.71) and elder abuse (25.2% vs 13.8%; aOR, 2.08; 95% CI, 1.57-2.75) than those not reporting child maltreatment. Individuals reporting intimate partner violence had increased odds of elder abuse than those not reporting intimate partner violence (48.8% vs 12.9%; aOR, 5.53; 95% CI, 4.01-7.64). Prior abuse across major lifespan stages is associated with higher odds of elder abuse. Health care professionals should be more aware of the possibility of abuse when there is a known history of violence in a patient and consider the cumulative effect of violence among those exposed to elder abuse.

MP34: Elder abuse in the emergency department: a systematic scoping review

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

Elder abuse among residents of Shivamogga: a cross sectional study

Background: As per the WHO estimates the global population of people aged 60 years and above will increase from 900 million in 2015 to about 2 billion in 2050. Abuse of elderly has become a problem even in India. Due to social taboo, the elder abuse at community setting is usually not reported. Even though elder abuse is an important public health problem, very little is known about the extent of abuse especially in developing countries.Methods: A community based cross-sectional study was conducted in Shivamogga. A total of 200 elderly persons were interviewed using a pretested semi structured questionnaire. The person showing suggestive score was further asked about type of abuse and perpetrator of mistreatment.Results: Our study showed total prevalence of elder abuse in the community to be 24%. The extent of abuse was more among females especially the housewives. The most common type of abuse was verbal abuse followed by psychological abuse. Son was the common perpetrator of mistreatment.Conclusions: Elder abuse is much prevalent in the community. There is a need for further studies to generalise the findings.

Prevalence of Elder Abuse and its Association with Psychiatric Morbidity in a Rural Setting.

Aim:The aim of this study was to evaluate the prevalence of elder abuse in a rural setting. In addition, the study aimed to evaluate the association of elder abuse with psychiatric morbidity and demographic factors.Methodology:A total of 125 elderly (age ≥55 years) were evaluated for psychiatric diagnosis as per the International Classification of Diseases, 10th revision (ICD-10) criteria by the qualified psychiatrist and were evaluated on Vulnerability to Abuse Screening Scale for elder abuse.Results:More than half (58.4%) of the participants had one psychiatric disorder, with depression being the most common. Elder abuse was seen in more than one-third (41.6%) of the study participants. Those with psychiatric morbidity had significantly higher prevalence of abuse. None of the demographic factors was associated with abuse.Conclusion:Elder abuse is highly prevalent in rural setting, especially among those with psychiatric morbidity.Implications:Considering the high prevalence of elder abuse, there is an urgent need to address the problem. Public awareness, education, and sensitization of people toward the abuse are need of the day.

Assessment Guideline for Elder Domestic Violence (AGED)

Introduction: Violence against the elderly is a complex multidisciplinary social problem that requires cooperation between institutions and professionals. World Health Organization [1] defines this kind of violence as a single or repeated action, or the absence of an appropriate action, arising in the context of a relationship where there is an expectation of trust that causes suffering or harm to an elderly person. Occurs through several behaviors involving psychological, physical, sexual, financial violence, neglect and self-neglect [2]. In Portugal it is possible to identify a small number of studies about elder abuse, only about general prevalence and about some subtypes of elder abuse [3], but not about risk assessment. According to Portuguese Association for Victims Support, between 2013 and 2015, were recorded 2.063 processes of elderly people were victims of violence [4]. The main goal of this research is to contribute for the definition and prevalence of elder abuse in Portugal, identifying familiar, social and cultural dynamics and develop an integrative risk management protocol that will allow the elder abuse risk assessment. Materials and methods: In order to assist the victims’ support professionals and the criminal justice system have been developed a new risk assessment tool, called “Assessment Guidelines for Elder Domestic Violence” (AGED). This work is organized in 3 phases/studies: Study I. Elderly abuse prevalence, risk, protective and vulnerability factors study, and checklist variables construction; Study II. Retrospective study of the elder abuse cases reported in the victims support organizations and criminal justice system; Study III. Development of the AGED. All ethical principles have been taken due to the sensitive nature of the data involved. Results: After study 1 and study 2, the results of the development of AGED were composed by five sections/areas: I. Victim’s Risk factors; II. Offender’s Risk Factors; III. External, Contextual and Relational Risk Factors; IV. Victim/Context Protective Factors; and finally, V. Institutional Risk Factors, if applicable. AGED also contemplates the possibility of the evaluator being able to add other additional factors that they consider necessary, contributing to the effectiveness of the measurement of the level of risk of the victim (low, moderate or high) and critical factors. Discussion and conclusions: AGED is developed with the main goal to supporting professionals who work in domestic violence. Scientific community make evident the need for an evidence-based, valid, user-friendly risk assessment tool of elder abuse to support the professionals. This study offers the opportunity to provide professionals specific knowledge, skills, competences and a tool, in order to an effective risk assessment and management of elder abuse, contributing to the efforts for protect victims and prevent the occurrence of future cases.

Prevalence of elder abuse among community-dwelling older adults in Turkey and its associated factors.

This study was performed to determine the prevalence of elder abuse among community-dwelling older adults and its associated risk factors. The sample in this cross-sectional study consisted of 691 older adults. Data were collected with an elder abuse and neglect assessment form, which had been prepared by the researchers in accordance with the literature. Logistic regression analysis was used to identify factors related to subtypes of elder abuse. In this study, 13.6% of the elderly subjects (n = 94) were exposed to at least one instance of abusive behaviour within the last year; emotional abuse was the most frequently occurring type of abuse. Risk factors for abuse were being 75 years old or older (odds ratio (OR) = 1.993, 95% confidence interval (CI): 1.105-3.592), being illiterate (OR = 4.863, 95%CI: 2.809-8.417), lack of own income (OR = 2.189, 95%CI: 1.179-4.064), having bad family relationships (OR = 20.564, 95%CI: 5.453-77.554), and lack of own home (OR = 3.945,; 95%CI: 1.167-13.330). The results of this study showed that abuse was an important problem for the elderly population. Therefore, elderly individuals, especially those who are 75 years old or older, have a low education level, lack their own home, and lack their own income, should be evaluated for abuse.