Abuse and Neglect Experienced by Aging Chinese in Canada

The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification.     

Abuse and neglect experienced by aging chinese in Canada

The traditional values of Chinese culture promote care and respect toward older adults. While it appears to be ironic to discuss issues of abuse and neglect in the Chinese culture, research findings in Chinese societies do indicate the occurrences of such problems. However, little research on the abuse and neglect of older Chinese in Western societies has been available. This study aims to examine the incidence of abuse and neglect and the associated correlates based on data collected from a random sample of 2,272 aging Chinese 55 years and older in seven Canadian cities. The findings show that 4.5% of the participants reported experiencing at least one incident of maltreatment or neglect within the past year. The most common forms of neglect and abuse experienced by the aging Chinese include being scolded, yelled at, treated impolitely all the time, and ridiculed. Close family members such as spouses and sons are those that most commonly maltreat older Chinese. Those who were more likely to report at least one incident of maltreatment or neglect were older adults living with others; they tended to have no education, more access barriers, more chronic illnesses, less favorable mental health, and a higher level of identification with Chinese cultural values. The findings implied that the face value of respect and care received by older people in Chinese culture should not be taken for granted. Culturally appropriate precautionary steps are needed for prevention and early problem identification.     

Cultural and Ethical Issues in Korea's Recent Elder Abuse Reporting System

The primary purpose of this article is to examine the relevance of cultural values, such as familism and individualism, that influence public policy implementation processes for protecting older adults in Korea and the United States. The secondary purpose is to identify ethical dilemmas and policy implications for effectively implementing the recently developed public law designed to protect vulnerable older adults in Korea. This article discusses both similarities and differences found in the two countries' elder abuse reporting systems and the service delivery systems for protecting older adults at risk of abuse and neglect.     

Public Opinion on Mandatory Reporting of Abuse and/or Neglect of Older Adults in Manitoba,Canada

This article discusses the results of a survey administered as part of a study titled, “Legislation and Service Provision Regarding Abuse and/or Neglect of Older Adults in Manitoba.” Public views of mandatory reporting and knowledge of legislation were investigated in the case where an older adult is living at risk of abuse and/or neglect in Manitoba, Canada. The survey data demonstrate that older respondents stated that mandatory reporting was not always preferable, except when an older adult was clearly diagnosed as incompetent and, even with no evidence, thought to be at risk. With less awareness of the topic in general, and with less contact with older adults, younger adults had much stronger views in support of mandatory reporting in all cases. Little knowledge and awareness of legislation existed in all age groups, although older adults knew more about such abuse and/or neglect than younger adults. Given the projected increase of older adults in Canada in the next 20 years, it is critical that the prevention of abuse and/or neglect and protection of older adults be addressed.     

‘I walk from trouble’: exploring safeguards with adults with intellectual disabilities – an Australian qualitative study

People living with intellectual disabilities have a right to be safe from abuse and neglect and have a right to be included in the decision-making process determining safeguards that will affect them. However, the research evidence that could underpin good professional practice in terms of co-producing safeguards against abuse and neglect directly involving people with intellectual disabilities is largely missing. This article, based on qualitative research involving semi-structured interviews conducted during the first half of 2014, seeks to strengthen this evidence base. It reports on the prevention strategies identified by 12 adults with intellectual disabilities about how to stay safe and compares these with the findings of similar research. The article suggests that a comprehensive safeguarding approach comprises both life course-focused safety training and access to assisted decision-making. The article argues that given the plethora of risk situations encountered by people living with intellectual disability, assisted decision-making should take the form of a co-creation process that is situation specific and grounded in everyday life.     

The neglected elder: a family systems approach.

Abuse and neglect of older adults is largely an invisible problem. Those who are vulnerable are often hidden from the public eye. Troubled families characteristically maintain an isolated existence and, therefore, the mistreatment of elders can occur without the knowledge of neighbors or interested community members. Factors that operate to keep the problem hidden include society's emphasis on family privacy, the victim's unwillingness or inability to report the problem, stereotypes about the aged, and denial (Quinn, 1986). Although the problem of abuse and neglect of elders is not as prevalent as child maltreatment, it is a significant societal problem in need of increased public awareness. This article will focus on the treatment of elder neglect within the context of the family.     

The Prevalence of Elder Abuse and Neglect of Older Adults Who Access Health and Social Services in London,Ontario, Canada

It is anticipated that older adults who seek professional intervention may be more at risk of abuse and neglect. This paper reports a prevalence study that focused on older adults who accessed health and social service organizations over a three month period. Respondents ranged from 55 to 100 with a mean age of 73.8 years. Over a quarter of the sample reported at least one form of violence during their lifespan. Higher prevalence rates than in the general population were found. Attempted material abuse was most frequent, followed by verbal abuse, physical abuse, unintentional neglect, actual material abuse, and intentional neglect.     

Family Members' Reports of Abuse in Michigan Nursing Homes

The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.     

Long-Term Services and Supports for Older Adults: A Review of Home and Community-Based Services Versus Institutional Care

Despite a shift from institutional services toward more home and community-based services (HCBS) for older adults who need long-term services and supports (LTSS), the effects of HCBS have yet to be adequately synthesized in the literature. This review of literature from 1995 to 2012 compares the outcome trajectories of older adults served through HCBS (including assisted living [AL]) and in nursing homes (NHs) for physical function, cognition, mental health, mortality, use of acute care, and associated harms (e.g., accidents, abuse, and neglect) and costs. NH and AL residents did not differ in physical function, cognition, mental health, and mortality outcomes. The differences in harms between HCBS recipients and NH residents were mixed. Evidence was insufficient for cost comparisons. More and better research is needed to draw robust conclusions about how the service setting influences the outcomes and costs of LTSS for older adults. Future research should address the numerous methodological challenges present in this field of research and should emphasize studies evaluating the effectiveness of HCBS.     

Elder abuse and neglect

Elder abuse and neglect is a critical health care issue that must be brought to the attention of health care providers and older adults' family members. Adults older than 65 who live at home or in long-term care facilities may be at risk for abuse. Nurses should be aware of the causes, screening questions, symptoms of abuse, and resources in the community. Armed with information and a better understanding about the issue, nurses can minimize the devastating effects of abuse on older adults and their families.     

Assessment of financial decision making: an informant scale

Older adults with cognitive impairment are a population at great risk for financial exploitation. At-risk older adults often have difficulty reporting on their own financial abilities. Collecting information from trusted others is vital for professionals investigating the financial exploitation older adults. There are few reliable, valid, and standardized informant-report measures of financial capacity, and none that assess decisional abilities for an ongoing, real-world financial transaction. The present study sought to examine the psychometric properties of a new informant-report scale of financial decisional abilities in older adults. One hundred fifty participants were recruited to complete the Family and Friends and Interview regarding a known older adult’s financial decisional abilities. A factor analysis identified two subscales. The full scale had adequate sensitivity and specificity to detect an informant’s current concerns regarding financial exploitation. The Family and Friends Scale is a useful tool for collecting informant-report regarding an older adult’s ability to make financial transactions.     

Intimate partner victimization among adults aged 60 and older: an analysis of the 1999 and 2004 General Social Survey

Accounts in both the scientific literature and popular media have brought about increased recognition of the reality of elder abuse. However, relatively little work has examined intimate partner victimization with respect to older adults. In this study, weighted data from cycles 13 (1999) and 18 (2004) of the General Social Survey are pooled to examine how factors uniquely influence the prevalence and risk of emotional, financial, and physical abuse among adults aged 60 and over. Considerations regarding elder abuse committed by spouses, versus abuse of older adults more broadly (by their children and other adults), are also discussed.     

Gendered policies and practices that increase older men's risk of elder mistreatment

We aim to detail some of the ways that social policy and gendered practices put older men at risk of elder mistreatment. Research on the abuse and neglect that older adults experience has often focused on the characteristics of the victims and the dynamics within families, emphasizing factors such as the likelihood of an intergenerational cycle of violence, substance abuse and dependency, and older men's financial status as key risks in elder abuse. The effect on men from this type of analysis is that elder mistreatment remains an individual or family problem rather than being viewed as a larger societal concern. This article challenges the individualistic focus by outlining the importance of societal forces affecting older men's risk of mistreatment.     

Physical Abuse of Older Adults in Nursing Homes: A Random Sample Survey of Adults With an Elderly Family Member in a Nursing Home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

Physical abuse of older adults in nursing homes: a random sample survey of adults with an elderly family member in a nursing home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

Powerlessness and Abuse and Neglect of Older Adults

ABSTRACT

This article is a qualitative study which addresses the interacting relationship between the environmental context of care giving and abuse and neglect of older adults. These are examined through a thematic content analysis of risk factors identified in sixteen ‘in depth’ interviews of abused and neglected victims including two of their abusers. The interviews provide a portrait of their past and present situations, their roles and relationships and the process through which the interviewees move into their described process of powerlessness.

The interviewees are analysed through a critical, systemic, ecological analysis of the historical, gender and cultural perspectives of the interviewees. Through the relationships of the victims and their abusers in the macro, meso, exo and micro systems, questions are raised about the growing debate regarding changes in family patterns and demographics that affect how societies define the provision of care to their dependent adults. They demonstrate that violence is produced by complex interacting systems and significant events, that impact on the life courses of some older adults and some care givers leading them into powerless positions and resulting in abuse and neglect.     

Elder mistreatment in urban India: a community based study

This study examined the extent and correlates of elder mistreatment among 400 community dwelling older adults aged 65 and above in Chennai, India. The prevalence rate of mistreatment was 14%. Chronic verbal abuse was the most common followed by financial abuse and the rate of physical abuse and neglect was similar. Among the mistreated, exactly half of them had experienced more than one type of mistreatment (multifaceted-mistreatment). With the exception of financial abuse, a significantly greater number of women experienced verbal and physical abuse as well as neglect compared to men. Adult children, daughters-in-law, spouses, and sons-in-law were the prominent perpetrators. The mistreated older adults were more depressed and less satisfied with life than those who were not mistreated. Logistic regression analysis revealed gender, social support, and subjective rating of physical health as significant factors associated with abuse.     

The impact of childhood abuse and neglect on adult mental health: a prospective study

This paper examines the impact of three types of victimization in childhood--sexual abuse, physical abuse, and neglect--on lifetime measures of mental health among adults. In contrast to research that relies on retrospective recall of childhood victimization, this work uses a prospective sample gathered from records of documented court cases of childhood abuse and neglect in a midwestern city around 1970. These subjects were interviewed about twenty years later. In addition, this research compares outcomes of the 641 members of the abuse and neglect group with a matched control group of 510 persons who did not have documented cases of abuse or neglect. The results indicate that men who were abused and neglected as children have more dysthymia and antisocial personality disorder as adults than matched controls, but they did not have more alcohol problems. Abused and neglected women report more symptoms of dysthymia, antisocial personality disorder, and alcohol problems than controls. After controlling for stressful life events, however, childhood victimization had little direct impact on any lifetime mental health outcome. This research indicates the importance of adopting an approach that places childhood victimization in the context of other life stressors and of prospective changes over the life course.     

Abuse among rural mentally ill.

Each American adult has the right to make individual decisions. These decisions include preferences in lifestyle, occupation, diet, housing, health-care treatment, and allocations of financial resources. The right to autonomous decision making is not limited to young or middle-aged adults, nor is it limited to those occasions during which the individual has the capacity to personally participate in the decisions (US Congress, 1987). The right also applies to elderly, incapacitated, mentally ill, or dependent adults. Because of this autonomy, no individual must suffer physical, psychological, or financial coercion. Based on these rights, all 50 states have enacted statutes to protect dependent adults and to authorize government intervention in cases of suspected adult abuse (Hunzeker, 1990). Iowa is one of the states that has enacted dependent adult abuse legislation, and in 1988, health-care practitioners in Iowa became mandatory reporters of adult abuse (Iowa Code, 1992). As mandatory reporters, all nurses who treat, counsel, examine, or attend dependent adults must observe the physical status and interpersonal relationships of their clients and significant others to identify potential conflict or injury. Categories of abuse recognized by the Iowa law include physical, sexual, and financial abuse, neglect by self, and neglect by another (Figure).     

Gendered Policies and Practices that Increase Older Men's Risk of Elder Mistreatment

SUMMARY

We aim to detail some of the ways that social policy and gendered practices put older men at risk of elder mistreatment. Research on the abuse and neglect that older adults experience has often focused on the characteristics of the victims and the dynamics within families, emphasizing factors such as the likelihood of an intergenerational cycle of violence, substance abuse and dependency, and older men's financial status as key risks in elder abuse. The effect on men from this type of analysis is that elder mistreatment remains an individual or family problem rather than being viewed as a larger societal concern. This article challenges the individualistic focus by outlining the importance of societal forces affecting older men's risk of mistreatment.