The Impact of Elder Abuse Education on Young Adults

The present study examined the effectiveness of educational interventions in altering tolerance for and behavioral intentions of elder abuse among college student young adults. Participants were 225 undergraduates who were assigned to one of four educational groups: Elder Abuse Education, Aging Education, Family Education, and a Pre- and Posttest only condition. While the Elder Abuse Education group reported less tolerance and intentions for elder abuse compared to the other groups at the immediate posttest, a decrement in such positive changes at 1-month follow-up was observed in such persons. These mixed findings suggest that while specific interventions may reduce elder abuse tolerance, supplemental educational efforts over time may be necessary to maintain intervention-specific gains in intentions and behaviors particular to elder abuse.     

Elder Abuse Telephone Screen Reliability and Validity

Purposes: (a) To identify reliable and valid questions that identify elder abuse, (b) to assess the reliability and validity of extant self-reported elder abuse screens in a high-risk elderly population, and (c) to describe difficulties of completing and interpreting screens in a high-need elderly population. Design and Methods: All elders referred to research-trained social workers in a community service agency were asked to participate. Of the 70 elders asked, 49 participated, 44 completed the first questionnaire, and 32 completed the duplicate second questionnaire. A research assistant administered the telephone questionnaires. Results: Twenty-nine (42%) persons were judged abused, 12 (17%) had abuse reported, and 4 (6%) had abuse substantiated. The elder abuse screen instruments were not found to be predictive of assessed abuse or as predictors of reported abuse; the measures tended toward being inversely predictive. Two questions regarding harm and taking of belongings were significantly different for the assessed abused group. Implications: In this small group of high-need community-dwelling elders, the screens were not effective in discriminating between abused and nonabused groups. Better instruments are needed to assess for elder abuse.     

Multidisciplinary Team Legislative Language Associated With Elder Abuse Investigations

Professionals from different disciplines providing care and services to persons at risk for or victims of elder abuse have formed various multidisciplinary teams (MDTs). The purpose of the study was to identify the adult protective services–related statutory trends in presence of MDT content and to determine the association of MDT legislation on the rates of reported, investigated, and substantiated domestic elder abuse. Aggregate reports of elder abuse and state statutes for 1999 and 2007 were retrieved from 50 states and the District of Columbia. Statutes of eight states in 2000 and nine in 2008 included text about MDTs. In 2007, investigation rates for those states having MDT text in the statutes were significantly higher than those states without. The incidence of MDTs in the country is unknown. Legislative text is but one factor associated with differences in elder abuse report, investigation, or substantiation rates.     

Protecting Older Americans: A History of Federal Action on Elder Abuse,Neglect, and Exploitation

ABSTRACT

Congressional hearings on elder abuse began over a quarter century ago. However, federal legislative and departmental activity for addressing the problem has been slow and lacks coordination and comprehensiveness. In addition, federal funding to combat elder abuse represents only a small percentage of that spent on such other abused populations as children and women. The barriers and challenges to addressing elder abuse are identified along with existing programs at the federal level. The article concludes with a discussion of state and local initiatives which show promise for effectively preventing or treating this problem.     

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.     

Longitudinal Prevalence and Correlates of Elder Mistreatment Among Older Adults Receiving Home Visiting Nursing

The objectives of this study were to identify elder mistreatment (EM) prevalence among a cohort of older adults receiving visiting nurse care in their homes, determine EM subtypes, and identify factors associated with EM. EM data were collected by nurses during monthly home visits for up to 24 months. It took the nurses a mean of 10.5 visits to discern EM. Fifty-four (7.4%) of 724 patients were identified as mistreated, of which 33 had enough information to subtype the EM. Of these 33, 27 were victims of neglect, 16 of psychological abuse, and 10 of financial exploitation, and 17 suffered more than one type. Among the entire sample, 11 variables were positively correlated with EM presence. Nurses visiting older adults in their homes should be aware that their patients are, as a group, vulnerable to EM, and that the factors identified here may be specific markers of greater risk.     

Elder Abuse Research: A Systematic Review

The purpose of this research was to provide a systematic review of, and assign an evidence grade to, the research articles on elder abuse. Sixteen health care and criminal justice literature databases were searched. Publications were reviewed by at least two independent readers who graded each from A (evidence of well-designed meta-analysis) to D (evidence from expert opinion or multiple case reports) on the quality of the evidence gained from the research. Of 6,676 titles identified in the search, 1,700 publications met inclusion criteria; omitting duplicates, 590 publications were annotated and graded.     

Correlates of Susceptibility to Scams in Older Adults Without Dementia

This study examined correlates of susceptibility to scams in 639 community-dwelling older adults without dementia from a cohort study of aging. Regression models adjusted for age, sex, education, and income were used to examine associations between susceptibility to scams, measured by a five-item self-report measure, and a number of potential correlates. Susceptibility was positively associated with age and negatively associated with income, cognition, psychological well-being, social support, and literacy. Fully adjusted models indicated that older age and lower levels of cognitive function, decreased psychological well-being, and lower literacy in particular may be markers of susceptibility to financial victimization in old age.     

Mapping Elder Mistreatment Cases: Interactions Between Mistreatment,Dementia, Service Utilization,Access to Services,and Disadvantage

Typical explanations of elder mistreatment have focused on individual-level models. The current study adds to the literature by considering the neighborhood context in which reports of elder mistreatment are made to protective services. Using geographic information system software, the distribution of 751 adult protective services (APS) reports from three cities in southeastern Virginia is analyzed. Results suggest that Alzheimer's cases are distributed differentially across cities and that in one city, reports primarily come from disadvantaged areas. The results also suggest that clients from disadvantaged areas are more likely to refuse services. Implications for policy, theory, and future research are provided.     

Mapping the Elder Mistreatment Iceberg: U.S. Hospitalizations With Elder Abuse and Neglect Diagnoses

Purpose: This study describes U.S. hospitalizations with diagnostic codes indicating elder mistreatment (EM). Method: Using the 2003 Nationwide Inpatient Sample (NIS) of the Healthcare Costs and Utilization Project (HCUP), inpatient stays coded with diagnoses of adult abuse and/or neglect are compared with stays of other hospitalized adults age 60 and older. Results: Few hospitalizations (< 0.02%) were coded with EM diagnoses in 2003. Compared to other hospitalizations of older adults, patients with EM codes were twice as likely to be women (OR = 2.12, 95% CI = 1.63–2.75), significantly more likely to be emergency department admissions (78.0% vs. 56.8%, p < .0001), and, on average, more likely to have longer stays (7.0 vs. 5.6 days, p = 0.01). Patients with EM codes were also three to four times more likely to be discharged to a facility such as a nursing home rather than “routinely” discharged (i.e., to home or self-care) (OR = 3.66, 95% CI = 2.92–4.59). Elder mistreatment–coded hospitalizations compared to all other hospitalizations had on average lower total charges ($21,479 vs. $25,127, p < .001), with neglect cases having the highest charges in 2003 ($29,389). Implications: Knowledge about EM is often likened to the “tip of the iceberg.” Our study contributes to “mapping the EM iceberg”; however, findings based on diagnostic codes are limited and should not be used to minimize the problem of EM. With the so-called graying of America, training is needed in recognizing EM along with research to improve our nation's response to the mistreatment of our elderly population.     

Elder Abuse in Chinese Populations: A Global Review

This review focuses on the epidemiology of elder abuse in the global Chinese population with respect to its prevalence, risk factors, and consequences, as well as the perceptions of elder abuse. Evidence revealed that elder abuse and its subtypes are common among the global Chinese population with prevalence ranging from 0.2% to 64%. Younger age, lower income levels, depression, cognitive impairment, and lack of social support were consistently associated with self-reported elder abuse. Caregiver burden was a constant risk factor for the proclivity to elder abuse by caregivers. The adverse health outcomes of elder abuse included suicidal ideation and psychological stress. Some primary research gaps exist: such as, lack of consistency in measurements and recall periods, insufficient studies on the causal relationships between potential risk factors and elder abuse, consequences of elder abuse, and possible interventions. In order to reduce the risk of elder abuse in the global Chinese population, collaboration is encouraged among researchers, health care professionals, social service providers, and policy makers.     

Essential Data Elements for Reporters of Elder Abuse

Most states' adult or elder protective services and aging agency personnel prepare annual reports about their protective services. These reports vary by state and have different terms for the reporter of abuse. Reviewing annual reports from 46 states and the District of Columbia, 248 different terms were used for the reporter of abuse. To develop essential data elements for reporters of abuse, a literature search, a compilation of state elder abuse annual report list of abuse reporters, and a sorting exercise were conducted. Eleven terms were recommended for the different reporters of abuse, encouraging all state administrators and caseworkers to reach consensus to standardize the language.     

A Systematic Review of Interventions for Elder Abuse

The purpose of this study was to use rigorous systematic review methods to summarize the effectiveness of interventions for elder abuse. Only eight studies met our inclusion criteria. Evidence regarding the recurrence of abuse following intervention was limited, but the interventions for which this outcome was reported failed to reduce, and may have even increased, the likelihood of recurrence. Elder abuse interventions had no significant effect on case resolution and at-risk caregiver outcomes, and had mixed results regarding professional knowledge and behavior related to elder abuse. The included studies had important methodological limitations that limit our ability to draw conclusions about the effectiveness of these interventions.     

Addressing Elder Abuse: The Waterloo Restorative Justice Approach to Elder Abuse Project

The Community Care Access Centre (CCAC) of Waterloo Region, in partnership with a number of other social service agencies, designed and implemented a restorative justice model applicable to older adults who have been abused by an individual in a position of trust. The project was very successful in building partnerships, as many community agencies came together to deal with the problem of elder abuse. The program also raised the profile of elder abuse in the community. However, despite intensive efforts, referrals to the restorative justice program were quite low. Because of this, the program moved to a new organizational model, the Elder Abuse Response Team (EART), which has retained the guiding philosophy of restorative justice but has broadened the mandate. The team has evolved into a conflict management system that has multiple points of entry for cases and multiple options for dealing with elder abuse. The team has developed a broad range of community partners who can facilitate referrals to the EART and also can help to provide an individualized response to each case. The transition to the EART has been successful, and the number of referrals has increased significantly.     

Times of Transition: Elder Abuse and Neglect in Israel

ABSTRACT

The present paper addresses the advancement of research, policies, legislation, and practice experiences designed to deal with the phenomenon of elder abuse and neglect in Israel in times of transition. The paper presents a short overview of the demographic scene, reflecting population characteristics and needs that impact care giving as well as elder abuse and neglect. The developments of scientific knowledge and its accumulation, especially the empirical data from the first national survey on elder abuse and neglect are discussed. Further, legislative developments relating to four generational laws and the advancement of policies and innovative practice experiences are described and analyzed. Finally, future challenges in the field are identified.     

Russian Perspectives on Elder Abuse: An Exploratory Study

ABSTRACT

The purpose of this exploratory study was to analyze Russian perceptions of elder abuse as reflected in their examples of abusive behavior from an adult child to an aging parent. Also of interest was the possibility of gender differences in the Russian perspectives on elder abuse. The convenience sample consisted of 21 Russian participants (10 males, 10 females, and one without gender identified), who provided examples of extreme, moderate, and mild abuse from an adult child towards an aging parent. Most examples of extreme abuse were forms of physical violence. Typical examples of moderate abuse were instances of psychological aggression–particularly verbal aggression–and neglect. The most common examples of mild abuse were verbal aggression and neglect. One-way analyses of variance revealed statistically significant gender differences in the number of references to psychological aggression in general and to verbal aggression in particular in the examples of moderate abuse, with females giving more examples than males.     

Seniors' Self-Administration of the Elder Abuse Suspicion Index (EASI): A Feasibility Study

This study explored the feasibility of seniors aged 65 and over with MMSE ≥24 completing the EASI-sa, a self-administrable version of the Elder Abuse Suspicion Index (EASI). A convenience sample of 210 was stratified by age, sex, and language (English and French). All completed the EASI-sa within an estimated 5 minutes, 82.9% within 2 minutes. Completion time decreased with higher education, but was not affected by age, sex, language, or measured physical or mental health. No questions went unanswered; no words were poorly understood or discomforting. The EASI-sa completion was associated with a significantly increased understanding about elder abuse (p < 0.0001).     

Notes on Newspaper Accounts of Male Elder Abuse

SUMMARY

Law enforcement press releases and other print-media miscellany detailing accounts of male elder abuse involving insurance fraud, false allegations by perpetrators, and abuse inflicted by care-givers, spawned interest in a more systematic review. That review was accomplished principally by accessing two search engines, with news articles from 1986 to the present. A review of these media accounts transformed the initial “insurance fraud” category into a broader one classified as “economic exploitation.” That same review also resulted in three distinctive categories of caregiver abuse. This article provides abbreviated case accounts within each category, and concludes with brief notes on several themes derived from the reported accounts.     

Definitions of Elder Abuse in an Italian Sample

ABSTRACT

The purpose of this exploratory qualitative study was to analyze definitions of elder abuse in an Italian convenience sample. Fifty-three Italian participants (15 males, 38 females) provided examples of mild, moderate, and extreme mistreatment of older individuals by their adult children. Analyses were conducted to identify frequently mentioned types of abuse and to determine how severe they were judged to be. Also examined was the extent to which gender and age contributed to response patterns. Most examples of extreme elder abuse made reference to physical abuse and neglect, while references to psychological aggression and neglect predominated as examples of moderate and mild abuse. Examples of neglect appeared with equal frequency at all levels of severity, but physical aggression was mentioned primarily as a form of extreme abuse, and psychological aggression was mentioned more frequently in examples of moderate and mild abuse. The most frequently identified types of specific abuse were abandonment, verbal abuse, emotional abuse, and psychological neglect. When giving examples of extreme abuse, females mentioned more instances of financial exploitation than males. They also gave more examples of verbal aggression and lack of respect as instances of moderate abuse and behaviors reflecting power or control as examples of mild abuse. A statistically significant negative relationship was found between age and the number of examples given of particular types of mistreatment at each of the levels of severity of abuse.