Experience of elder abuse among older Korean immigrants

ABSTRACT

Studies on the scope and nature of Asian American elder abuse conducted with older immigrants are extremely limited. The overall purpose of this study was to examine the extent and type of elder abuse among older Korean immigrants, and to investigate critical predictors of elder abuse in this population. The sample consisted of 200 older Korean immigrants aged 60 to 90 years who resided in Los Angeles County in 2008. One of the key findings indicated that 58.3% of respondents experienced one or more types of elder abuse. Logistic regression indicated that the victims’ health status and educational level were statistically significant predictors of the likelihood of experiencing abuse. The present study, although limited in sample size, measures, sampling methods, and population representation, has contributed to this important area of knowledge. It is recommended that future studies conduct research on elder abuse with more representative national samples that can measure the extent of abuse and neglect more accurately.     

Exploring Definitions of Financial Abuse in Elderly Korean Immigrants: The Contribution of Traditional Cultural Values

The purpose of this study is to explore the cultural definitions of financial abuse from the perspective of 124 elderly Korean immigrants and to examine the role of traditional cultural values in their definitions by using a mixed methods approach. The qualitative analysis generated four themes relevant to definition of financial abuse. A binary logistic regression indicated that those with stronger cultural adherence to traditional values had higher odds of providing culture-based definitions of financial abuse. Education is needed for health professionals, social service providers, and adult protective workers to increase their understanding of culture-specific experiences of financial abuse among ethnic minority elders.     

Cambodian Refugee Families: Impacts of Immigration-Related Stressors on Intergenerational Relationships

The purpose of this study was to elucidate Cambodian refugees’ perceptions of immigration-related stressors and their impacts on intergenerational relations during the processes of immigration and settlement. We used narrative analysis to evoke older immigrants’ voices as they transitioned to the United States. Thirty-one Cambodian immigrants were interviewed using open-ended interview guides informed by ethnographic tenets of data collection. Participants expressed (a) changes in family structure and elder isolation and (b) intergenerational ambivalence and elder’s dependence on adult children as products of immigration-related stressors. Implications of these results for refugee and immigrant mental health research are discussed.     

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.     

Tolerance of Elder Abuse and Attitudes Toward Third-Party Intervention Among African American,Korean American,and White Elderly

SUMMARY

Studies have found that professionals and the lay public differ consistently from one another in the ways in which they perceive elder abuse. A potential variable that may explain this observed difference is cultural norms among ethnic groups. Using 18 statements, this study examined similarities and differences among elderly from three ethnic groups in their tolerance for potential elder abuse, perceptions regarding perpetrators and the causes of elder abuse, and attitudes toward third-party intervention and reporting of elder abuse to the authorities. Results suggest that while African American and White elderly are remarkably similar in their responses to most statements, Korean American elderly differed significantly from the other two groups in their tolerance for medical mistreatment, financial exploitation and neglect, perceptions of causes, and attitudes toward reporting elder abuse. These findings have implications for understanding potential barriers to preventive outreach efforts, investigation, and intervention in cases of elder abuse in a culturally diverse community.     

Korean American Elderly's Knowledge and Perceptions of Elder Abuse

ABSTRACT

“This study examines Korean American elders” perceptions of elder abuse and its perpetrators and explores cultural, as well as non-cultural influences on such perceptions. Face-to-face interviews were conducted with 100 elderly Korean Americans, 60 years of age or older, residing in Los Angeles County. Respondents reported 46 abuse cases, categorized into the following six types: financial abuse (36%), psychological abuse (24%), culturally specific abuse (17%), neglect (15%), physical abuse (4%), and other (4%). Most respondents identified elder abuse in terms of abrogation of filial piety, suggesting the centrality of “children” in Korean American elders⁵ lives and well-being. Findings demonstrate that employing a uniform definition of elder abuse across all cultures and ethnic groups without attending to the cultural and subjective aspects of a given situation may result in missing problems and needs identified as important by the elderly themselves. Implications for social work practice and program development are discussed.     

The Legal Response to Elder Abuse and Neglect

ABSTRACT

The United States legal system, both civil and criminal, has been underutilised in dealing with elder abuse and neglect. Social service and health practitioners have been unfamiliar with the language and procedures in legal settings. Legal remedies have been obscure or inadequate to address the problems. When elder abuse and neglect were first “discovered” in the late 1970s, efforts focused on safeguarding the victim through civil justice remedies, i.e., guardianships, mandatory reporting laws, adult protective services. The criminal justice system also became involved in order to hold the alleged wrongdoer accountable. Specialised units have developed in police departments and prosecutor offices to deal with the criminal behavior. New laws are providing more flexibility for the legal system, both civil and criminal. A multidisciplinary approach to elder abuse and neglect is needed because abused or neglected elders are frequently involved with many agencies. Attention to the legal aspects of the issue are apparent in the Summit Conference held by the National Center on Elder Abuse in 2001 and the development of the Elder Justice Act which was introduced into the U.S. Senate in 2003.     

Preventing Elder Abuse and Neglect Through Advance Legal Planning

Recent trends in adult protective service literature and legislation reflect a growing interest in advance planning to prevent elder abuse and neglect. This article provides basic planning guidelines and discusses in general terms the most important legal planning documents: the living will, the durable power of attorney for health care, the durable power of attorney, and the last will and testament. It also presents in general terms potential legal, medical, and financial planning tools that may function as alternatives to guardianship. Both the benefits and limitation of these documents and tools are discussed.     

The devil is in the details: self-neglect in Australia

Although elder self-neglect is of significant concern to adult protective service (APS) workers in the United States, minimal research has been conducted on this topic in Australia. Using qualitative research methods, this article examines how 24 Australian professionals understand situations of self-neglect. Unlike in the United States, where the term self-neglect is used in a broad and all-encompassing manner, participants in this research differentiated among self-neglect (the neglect of self), squalor (extreme neglect of environment), collecting (the accumulation of certain objects), and hoarding (the inability to throw objects away). It is argued that separating out the various behaviors that are classified under the broad umbrella of neglect can be useful in fostering reflective interventions in these situations.     

Implicit Theories of Elder Abuse in a Sample of European-American Descent

ABSTRACT

The purpose of this exploratory study was to examine implicit theories of elder abuse in a sample of men and women of European-American descent. Seventy-six participants, ranging in age from 17 to 79, filled out an open-ended qualitative survey asking them to give examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive in the context of an adult child-older adult parent dyad. Results indicated that various types of physical aggression and neglect (with an emphasis on physical neglect) were the most common examples of extreme abuse. Psychological aggression was the most common example of moderate abuse, and forms of psychological abuse and neglect were the most frequent examples of mild abuse. Gender differences were found, with females more often mentioning examples of neglect than males. Sexual and economic abuse did not seem to be commonly identified forms of mistreatment in implicit theories of elder abuse.     

Senator Breaux's Elder Justice Proposal of 2002 Executive Summary

ABSTRACT

The purpose of this exploratory study was to investigate an English sample's perceptions on elder abuse, inflicted by adult children against their aging parents. Fifty participants (14 males, 46 females) provided examples of extreme, moderate, and mild elder abuse. As examples of extreme abuse, most participants mentioned neglect and physical aggression. Various forms of neglect and psychological abuse were their most common examples of moderate and mild abuse. References to physical aggression appeared most often as examples of extreme abuse rather than of moderate or mild abuse. Within these main categories, the specific subtypes most frequently mentioned by the sample included physical neglect, psychological neglect, verbal abuse, and deprivation. More females than males provided examples of financial abuse and physical neglect. Females were also more likely than males to list psychological neglect as an extreme form of abuse and disrespect as a form of mild abuse. At the moderate level, males referred to abuse relating to power more often than females. A positive relationship was found between age and the number of examples of physical neglect given at the moderate level and the number of examples of emotional abuse given at the mild level.     

Financial Exploitation of Elders: Analysis of Risk Factors Based on County Adult Protective Services Data

ABSTRACT

While all types of elder abuse and neglect are serious problems affecting thousands of vulnerable elders, financial exploitation has especially serious implications for the victims’ economic well-being and quality of life, because it may deprive the victims of their life savings and assets and thus their economic foundation for independence. In this study, data from the case files of a county adult protective services program were analyzed to identify risk factors associated with financial exploitation of and mismanagement by elders. The elders who were financially exploited were, on average, in their late seventies and tended to be cognitively impaired. We also found that owner-occupant elders were especially vulnerable to exploitation and that financial mismanagement and exploitation often occurred together. Approximately 60% of the perpetrators were relatives of the elderly victims, mostly their adult children, and the rest of the perpetrators were not related to the victims. Implications for interventions include case management for frail, cognitively impaired elders; preventive educational programs; and ongoing collaboration among adult protective services, financial institutions, and law enforcement agencies.     

Analyses of the Concepts of Elder Mistreatment:

The lack of precise and accepted definitions of elder neglect and elder abuse impairs identification of these two distinct but related forms of elder mistreatment and prevents systematic comparison of research findings. As professional attention to elder mistreatment is relatively new, continued progress in various areas is warranted-research, theory development, diagnostic instruments, and prevention and treatment strategies. First, however, some degree of definitional precision and consensus needs to be established. This paper critically examines the current research definitions of elder neglect and abuse and offers suggestions for future progress on this foundational issue.     

Elder Abuse and Neglect:

The study analyzes data from a 1987 survey of 1,137 adult protective service workers in forty states and Washington, D.C. A four-page questionnaire was mailed to obtain information on the perceptions and practices of those practitioners in dealing with cases of elder abuse neglect. Data were collected on the incidence of elder abuse, neglect, self-neglect, and exploitation; the observed frequencies of hypothesized causes of elder abuse and neglect in actual cases; barriers to service; the effectiveness of various methods of intervention; the outcomes of elder abuse and neglect cases; adn the perceived potential of community resources for reducing elder abuse and neglect.     

Depression and elder abuse and neglect among a community-dwelling Chinese elderly population

Our recent survey of an elderly cohort in mainland China suggests that elder abuse and neglect are common. Unfortunately, there is minimal knowledge about the risk factors for elder abuse and neglect among this population. We aimed to examine depression as a risk factor for elder abuse and neglect among Chinese elderly. A cross-sectional study was performed in a major urban medical center in NanJing, China. Depression was assessed using the Geriatric Depression Scale and direct questions were asked regarding abuse and neglect experienced by the elderly since the age of 60; 412 patients completed the survey. The mean age of the participants was 70 and 34% were female. Depression was found in 12% of the participants and elder abuse and neglect was found in 35% of the participants. After multiple logistical regression, feeling of dissatisfaction with life (OR, 2.92; 95% CI, 1.51-5.68, p < 0.001), often being bored (OR, 2.91; CI, 1.53-5.55, p < 0.001), often feeling helpless (OR, 2.79; CI, 1.35-5.76, p < 0.001), and feeling worthless (OR, 2.16; CI, 1.10-4.22, p < 0.001) were associated with increased risk of elder abuse and neglect. Multiple logistic regression modeling showed that depression is independently associated with elder abuse and neglect (OR, 3.26; CI, 1.49-7.10, p < 0.003). These findings suggest that depression is a significant risk factor associated with elder abuse and neglect among Chinese elderly.     

Australian Service Providers' Responses to Elder Abuse

This article presents the findings of a survey of 175 service providers in Sydney, Australia, the majority of whom were doctors in general practice. Thirty-two percent of respondents had encountered cases of physical, psychological, or financial abuse or caregiver neglect of people 65 years old and over. Community nurses and social/welfare workers were particularly likely to have encountered cases of abuse. The findings suggest that coordination between health, welfare, and criminal justice agencies in Australia needs improvement. Policies to address elder abuse and neglect in Australia are in their infancy. As a priority governments should work towards effective training of professionals and appropriate intervention guidelines for services.     

What Is “Elder Abuse”? Voices From the Margin: The Views of Underrepresented Canadian Older Adults

We know relatively little about the definitions and perceptions of elder abuse held by marginalized groups of older adults in Canada. The current study used focus group methodology to explore perceptions of elder abuse among marginalized groups such as Aboriginal persons, immigrants, refugees, and lesbians. We found both similarities and differences in perceptions of elder abuse across groups. Groups identified traditional forms of elder abuse (i.e., physical, sexual, psychological/emotional, financial abuse, and neglect) as well as less frequently identified types of abuse such as disrespect and government or systemic abuse. Groups also discussed issues related to immigrant sponsorship arrangements and abuse in nursing homes.     

The Devil is in the Details: Self-Neglect in Australia

ABSTRACT

Although elder self-neglect is of significant concern to adult protective service (APS) workers in the United States, minimal research has been conducted on this topic in Australia. Using qualitative research methods, this article examines how 24 Australian professionals understand situations of self-neglect. Unlike in the United States, where the term self-neglect is used in a broad and all-encompassing manner, participants in this research differentiated among self-neglect (the neglect of self), squalor (extreme neglect of environment), collecting (the accumulation of certain objects), and hoarding (the inability to throw objects away). It is argued that separating out the various behaviors that are classified under the broad umbrella of neglect can be useful in fostering reflective interventions in these situations.     

Mental health and substance use disorders among foster youth transitioning to adulthood: Past research and future directions

At a time when there is increasing attention being given to systematically integrating the well-being of children with the goals of safety and permanence in child welfare, little is known about the psychosocial functioning of foster youth transitioning to adulthood from substitute care. This article systematically reviews 16 peer-reviewed articles and/or research reports to identify lifetime and past year prevalence rates of mental health disorders and service utilization. At ages 17 or 18, foster youth are 2 to 4 times more likely to suffer from lifetime and/or past year mental health disorders compared to transition aged youth in the general population. Findings show that mental health service use declines at ages when the prevalence rate of mental health disorders is peaking. The findings of this review suggest the need to focus future efforts in three main areas: 1) setting a common research agenda for the study of mental health and service use; 2) routine screening and empirically supported treatments; and 3) integration and planning between child and adult mental health service systems.