Elder Abuse in Turkey and Associated Risk Factors

Abstract

Elder abuse is one of the most important problems encountered by the elderly. Health, economical and psychological dimensions of the experience of aging also pose risk for elder abuse. This study aims to determine the abuse to which elder people are exposed based upon their own evaluations and to investigate the risk factors associated with elder abuse. This is a cross-sectional study among quantitative designs. Population of the study comprises 309 outpatient elders over the age of 65 referring to Ayd?n Do?an Geriatrics Clinic of Ankara University, Turkey. Collected data were analyzed by chi-square test and logistic regression. In total, 70.9% of the elderly participating in this study experienced abuse more than once. Majority of the participants were victims of emotional abuse (64.1%), followed by neglect and abandonment (26.9%) and economic abuse (12.6%). There was significant relation between sex, marital status, health status of the elderly and being abused (p?p?相似文献   

Validation Study: The Iranian Version of Caregiver Abuse Screen (CASE) among Family Caregivers of Elderly with Dementia

Since abuse screening is difficult among the elderly with dementia, detection of elder abuse is a serious issue; meanwhile, the number of available tools to assess elder abuse by caregivers is limited. The aim was to evaluate validity and reliability of the Iranian version Caregiver Abuse Screen (CASE) tool. After the translating process of the tool to the Farsi language for 236 dementia participants ≥60 years old and their informal caregivers’ from outpatient’ clinics, in a cross-sectional method then the validity, reliability and factorial structure of the CASE was evaluated. The translated Iranian version CASE reveals a good psychometric property (α = 0.868) with strong internal consistency and reliability. Some variables (depression, burden, dementia intensity, and ADLs) were associated with abuse in dementia elderly. The two-factor structure was obtained in exploratory factor analysis labeled interpersonal abuse and neglect. Generally, the Iranian version of CASE approved with sufficient validity and reliability as a suitable instrument to find the risk of elder abuse among dementia caregivers.     

The Abuse of Elderly People: Considerations for Practice

Correspondence to Ms. B. Penhale, Team Leader, Social Work Department, West Norwich Hospital, Bowthorpe Road, Norwich NR2 2TU. Summary Within the last six years, concern about the abuse of elderlypeople by their informal carers has increased in Britain. However,problems remain in the identification and treatment of boththose who are abused and their abusers. The purpose of thispaper is to consider some of the barriers to the identificationof abuse; to look at the similarities and differences betweenthe abuse of elderly people and other forms of family violence(in particular child abuse) and to discuss the implicationsof these for social work practice.     

Alcohol and the Elderly:

This paper provides an overview of what is currently known about elderly alcohol use and abuse. It identifies areas of social work practice that need to be improved to meet the needs of elderly problem drinkers, and makes recommendations regarding identification, treatment, and coordination of services for this population.     

Elderly Victims of Family Abuse,Neglect, and Maltreatment:

Analysis was conducted on 30 cases of elder abuse, neglect, and maltreatment of the elderly seen by attorneys in a legal aid agency in Detroit between 1979 and 1981. The data were collected as part of a larger study of elder abuse cases seen by a variety of agencies in the Detroit area. Analysis revealed that most of the victims suffered from more than one type of abuse or maltreatment. As might be expected, the most common type of abuse seen in the legal aid agency was financial abuse. The study also showed that a legal agency can provide a type of service other agencies cannot provide. These services include: court actions, non-court actions which require the service of a lawyer, and non-legal actions in which an attorney can bring about action through the perceived threat of court action.     

Charging and Quasi-Markets in Community Care: Implications for Elderly People with Dementia

Social services authorities in the UK are increasingly involved in charging and fee collection activities with clients in receipt of community care services. This article explores the implications of these developments for elderly people with dementia. The starting point of the article is a critique of existing legal and administrative options for handling other people's money, including the difficulties and dilemmas raised for both paid and unpaid carers by the existing arrangements. This is then related to the failure of charging and fee collection systems which have developed as a result of the community care reforms to address the particular needs of elderly people with dementia. A case study of policies in one local authority is outlined and this is followed by the presentation of the view of 37 fieldlevel professionals who were interviewed in focus groups. The concerns of these respondents included the complexity of the assessment task, conflicts between care managers and finance/revenue staff, the difficulty of defining and responding to financial abuse, and dilemmas over the extent to which relatives and carers should be trusted. The final section of the article considers the implications of a move to quasi-markets in social care for elderly people with dementia, particularly in terms of their vulnerability to financial exploitation.     

Alcohol Use and Abuse in Old Age:

Alcohol use and abuse among the elderly is a serious problem surrounded by confusion. Traditionally older problem drinkers have been divided into two categories: Type I, individuals who have drunk excessively throughout life yet survived to old age and Type II, individuals whose problem drinking began late in life. An extensive renew of the research produced some paths to late-onset problem drinking but only a weak profile of the Type II alocholic. Popular situational factors purported to be the triggers for late-onsest abuse have mixed support and no clear causal theory has yet been delineated. A number of alternative theories deserve further attention. Current information does not support the usefulness of the Type II classification or traditional definitions of alcoholism for the late-onset abuser. Research and treatment efforts may need to be redirected to include male-female differences, and family conflicts with less emphasis on the disease model of alcoholism.     

An elder abuse shelter program: build it and they will come, a long term care based program to address elder abuse in the community

This article describes how The Hebrew Home for the Aged at Riverdale (the Hebrew Home), a non-profit geriatric care center, has established one of the nation's first long term care based elder abuse prevention and intervention programs for elderly living in the community. This program, known as the Weinberg Center for Prevention, Intervention and Research in Elder Abuse (the "Weinberg Center"), received start-up funding in the form of a matching grant challenge from the Weinberg Foundation of Baltimore, which has a history of funding innovative geriatric programs throughout the United States. Utilizing the Hebrew Home's extensive integrated service model, a multidisciplinary team works with a network of private and governmental agencies. This model was designed based upon the needs of this population as described in the nascent research, evaluation of the few programs in existence, and the emerging state of elder abuse as a matter of public policy. The goals are to increase public awareness, intervene to make the home safe, and provide a secure and fulfilling short or long term shelter. Research in prevalence and efficacious use of the shelter is being conducted.     

An Ethical Dilemma in Elder Abuse

Abstract

While most elder abuse is perpetrated by family members, some may be performed by strangers. When the elderly victim reaches out to the social agency but then refuses services, an ethical dilemma is created for the social worker. Conflicts arise among social work values and the ethical principles of autonomy and paternalism, beneficence, and nonmaleficence. A model of ethical justification is applied that explains the possible decisions in this case. The actual resolution of the dilemma is accomplished through a social work practice principle.     

Physical and Sexual Abuse,Battering, and Substance Abuse

Abstract

Women born before 1945 are the older women of today. Many of these women were subjected to childhood physical and sexual abuse and spouse battering at a time where there were no laws to protect them and few people discussed such subjects. Some of these women became substance abusers or lived with substance abusers. While there are retrospective studies on the experiences of adult women who suffered abuse in the family, little is known about the experiences of women over the age of 60 years.

Similarly, there is information on substance abuse among young and middle-aged women, but very little information on or about older womens' experiences with substance abuse. In this study, we review the literature on abuse and substance abuse. We present three clinical cases of older women who have experienced various forms of abuse and who in turn abuse substances. The cases are analyzed. Assessment, treatment, and evaluation methods for social workers are discussed.     

Children's narratives of sexual abuse

Children rarely disclose sexual abuse. Hence, studies of children's abuse experiences are relatively rare. This paper reports on a qualitative analysis of 2986 cases of self‐disclosure of sexual abuse from children, aged 5–18 years, who contacted ChildLine Scotland, a free, confidential telephone counselling service. Children discussed their feelings regarding the abuse, the impact of abuse on their health and well‐being, sources of support, disclosure, coping strategies, the context in which abuse occurs and the various ways in which they were groomed or their compliance in abuse was gained. Children's narratives contained detailed contextual information on their experiences of sexual abuse, perpetrators of sexual abuse and the circumstances in which sexual abuse occurs. The way in which children communicated about sexual abuse was found to differ quite considerably, and the terminology they employed was often markedly different from adult constructs. Nonetheless, children of all ages were able to describe their experiences and their feelings around the abuse in considerable detail. This study provides a rare insight into children's accounts of sexual abuse. The findings illustrate the profound impact that sexual abuse has on the lives of children and their understandings of the circumstances in which abuse occurs.     

Double jeopardy: the link between child abuse and maternal depression in child and family social work

The link between child care and mental health problems in social work clients has begun to attract some attention. Despite some review articles, research is, as yet, at a very early stage of development. Maternal depression and child care problems in particular appear likely to be closely associated. This paper focuses on the link between maternal depression and the most severe of child care problems: child abuse. The paper shows a significant relationship between maternal depression and child abuse. It explores this relationship by distinguishing three groups: families where no abuse had occurred (non abuse families), families where abuse had occurred but where the mother was not depressed (non depressed-abuse group) and families where both child abuse and maternal depression were present (depressed-abuse group). The depressed-abuse group are shown to be considerably worse off than both the other groups for a range of measures, including indices of deprivation and range and severity of social problems. The depressed-abuse group were also more chronic users of services and consumed far more resources than the other two groups. Remarkably, there were few differences between the non abuse group and the non depressed abuse group in nature and severity of problems and intervention. Depression in mothers, then, provides the major distinction between families where abuse was an issue compared with families where abuse was not present. Such families are characterized not simply by maternal depression and child abuse, but frequently by abuse of the mother herself, who is often socially isolated. These findings are of major importance for child care practice, indicating that working with the mother's depression and the social conditions that provide its backdrop, are a major aspect of social work practice.     

The Physical Abuse of Adolescents

The literature on adolescent abuse suggests that it may differ from child abuse. Issues raised in the literature focus on severity, provoking behavior by the adolescents, and community norms for discipline as crucial issues. There are several models of the dynamics of adolescent abuse in the literature. These issues and theoretical models are examined by reviewing twenty-five cases of adolescent abuse from a public welfare office in a large midwestern city. Implications of the findings for reporting injuries and planning interventions are discussed.     

BREAKING THE LAST TABOO: CHILD SEXUAL ABUSE BY FEMALE PERPETRATORS

In the past two decades the truth about the sexual violation of children has been spoken over and over. Finally, the magnitude of this problem is being recognised. Volumes have been written about the prevention of and intervention in child sexual abuse, and services (although inadequate) have been established. Sexual abuse by women until recently, has been treated as a taboo subject. The knowledge that the overwhelming proportion of child sexual abuse is perpetrated by males left the issue of female perpetrators unexamined. Having only recently made progress in a hard-fought battle to place gender and male power at the centre of an analysis of sexual abuse, practitioners and theoreticians are understandably reluctant to focus any attention on female abusers. However, it is now becoming clear that a significant minority of victims are abused by women and it is essential that no child should be silenced by ideology which denies the reality of abuse by females. This article examines the controversies surrounding the issue of female sexual abuse and the struggles which we have in confronting this abuse. An explanation of sexual abuse by women within feminist understanding is proposed. Current evidence on the prevalence of female sexual abuse and characteristics of perpetrators is outlined. Practice implications for practitioners working with child victims or adult survivors are explored.     

Ombudsman program characteristics related to nursing home abuse reporting

The purpose of this research is to determine if there is an association between ombudsman report rates of abuse, gross neglect, and exploitation from 1997 through 2002 and ombudsmen's public and staff education, investigative process, program expenditures, and census demographics. Data were obtained from the National Ombudsman Reporting System. Ombudsman annual reports of nursing home abuse, neglect, and exploitation are representative of that state's individual program. These reports should not be construed to represent all abuse in nursing homes. Physical abuse and resident-to-resident abuse were the highest rates of abuse reported. Census demographics and ombudsman program characteristics were associated with rates of abuse.     

Coping skills of ritual abuse survivors: An exploratory study

Abstract

This research project was undertaken with survivors of ritual abuse to explore their coping skills at the time of the abuse and in adulthood around the memories of the abuse. In this qualitative study, data were gathered both from 14 therapists who specialize in treating survivors of ritual abuse and from three survivors of ritual abuse. Data gathering utilized semi‐structured interview schedules and structured coping scales.

Principal findings were that the ritual abuse survivors represented in this study used dissociation as the main coping mechanism both during the time of the abuse and in adulthood around memories of the abuse, that there was a developmental progression of coping skills used by these survivors over time, and that they relied on the use of self‐mutilating behaviors as creative means of affect management. Implications and future research are discussed.     

Violence Across the Lifespan: Interconnections Among Forms of Abuse as Described by Marginalized Canadian Elders and their Care-givers

Elder abuse is recognized as a major problem, with profoundeffects on the health and quality of life of older persons.In our aging population, elder abuse represents an escalatingclinical issue for social workers and health care professionalswho provide care to older people. A major gap in our examinationof elder abuse is the potential contribution and applicationof knowledge developed within research derived from other formsof family violence. This paper explores the interconnectionsamong various forms of violence across the lifespan, and theexperiences voiced by marginalized elders and their care providers.We interviewed seventy-seven rarely consulted older adults andforty-three formal and informal care-givers of older adultsin focus groups in Ontario and Alberta, Canada. Study findingsrevealed four major themes that describe interconnections amongtypes of abuse: (i) intergenerational cycles of abuse; (ii)violence across the lifespan; (iii) exposure to multiple subtypesof elder abuse; and (iv) ongoing spouse abuse that shifted intoelder abuse. The results from this study indicate that victimsoften ‘suffer in silence’ and cultural factors,ageism and gender are ubiquitous to elder abuse. Recommendationsto reduce elder abuse include education, formal and informalsupports and services.     

Child abuse in China: a yet-to-be-acknowledged 'social problem' in the Chinese Mainland

Child abuse or child maltreatment has been a worldwide concern. In China, however, it receives scant attention from both academic communities and government. Chinese society has little awareness of child abuse as it is known in the West and there are apparently different conceptions and treatments of the problem. This paper attempts to delineate how the problem is now understood and treated in Mainland China. The reasons why child abuse has not yet been recognized as a social problem worthy of public concern in China are explored. It is argued that as a signatory of the UN Convention on the Rights of the Child there is a need for the Chinese government, the academic community and professionals to reflect on their conception and treatment of child abuse so as to achieve more effective child protection for all children who are victims of child abuse.