Elder Abuse and Oppression: Voices of Marginalized Elders

The voices of elderly people from marginalized groups are rarely solicited, and the relationship between elder maltreatment and belonging to an oppressed group has not been adequately investigated. This article reviews the literature on oppression and elder abuse and describes findings from the secondary analysis of data from focus group discussions on elder abuse held with marginalized older adults and (quasi)professionals caring for them in two Canadian cities. Participants identified that increased vulnerability to elder abuse was related to oppression experienced as a consequence of ageism, sexism, ableism/ disability, racism, heterosexism/homophobia, classism, and various intersecting types of oppression.     

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.     

Developing strategies for the prevention, detection and management of elder abuse: the Irish experience

It is only within the past two decades that elder abuse has received governmental attention in Ireland. There had been little awareness, and no structures in place to tackle this problem prior to this. Media highlighting of particular cases, and an exploratory study undertaken in 1998, prompted the setting up of a governmental working group on elder abuse. Unique to this group was the trialling of a proposed system in two pilot sites. This allowed for recommendations based on actual practice, and has lead to the adoption of a network of elder abuse caseworkers, among other recommendations.     

Elder abuse in nursing homes: an ecological perspective

Population trends suggest that the next 20 years will witness a dramatic increase in the adult population aged 65 and older. Projected increases in the elderly population are expected to significantly increase the stress on family and professional caretakers. Stress, in the context of caregiving relationships, is a risk factor associated with increased prevalence of elder abuse in familial and institutional settings. As increasing numbers of older adults are moved from family caregiving to nursing home care settings, it becomes important to identify the pattern of elder abuse risk factors in nursing home facilities. An ecological model is proposed for better understanding the risk factors associated with elder abuse in nursing homes and the complex interaction of individual/person characteristics and contextual factors in institutional elder abuse. An ecological perspective to institutional elder abuse provides a framework for guiding and informing future research on the risk factors of nursing home abuse and, in turn, for the development of effective interventions and relevant social policies.     

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.     

Elder Abuse in Nursing Homes: An Ecological Perspective

Population trends suggest that the next 20 years will witness a dramatic increase in the adult population aged 65 and older. Projected increases in the elderly population are expected to significantly increase the stress on family and professional caretakers. Stress, in the context of caregiving relationships, is a risk factor associated with increased prevalence of elder abuse in familial and institutional settings. As increasing numbers of older adults are moved from family caregiving to nursing home care settings, it becomes important to identify the pattern of elder abuse risk factors in nursing home facilities. An ecological model is proposed for better understanding the risk factors associated with elder abuse in nursing homes and the complex interaction of individual/person characteristics and contextual factors in institutional elder abuse. An ecological perspective to institutional elder abuse provides a framework for guiding and informing future research on the risk factors of nursing home abuse and, in turn, for the development of effective interventions and relevant social policies.     

Developing Strategies for the Prevention,Detection and Management of Elder Abuse: The Irish Experience

ABSTRACT

It is only within the past two decades that elder abuse has received governmental attention in Ireland. There had been little awareness, and no structures in place to tackle this problem prior to this. Media highlighting of particular cases, and an exploratory study undertaken in 1998, prompted the setting up of a governmental working group on elder abuse. Unique to this group was the trialling of a proposed system in two pilot sites. This allowed for recommendations based on actual practice, and has lead to the adoption of a network of elder abuse caseworkers, among other recommendations.     

Protection studies: Challenging oppression and discrimination

Social work students on qualifying programmes should have abundant opportunities to challenge racism, sexism, disablism and other oppressions in society, that is in the macro environment. Equally they are required to confront oppression in the micro environments of the family home or small institution. One way of achieving this is through integration of the issues into the whole curriculum but also through a specific module devoted to protection studies.

Child and ‘elder’ abuse and the mistreatment of dependent younger adults is at one end of a continuum of oppression with societal discrimination at the other. Oppression, whatever its form, has four essential components: the misuse of power, processes of objectification, the silence of witnesses and the entrapment or accommodation of victims. Social work students who do not fully appreciate the dynamics of the abuse of power, and the perspectives of victims are ill equipped to challenge oppression.

A rationale for a protection studies module is given. The objectives and content of the proposed studies are also suggested. Protection studies, it is argued, are essential because social workers are faced with complex issues of power and control. Those who overlook the need to protect all of society's weakest members can be seen as facilitating abusers in the same way that those who do not embrace anti-discriminatory and anti-oppressive practices are perpetuating bigotry and injustice.     

Recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect

Increased interest in pursuing criminal and civil actions against alleged perpetrators of elder abuse and neglect has revealed that efforts to assist victims and hold perpetrators accountable are often hampered by the lack of knowledge about the detection and diagnosis of elder abuse and neglect and by the lack of resources for development of research and assistance in these matters. This report sets forth recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect. The recommendations were developed by a "working group" of experts representing an array of disciplines that address the problem of elder abuse and neglect pursuant to a grant project funded by the National Institute of Justice (NIJ), the research, development, and evaluation agency of the U.S. Department of Justice (DOJ). The project was conducted by the American Bar Association Commission on Law and Aging, with the assistance of the University of California, Irvine School of Medicine. This was the final project report submitted to NIJ; it has been updated to include information about the availability of reports and products from other grant projects that are discussed in the report.     

Recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect

Increased interest in pursuing criminal and civil actions against alleged perpetrators of elder abuse and neglect has revealed that efforts to assist victims and hold perpetrators accountable are often hampered by the lack of knowledge about the detection and diagnosis of elder abuse and neglect and by the lack of resources for development of research and assistance in these matters. This report sets forth recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect. The recommendations were developed by a "working group" of experts representing an array of disciplines that address the problem of elder abuse and neglect pursuant to a grant project funded by the National Institute of Justice (NIJ), the research, development, and evaluation agency of the U.S. Department of Justice (DOJ). The project was conducted by the American Bar Association Commission on Law and Aging, with the assistance of the University of California, Irvine School of Medicine. This was the final project report submitted to NIJ; it has been updated to include information about the availability of reports and products from other grant projects that are discussed in the report.     

Elder Abuse and Oral Health Care Providers: An Intervention to Increase Knowledge and Self-Perceived Likelihood to Report

The objective of this study was to ascertain whether a symposium on elder abuse raises the level of knowledge and the self-reported likelihood to report elder abuse among licensed oral health care providers. 130 dentists, hygienists, and assistants voluntarily attended a 4-hour training symposium and completed both pre- and postsurveys testing their level of knowledge. Results by statistical analyses, using repeated measurements, Wilcoxon signed-rank test for nonparametric data, showed increases in awareness of reporting process, knowledge/awareness of elder abuse, knowledge of mandated reporter requirements, and comfort levels with recognizing signs and symptoms of elder abuse and neglect. In conclusion, a symposium can increase the self-reported likelihood of reporting elder abuse.     

Elder abuse and oral health care providers: an intervention to increase knowledge and self-perceived likelihood to report

The objective of this study was to ascertain whether a symposium on elder abuse raises the level of knowledge and the self-reported likelihood to report elder abuse among licensed oral health care providers. 130 dentists, hygienists, and assistants voluntarily attended a 4-hour training symposium and completed both pre- and postsurveys testing their level of knowledge. Results by statistical analyses, using repeated measurements, Wilcoxon signed-rank test for nonparametric data, showed increases in awareness of reporting process, knowledge/awareness of elder abuse, knowledge of mandated reporter requirements, and comfort levels with recognizing signs and symptoms of elder abuse and neglect. In conclusion, a symposium can increase the self-reported likelihood of reporting elder abuse.     

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.     

Note From Iran: Self-Reported Elder Abuse in Qazvin, 2012

This brief report provides a first look at self-reported instances of elder abuse by a sample of people 60 years and older living in Qazvin, Iran. Six hundred community-dwelling persons, drawn from the registry files of each health center in Qazin, completed questionnaires during April to October 2012. At least 80% of the participants reported experiencing some form of psychological abuse, financial abuse, and/or neglect at least once during a 2-month period. Physical and sexual abuse were rarely reported. Despite a strong Iranian cultural emphasis on respect for elders, the self-reporting of elder abuse, especially psychological abuse, is greater than our expectation. We recommend that health-related policies and programs begin to identify elder abuse and neglect as a first step in prevention.     

The Hospital Elder Assessment Team:

Elder abuse literature shows that health care professionals are aware of elder abuse/neglect laws but do not understand the requirements nor have the skills to diagnose the problem (Clark-Daniels & Daniels, 1990). Many victims of elder abuse appear in hospital emergency rooms for medical evaluation. Although 42 of the 50 states now have mandatory elder abuse/neglect reporting laws, few hospitals have responded with interdisciplinary elder protective teams in contrast to the situation with child abuse reporting laws. One exception has been the establishment of a multidisciplinary elder assessment team at Beth Israel Hospital, Boston, MA, to address the complex issues of recognition and assesssment of elders seen in the hospital who are suspected victims of abuse. Included in the mission of the team are consultation, support, and education to hospital staff about elder abuse and neglect.     

Financial exploitation of older persons in adult care settings: comparisons to physical abuse and the justice system's response

The current study uses a sample of 242 elder financial abuse cases and 314 elder physical abuse cases handled by fraud control units to shed some light on the dynamics of elder financial exploitation and the way the justice system processes these cases. Attention also is given to the way that the processing of elder financial exploitation cases can be distinguished from the processing of elder physical abuse cases. Results show that a wide range of elder financial exploitations cases are committed, and these cases should be broadly defined. Implications are provided.     

State of the science on prevention of elder abuse and lessons learned from child abuse and domestic violence prevention: Toward a conceptual framework for research

ABSTRACT

The goal of this review is to discuss the state of the science in elder abuse prevention. Findings from evidence-based programs to reduce elder abuse are discussed, drawing from findings and insights from evidence-based programs for child maltreatment and domestic/intimate partner violence. A conceptual measurement model for the study of elder abuse is presented and linked to possible measures of risk factors and outcomes. Advances in neuroscience in child maltreatment and novel measurement strategies for outcome assessment are presented.     

Development of short-form measures to assess four types of elder mistreatment: Findings from an evidence-based study of APS elder abuse substantiation decisions

Improving the standardization and efficiency of adult protective services (APS) investigations is a top priority in APS practice. Using data from the Elder Abuse Decision Support System (EADSS), we developed short-form measures of four types of elder abuse: financial, emotional/psychological, physical, and neglect. The EADSS data set contains 948 elder abuse cases (age 60+) with yes/no abuse substantiation decisions for each abuse type following a 30-day investigation. Item sensitivity/specificity analyses were conducted on long-form items with the substantiation decision for each abuse type as the criterion. Validity was further tested using receiver–operator characteristic (ROC) curve analysis, correlation with long forms and internal consistency. The four resulting short-form measures, containing 36 of the 82 original items, have validity similar to the original long forms. These short forms can be used to standardize and increase efficiency of APS investigations, and may also offer researchers new options for brief elder abuse assessments.     

Dependent Adult Children and Elder Abuse

This study investigates quantitatively and qualitatively the characteristics of dependent adult children in substantiated cases of elder abuse. The data come from the Wisconsin elder abuse reporting system in which 204 substantiated cases of abuse by an adult child were reported during an 18 month period. Quantitative analysis indicated that financially dependent adult children were under the age of 40, lived with the elder, and had problems related to alcohol and drugs. The qualitative analysis of 14 case records showed that a second but smaller group of adult children were dependent because of problems related to mental illness. This analysis of case records revealed substantial depression among this population of abused elders. Implications for future research are discussed.     

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.