Elder Abuse and Neglect in African American Families: Informing Practice Based on Ecological and Cultural Frameworks

Despite the rapid growth of the elderly African American population in the U.S., elder abuse and neglect in African American families continue to be underdeveloped areas of study. This article presents an ecological and culturally informed framework for the study of elder abuse in African American populations. The model was developed based on Bronfenbrenner's Human Ecological Theory. The model identifies risk factors associated with different systems that have an influence on the lives of African American families. Cultural protective factors also are identified in the model. The model is intended to provide an understanding of elder abuse and neglect in African American families by considering the influence of contextual factors such as the legacy of slavery, social exclusion, and structural segregation and racism. Specific suggestions for practice are proposed according to cultural strengths of African American communities as well as the ecological premises of the model.     

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.     

Racial Differences in Abused Older African American Males, Caucasian Males, and their Abusers

This study examined racial differences between mistreated and abused older African American and Caucasian men. The racial and gender differences of their perpetrators were also examined. Data from a single elder abuse provider agency in the State of Illinois were analyzed. Differences with respect to physical abuse, emotional abuse, physical neglect, deprivation, confinement, and financial exploitation were examined, as were demographic characteristics and limitations of victims and abusers.     

Elder abuse and neglect in an urban chinese population

This study aims to investigate the prevalence of elder abuse and neglect in an urban Chinese population. A cross-sectional study was performed in a major urban medical center in NanJing, China. A total of 412 participants completed the survey and 145 (35%) participants screened positive for elder abuse and neglect. The mean age of the victims was 69 years and 59% were male. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse, and abandonment. Thirty-six percent of the victims suffered multiple forms of abuse and neglect. In the logistical regression analyses of the data, female gender, lower education and lower income were demographic risk factors associated with elder abuse and neglect. A better understanding of these and additional risk factors associated with elder abuse and neglect in older Chinese people is needed.     

Elder Abuse and Neglect in an Urban Chinese Population

ABSTRACT

This study aims to investigate the prevalence of elder abuse and neglect in an urban Chinese population. A cross-sectional study was performed in a major urban medical center in NanJing, China. A total of 412 participants completed the survey and 145 (35%) participants screened positive for elder abuse and neglect. The mean age of the victims was 69 years and 59% were male. Caregiver neglect was the most common form of abuse, followed by financial exploitation, psychological abuse, physical abuse, sexual abuse, and abandonment. Thirty-six percent of the victims suffered multiple forms of abuse and neglect. In the logistical regression analyses of the data, female gender, lower education and lower income were demographic risk factors associated with elder abuse and neglect. A better understanding of these and additional risk factors associated with elder abuse and neglect in older Chinese people is needed.     

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.     

An Ecological Framework for Contextual Risk Factors in Elder Abuse by Adult Children

ABSTRACT

Future trends suggest both a continued growth of the elderly population, as well as the likelihood of increased demand for family caregiving which may, in turn, be associated with increasing rates of elder abuse. It is important to consider issues related to such caregiving, including potential abuse from an ecological perspective which, in turn, provides a fruitful basis for framing the problem of abuse as a set of contextually-based risk factors. This paper focuses on the contextual risk factors using an applied ecological model, a useful framework for understanding the intergenerational character of elder abuse in families, for developing recommendations for empirically-based action research, and for the development of community-based prevention and intervention strategies.     

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.     

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.     

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.     

Depression and Elder Abuse and Neglect Among a Community-Dwelling Chinese Elderly Population

ABSTRACT

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.     

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.     

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.     

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.     

Elder abuse and neglect in South Africa: a case of marginalization, disrespect, exploitation and violence

The problem of elder abuse and neglect in South Africa is widespread, but the definition of abuse remains problematic. An expanded typology is needed to classify certain types of abuse reported commonly, such as marginalization, disrespect, exploitation and violence. The history of elder abuse and responses is traced, relevant legislation and selected intervention programs are reviewed, and research and the status of elder abuse are evaluated. Interventions to address sociostructural factors that impact elders' settings, increase their vulnerability, and diminish their ability to realize human rights can contribute to an improvement in their condition and a reduction in abuse and rights violations in the long-term.     

A systematic review on community-based interventions for elder abuse and neglect

Elder abuse and neglect is a societal issue that requires prevention and intervention strategies at the practice and policy level. A systematic review on the efficacy of community-based elder abuse interventions was undertaken to advance the state of knowledge in the field. The peer-reviewed literature between 2009 and December 2015 were searched across four databases. Two raters independently reviewed all articles, assessed their methodological quality, and used a modified Sackett Scale to assign levels of evidence. Four thousand nine hundred and five articles were identified; nine were selected for inclusion. Although there was Level-1 evidence for psychological interventions (n = 2), only one study on strategies for relatives (START) led to a reported decrease in elder abuse. There was Level-4 evidence for conservatorship, an elder abuse intervention/prevention program (ECARE), and a multidisciplinary intervention (n = 4), in which one study yielded significant decreases in elder abuse and/or neglect. The remaining three were classified as Level-5 evidence (n = 3) for elder mediation and multidisciplinary interventions. There are limited studies with high levels of evidence for interventions that decrease elder abuse and neglect. The scarcity of community-based interventions for older adults and caregivers highlights the need for further work to elevate the quality of studies.     

Elder Abuse: Risk Factors and Use of Case Data to Improve Policy and Practice

ABSTRACT

Countering the generally reactive community approach to prevention and treatment of elder abuse, this study employs analysis of local elder abuse case data to estimate the incidence of elder abuse, neglect, and exploitation and to measure the risk factors, including co-location of other forms of abuse, that predict elder abuse in Miami-Dade County, Florida. The authors also compare the model of intervention used in Florida and elsewhere to best practice models that incorporate elements of domestic violence treatment models. They present a series of specific recommendations for improving local abuse data-collection, analysis, and training so that local policy makers, planners, and practitioners can make proactive, community-specific, culturally-sensitive preventive efforts effective. The findings and recommendations have direct relevance for policy and practice in any community in the United States.     

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.