Elder abuse and neglect among veterans in Greater Los Angeles: prevalence, types, and intervention outcomes

This study examined the prevalence, types, and intervention outcomes of elder abuse/neglect among a veteran population. A review of medical records of 575 veterans who had received services from the Veteran's Affairs Geriatric Outpatient Clinic in Los Angeles during a three-year period found 31 veterans (5.4%) who had an elder abuse report filed on their behalf. Prevalence of elder abuse/neglect was higher among older (80+) and Caucasian and African American veterans. Eight of 31 victims suffered from more than one type of elder abuse including self-neglect. Financial abuse and self-neglect were the most commonly reported types. Family members were perpetrators in the majority of the cases, excluding self-neglect. However, three-quarters of financial abuse cases were committed by non-family members. Almost one-half of the victims had dementia and eight were clinically depressed. The most common intervention was to move victims from their unsafe home into a nursing home or board and care facility, followed by conservatorship arrangement. These interventions were most frequently used for victims with dementia, and conservatorship was often arranged with another type of intervention, such as a move to a nursing home. Victims who remained at home received conservatorship or outside supportive services or a combination of both. This study calls for more comprehensive and systematic research on elder abuse/neglect at multi-settings in order to generate useful information for prevention and detection of, and effective intervention in elder abuse and neglect in the veteran population.     

Hearing the Voices of Abused Older Women

Summary

This paper focuses on a qualitative research process that gathered responses from 64 older women aged fifty and older on their experience of violence and abuse. What older women said about abuse in their lives supports the use of a feminist framework as well as the age based analysis of the elder abuse field. Some respondents spoke of abuse from childhood into their later years. Some spoke of partners witnessing or experiencing abuse as children. Some women express concern about possible abuse by their adult children of their own children.

Abused older women like younger women need a safe environment, emotional support, advocacy, information, and peer support. While it is important to consider the perspectives and knowledge of service providers when developing policy and practice on abuse of older women, it is critical to ask the women survivors of abuse or neglect what they believe would benefit them, and others in similar situations.     

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.     

Assessment in Adult Protective Services: do multidisciplinary teams make a difference?

This study compared 2 approaches to the assessment of Adult Protective Services (APS) cases. Using administrative data from 869 cases in 2 counties in Maryland, the differences between a nurse/social worker team and a lone social worker in case disposition, risk reduction, recidivism, and cost effectiveness were examined. Lone social workers were significantly more likely to confirm financial exploitation, physical abuse, and neglect by others; while the team approach resulted in significantly greater risk reduction. No differences were observed in relation to recidivism, self-neglect and cost savings. Given limited resources, research that examines optimal staffing patterns in APS agencies is warranted.     

A Definitional Discussion of Elder Maltreatment

Currently, there is no one uniform accepted or acceptable definition of elder maltreatment. As an important first step in the continued understanding of elder maltreatment, a differentiation is made between legal and social work definitions and a classification system for defining elder maltreatment from a social work orientation is suggested as a guide for assessment and intervention. Distinctions within each of three major categories of elder maltreatment (elder neglect, elder abuse and violation of the elder's rights) is presented.     

The Complexities of Elder Homelessness,a Shifting Political Landscape and Emerging Community Responses

Despite their growing numbers, homeless older adults remain largely invisible in society and there has been a pervasive lack of public focus on elder homelessness. In this article, we seek to shine light on this forgotten population and deepen understanding of difficult challenges they confront in regaining housing security. We also examine the shifting political climate regarding homelessness, particularly the enactment and subsequent reauthorizations of the McKinney–Vento Homeless Assistance Act, and how these shifts are influencing community responses to elder homelessness. Finally, future challenges and policy directions for breaking the cycle of elder homelessness in the U.S. are discussed.     

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   

Self-determination and elder abuse do we know enough?

This article explores the principle of self-determination as it relates to victims of elder abuse and neglect. Using newspaper accounts and cases from the author's practice and consulting files, various factors influencing the professional's interpretation of this principle are explored. The notion that self-determination allows victims of abuse and neglect to refuse intervention is challenged. The author concludes that the principle of self-determination and the notion of competency are overly simplified in the social work and elder abuse literature and may be misused by allowing abused older victims to choose to remain in often life-threatening situations. Special focus is given to Adult Protection Service worker, but the author asserts that protecting older people, assisting in creative interventions and developing needed services is a shared professional responsibility.     

Satisfaction,Communication and Affection in Caregiving

Multigenerational caregiving is becoming a prevalent means of caring for moderately to severely impaired elders. Handling the stress created in these arrangements may depend on the relationship between the elder and the caregiver. This study examines components of such relationships and highlights caregiving as experienced by the elder receiving care. Findings 'indicate that improved quality of relationship between elder and caregiver is related to a high degree of elder's satisfaction with the arrangement, whereas level of functioning of the elder is not related to degree of satisfaction. However, findings also suggest that elders fear being a burden, hide their troubles and feelings and generally feel no sense of contribution to the household.     

Hearing the voices of abused older women

This paper focuses on a qualitative research process that gathered responses from 64 older women aged fifty and older on their experience of violence and abuse. What older women said about abuse in their lives supports the use of a feminist framework as well as the age based analysis of the elder abuse field. Some respondents spoke of abuse from childhood into their later years. Some spoke of partners witnessing or experiencing abuse as children. Some women express concern about possible abuse by their adult children of their own children. Abused older women like younger women need a safe environment, emotional support, advocacy, information, and peer support. While it is important to consider the perspectives and knowledge of service providers when developing policy and practice on abuse of older women, it is critical to ask the women survivors of abuse or neglect what they believe would benefit them, and others in similar situations.     

Social inclusion: an interplay of the determinants of health - new insights into elder abuse

Social and economic exclusion and inclusion are receiving growing attention and study in North America for their usefulness as a conceptual framework that addresses the many dimensions of poverty and inequality in our society. A discussion of social and economic exclusion/ inclusion flows naturally out of the population health field in which the social determinants of health have become well-established over the last twenty years or more. The determinants of health provide a broad and inclusive outline within which to situate prevention, early detection and effective intervention of the abuse of older persons. A Social Inclusion Lens offers exciting possibilities for addressing the issue of elder abuse and neglect.     

Hybridization in China's elder care service provision

Although the party‐state has embarked on a mission to increase elder care services, evaluating this development according to different sectors demonstrates certain challenges. Official statistics do not include sector‐specific information, and while provider websites suggest that elder care services are largely in public hands, Chinese experts argue that they are mostly “civilian‐run.” How can we explain these discrepancies in data on Chinese elder care? Drawing on the concept of hybridization and triangulating quantitative and qualitative data, I argue that the party‐state's efforts to “socialize” elder care provision has resulted in hybridization within the industry which blurs the line between care providers and obfuscates the stark role of the state in elder care service provision. During the implementation of state‐initiated hybridization, providers misclassify their ownership type to benefit from financial incentives or circumvent political control, resulting in even greater hybridization and fragmentation on the ground.     

Unmet Needs and Depressive Symptoms Among Low-Income Older Adults

Previous studies have found that declining health, decreased social interaction, and inadequate financial resources were significant risk factors for late-life depression, and social support from families and friends and religiosity were significant protective factors. In this study, we examined if low-income older adults' perceived unmet need for home- and community-based services for many aging-associated problems would be independently associated with their depressive symptoms, controlling for these known risk and protective factors. We interviewed a total of 213 community-residing older adults to assess their depressive symptoms, using the Geriatric Depression Scale (GDS), and unmet needs in the areas of personal assistance, instrumental and environmental support, emotional support, and other facilitative/enabling services. We found that the number of unmet needs was significantly positively associated with these older adults' depressive symptoms, although it explained only a small proportion of the variance of the GDS scores. Future research and practice implications are discussed.     

Individual- and Contextual-Level Factors Affecting the Use of Social Support Services among Older Adults

ABSTRACT

By 2060, the number of Americans aged 65 and older is expected to more than double, while the number of Americans aged 85 and older is expected to nearly triple. As the nation's aging population grows, older adults will need to rely on social support services, such as transportation and housing services, in order to remain active and lead independent lives. In this study we use data collected from the elderly supplement of the Southeastern Pennsylvania Household Health Survey (SPHHS) (n = 3,042) to explore the relationship between the availability of elderly specific social service providers and utilization of social support services among older adults. We find that while the number of elderly specific social service providers can increase use of social support services among older adults, its impact is relatively minimal. We find that individual factors, instead, are stronger predictors of service use. This is a finding that should be particularly encouraging for elder care providers who may not have the resources needed to undertake large structural changes (like building new facilities). Still, future research should explore how the availability of a broader range of elderly specific social services (than explored in this study) impacts use.     

Care management in practice: on the use of talk and text in gerontological social work

Cedersund E, Olaison A. Care management in practice: on the use of talk and text in gerontological social work Int J Soc Welfare 2010: 19: 339–347 © 2010 The Author(s), Journal compilation © 2010 Blackwell Publishing Ltd and International Journal of Social Welfare. This is a study of encounters between social workers and citizens in one type of welfare organisation, the municipal elder care system. The article sheds light on how older people's claims are dealt with in the processing of home care applications. Twenty encounters between social workers and older people were studied using discourse analysis. The findings reveal that discursive practices are part of the routine when the applications are processed. The application handling follows an agenda‐bound pattern that is visible in the encounters. In these standardised procedures, oral discourse is embedded in routines that also include the use of texts. However, within this institutional order, there is also an important element of negotiation between the parties. It is therefore claimed that the encounters include a negotiated order that does not exist on its own, but is achieved in the ongoing interaction.     

Kinship Foster Care and Its Impact on Grandmother Caregivers

Summary

Kinship foster care programs are designed to address the needs of relatives, usually grandparents, who have taken in children who have been removed from their homes voluntarily, or following a substantiated report of neglect and/or abuse. The author reviews the history of kinship foster care nationally and examines related research. Reported are findings on a survey of kinship foster care programs nationwide and from qualitative interviews with nine grandmothers from New York City who were kinship foster care providers. Particular attention was paid in these surveys to the impact of kinship foster care on families caring for children with disabilities.     

Ecological factors associated with elder abuse in Taiwan: a systematic review

Elder abuse is a serious issue in Taiwan because of rapid growth among the aging population and the deterioration of traditional values. Understanding of elder abuse in Taiwan has been fragmented, as a bulk of studies have primarily focused on socio-demographic characteristics and past childhood abuse. Only a handful of studies have focused on the environmental contexts. To address this research gap, we systematically review the prevalence, socio-demographic characteristics, and risk factors associated with elder abuse in Taiwan by applying Bronfenbrenner's ecological framework. Twenty-nine research articles are reviewed to address this research gap. Practice and policy implications are also discussed.     

Mosaic of Difference

Summary

The professional literature has not adequately addressed the behavioral and social factors that contribute to different coping outcomes for African American elder caregivers as compared to non African Americans. Awareness and understanding of these unique experiences would better prepare professionals to work with such clients. This study examines the predictors of emotional distress among 46 African American women who provide care to dependent elderly parents. Multivariate statistical analyses show that elder caregivers' rating of quality of life, their years of caregiving, as well are their poor heath constitute significant predictors of risk for depression. The results of the study provide support for the inclusion of more culturally appropriate measures of caregiver distress, and provide insights to inform social work practice, policy and research concerning African American female elder caregivers in the 21st century.     

A Quantitative Evaluation of the Multi-Disciplinary Approach to Prevention Services (MAPS) Program to Protect Children and Strengthen Families

This article presents the results from an evaluation of a state-funded, prevention-based, pilot program called the Multi-Disciplinary Approach to Prevention Services that was designed to reduce the potential for child abuse and neglect. The program served 64 families of various races and ethnicities over two years. A quantitative pretest–posttest design was used to analyze existing program data related to client outcomes including parenting skills, parenting satisfaction, and the use of non-family resources to assist in improving skills and satisfaction. Means comparisons were used to assess the relationship between three standardized instruments (the Parenting Scale, the Eyberg Child Behavior Inventory and the Kansas Parental Satisfaction Scale). Findings indicated a statistically significant improvement regarding resource engagement by families, parenting behaviors and perceptions, and involvement with Child Protective Services. The results from this study offer insight into how to improve parenting behaviors and increase child protective factors for youth who are at risk of maltreatment. In addition, these findings contribute to strengthen the legitimacy of Weiner's Attribution Theory while providing the social work profession with additional data in areas of research targeting the intersection of financially viable prevention programs, family stability, parental education, resources engagement, and the reduction of child abuse and neglect. If additional research supports the efficacy of prevention programs such as MAPS, funding similar programs could lead to improved parenting and decreases in child maltreatment.