Elder abuse in Europe: an overview of recent developments

Elder abuse is a global phenomenon. Despite recognition and action several decades ago in a number of countries, in many others the phenomena of abuse and neglect have been much more recently identified as in need of attention. This brief will discuss the situation relating to responses to and interventions in elder abuse that have been evolving in a number of countries in the European region, which are at different stages of development. The examples provided will assist in meeting the worldwide challenge that elder abuse presents.     

The effect of a family-based intervention with a cognitive-behavioral approach on elder abuse

ABSTRACT

Elder abuse may become a health issue in developing countries, including Iran. The purpose of this investigation was to study the effectiveness of Family-Based Cognitive-Behavioral Social Work (FBCBSW) in reducing elder abuse. In a randomized clinical trial in Iran, 27 elders participated in intervention and control groups. The intervention groups received a five-session FBCBSW intervention and completed the Domestic-Elder-Abuse-Questionnaire (DEAQ), which evaluates elder abuse at baseline and follow-ups. Repeated measures of analysis of variance (ANOVA) and the Wilcoxon test were used to analyze the data. The repeated measures ANOVA revealed that FBCBSW was successful in reducing elder abuse. The Wilcoxon test indicated that emotional neglect, care neglect, financial neglect, curtailment of personal autonomy, psychological abuse, and financial abuse significantly decreased over time, but there was no statistically significant difference in physical abuse before and after the intervention. The findings from this study suggest that FBCBSW is a promising approach to reducing elder abuse and warrants further study with larger samples.     

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.     

Searching for Elder Abuse: A Systematic Review of Database Citations

ABSTRACT

The aim of this review was to describe trends and patterns in elder abuse literature and research. All citations in PUB MED, CINAHL, and PsycINFO databases located using the search term “elder abuse” were retrieved (3,059 citations) and 2,418 unique references were identified. Using manifest content analysis, non-research material (1,986 references) was sorted by type and research references (34 dissertations and 398 research articles) were categorized. Research article references most commonly: (1) investigated prevalence, typology, and definitions of elder abuse; (2) utilized quantitative methodology; (3) had first author affiliations to medicine, nursing, and social sciences; and (4) sampled populations of professionals, personnel, cases, or charts. The USA was most frequently listed of 24 identified countries of origin. Elder abuse research shows lack of diversity, slow increase of qualitative research, limited involvement of older persons and family members as participants, and minimal research from developing countries. This review contributes to knowledge valuable for researchers and experts planning future studies or elder abuse projects.     

Trauma-informed care and elder abuse: a synergistic alliance

ABSTRACT

Elder abuse is a global systemic problem in which one or more traumatic or stressful life experiences directly affect older adults, their families, and communities. Despite its devastating impact, the understanding of—and response to—elder abuse has rarely been explored through a trauma-informed lens. Despite the prevalence of traumatic and stressful life experiences, research and practice are just beginning to target the intersection of elder abuse and life course trauma. This article demonstrates how knowledge about the causes, consequences, and responses to elder abuse can be integrated with the principles of trauma-informed care to improve agency and community responses to preventing or intervening with elder abuse and neglect. In order to address the ongoing problems with detection and treatment of elder abuse, we assert that instilling trauma and elder abuse informed care in organizational services and policies forms a synergistic alliance and would address many of these concerns.     

Understanding and Combating Elder Abuse in Hispanic Communities

ABSTRACT

A knowledge of the conditions associated with elder abuse and the manner in which certain cultural factors influence the response to abuse can provide the foundation for developing prevention and treatment strategies. This article describes elder abuse and domestic violence in the context of Hispanic culture. Important aspects are examined: individual personalismo, lafamilia, commu-nidad, and The Church as they apply to the older generations and to current cohorts that have not been exposed to the majority culture for long periods. Combating abuse involves recognizing and incorporating the cultural strengths of the Hispanic community and empowering the community to create a society where all peoples can live con dignidad.     

The Vulnerability for Elder Abuse Among a Sample of Custodial Grandfathers: An Exploratory Study

ABSTRACT

Older adults have been known to make sacrifices in their caregiving roles. Gerontology literature on custodial grandparents has primarily focused on grandmothers and the challenges they face when they assume primary care for grandchildren. Little is known about the risks that older men face when they become custodial grandparents. This article highlights types and warning signs of abuse, exploitation and neglect. Exploratory study was undertaken with a racially diverse group of custodial grandfathers to fill a gap in the literature about the vulnerability for elder abuse, exploitation and neglect as expressed by older Black, Latino and White custodial grandfathers. To provide a more inclusive understanding of elder abuse, areas of vulnerability were identified for consideration by practitioners, educators and researchers. The implications of this research point to the need to rethink elder abuse assessment, prevention and intervention strategies with older men.     

Elder Abuse Coverage in Newspapers: Regional Differences and its Comparison to Child-Abuse Coverage

ABSTRACT

Dozens of studies have examined how the press portrays crime. Most of these studies focus on some aspect of the criminal or the response to the event. Few have considered the portrayal of victims and even fewer have examined the way the media portrays older victims. To fill this void, this study examines (1) whether elder abuse coverage varies across newspapers and (2) how the extent of elder abuse coverage compares to child-abuse coverage. Results indicate that regional differences appear to exist and child abuse receives far more coverage than elder abuse. Implications are provided.     

An Overview of Elder Abuse and Neglect in Australia

ABSTRACT

Only relatively recently has the issue of elder abuse come to prominence in Australia. Until the late 1980s it was a hidden problem with little knowledge of its presence. Attention was drawn to elder abuse after the publication of a number of reports and research projects, allowing the development of responses at national and state levels. This paper gives an overview of the development of elder abuse as a social, legal and medical issue in Australia, and describes the diverse range of responses from the national, state and territory governments.     

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.     

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.     

A Telephone Counseling Program for Elder Abuse in Japan

ABSTRACT

In the 21st century, one-fourth of the Japanese population will be 65 years and older. Not only is the duty to report elder abuse not defined by the law but there is no special organization with clinical facilities to respond to incidents of elder abuse. A report in 1994 by the Society for the Study of Elder Abuse (SSEA) showed the need for definitive social measures to prevent elder abuse. Based on that research, SSEA organized the Japan Elder Abuse Prevention Center and initiated a volunteer telephone counseling service “Help Line” that was available for several hours on Mondays. Within an 18 month period, 209 cases were handled of which 150 concerned abuse, neglect, and financial exploitation. Callers were more often the elder or the daughter than other relatives or outsiders. Sons were the more prevalent perpetrators, and financial abuse the most common type of mistreatment reported. Recommendations include new laws and social welfare policies that adapt to the changes in an aging society.     

Addressing the measurement challenge in elder abuse interventions: need for a severity framework

ABSTRACT

The field of elder abuse is evolving toward an emphasis on intervention research. However, researchers currently rely on binary approaches to measure elder abuse phenomena, which fail to capture changes in problem status over the course of intervention. This commentary develops a case for severity as a framework to operationalize and measure elder abuse in intervention research and practice. A severity framework provides enhanced elder abuse measurement responsiveness and aligns with the dominant client-centered, harm-reduction clinical approach to intervening with elder abuse cases.     

Protecting Older Americans: A History of Federal Action on Elder Abuse,Neglect, and Exploitation

ABSTRACT

Congressional hearings on elder abuse began over a quarter century ago. However, federal legislative and departmental activity for addressing the problem has been slow and lacks coordination and comprehensiveness. In addition, federal funding to combat elder abuse represents only a small percentage of that spent on such other abused populations as children and women. The barriers and challenges to addressing elder abuse are identified along with existing programs at the federal level. The article concludes with a discussion of state and local initiatives which show promise for effectively preventing or treating this problem.     

Elder Abuse: The Canadian Experience

ABSTRACT

Abuse and neglect of older adults occurs in all Canadian communities and solutions require the coordinated efforts of society at large. Amelioration entails more than a legislative approach. Prevention of this growing problem is a social responsibility that requires networking and collaboration between different disciplines in all sectors of the community. This article will discuss elder abuse in Canada from a historical perspective, as well as current legislation, model programs, and research initiatives. It is intended to allow for comparison from the various countries presented in this volume. Hopefully, readers will find some models, or ideas, they may wish to explore or even replicate within their own jurisdictions.     

Mental Health and Criminal Justice Issues Among Perpetrators of Elder Abuse

ABSTRACT

Recent studies on elder abuse suggest that the pathology or impairment of the abuser may be a stronger predictor of elder abuse than characteristics of the victim. To examine the relationship between elder abuse, abuser pathology, and the criminal justice system, the New York City Department for the Aging (DFTA) undertook a survey of older victims of reported domestic abuse seeking assistance from the DFTA Elderly Crime Victims Resource Center. Preliminary findings from the survey indicate that impaired abusers were significantly younger than unimpaired abusers and more likely to live with their elderly victims, to be unemployed, and to have a history of involvement with the criminal justice system.     

Elder Abuse: Feminist and Ageist Perspectives

ABSTRACT

Elder abuse research reports little consensus regarding gender and age. This project examined 99 incidents of elder abuse by an adult child and 86 incidents of elder abuse by a spouse, and compared the groups using the variables: gender, age, and incidents. The results are discussed from a feminist and age perspective. Differences between the groups were found, namely that elder abuse by an adult child is most likely to be financial abuse. Traditional ideas about women and men, as well as ideas about the nature of the old were found to be factors in elder abusive relationships.     

Development and Validation of a Tool to Improve Physician Identification of Elder Abuse: The Elder Abuse Suspicion Index (EASI)©

ABSTRACT

This study aimed to develop and validate a brief tool for physician use to improve suspicion about the presence or absence of elder abuse. A literature review on elder abuse, obstacles to its identification, limitations of detection tools, and characteristics of screeners employed by physicians were used to generate elder abuse detection questions for critique by 31 doctors, nurses, and social workers in focus groups. Six resulting questions became the Elder Abuse Suspicion Index (EASI) administered by 104 family doctors to 953 cognitively intact seniors in ambulatory-care settings. Findings were compared to a recognized, detailed elder abuse Social Work Evaluation (SWE) later administered to participants by social workers blinded to the results of the EASI. The EASI had an estimated sensitivity and specificity of 0.47 and 0.75, usually took less than 2 minutes to ask, and 97.2% of doctors felt it would have some or big practice impact. This research is a first phase in the development and validation of a user-friendly tool that might sensitize physicians to elder abuse and promote referrals of possible victims for in-depth assessment by specialized professionals.     

Elder Abuse and Neglect in South Africa: A Case of Marginalization,Disrespect, Exploitation and Violence

ABSTRACT

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.     

Older adults affected by polyvictimization: A review of early research

ABSTRACT

In contrast to work within the child-abuse field, polyvictimization of older adults did not become a focus of professional attention until this decade. Despite this lack of formal identification, a search of the research and practice literature revealed that prior research investigating single forms of or other elder abuse issues contained evidence of what was variously termed “multiple,” “multi-faceted,” “co-occurring,” or “hybrid” elder abuse. A wide range of victims (1.4%–89.7%) identified in existing elder abuse studies was found to have experienced what constitutes “polyvictimization.” This late-life polyvictimization evidence, the contexts in which victims are harmed, and information regarding the impact of multifaceted elder abuse are all presented and discussed in this article. Selected published cases illustrate the clinical dynamics operating in late-life polyvictimization situations.