Elder Abuse in Portugal: Findings From the First National Prevalence Study

In this study, we present findings of the Portuguese national prevalence study, “Aging and Violence,” the purpose of which was to estimate the prevalence of abuse and neglect of older people in family settings over a 12-month period and examine the relationship between abuse and sociodemographic and health characteristics. Through a telephone survey of a representative probability sample (N = 1,123), we evaluated 12 abusive behaviors and demographic data. Overall, 12.3% of older adults experienced elder abuse in family settings. The prevalence rates of specific types were as follows: psychological, 6.3%; financial, 6.3%; physical, 2.3%; neglect, 0.4%; and sexual, 0.2%. Logistic regression was employed to determine the relationship between abuse and covariates. The study suggests that education level, age, and functional status are significantly associated with abuse. Accurate estimates of the prevalence of elder abuse and understanding of victim and perpetrator characteristics are fundamental to designing effective strategies for prevention and intervention.     

Financial Abuse of Older People by a Family Member: A Difficult Terrain for Service Providers in Australia

Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.     

The Critical-Ecological Framework: Advancing Knowledge,Practice, and Policy on Older Adult Abuse

The abuse of older adults in our society is a recognized yet understudied issue compared to other forms of family violence. Within this article, research, theory, and practice in family violence and older adult abuse are compared; elements that can be transferred to the field are analyzed; and gaps are identified. An extensive literature review, two focus groups with local stakeholders, and interviews with six key informants recognized as national subject experts formed the basis of this analysis. The results informed the development of a critical-ecological model designed to address the gaps and advance the field.     

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.     

Material Abuse and Powers of Attorney in Canada:

The finding that material abuse may be the most prevalent form of elder mistreatment has prompted an examination of the enduring power of attorney used when an elderly person anticipates or has existing physical and mental impairment. This paper provides a background on the enduring and ordinary powers of attorney in the Canadian context, describes the abuses, and suggests measures of prevention.     

Financial Exploitation of Older Adults in Rural Settings: A Family Perspective

Federal agencies responsible for funding protective services to older adults are increasingly concerned with the growing incidence of financial exploitation in rural areas. The Wall Street Journal recently has reported an increasing trend of unemployed adult children migrating from urban centers to smaller rural towns and countrysides to live with their parents since 2008. This current study explores the attitudes of family caregivers regarding management of financial matters for their elderly care recipients. The major findings of the study include that adult children often (1) overestimate their parents' ability to manage their finances; (2) prefer to manage their parents' finances informally, as opposed to using legal options like power of attorney; and (3) tend to think of their parents' assets as “almost theirs.” The study concludes with recommendations on the critical need for information to help families make important decisions about helping elderly parents with their finances. This information would not only promote the use of safeguards against abuse, but could potentially provide caregivers with greater confidence and protection.     

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.     

Definitions of Elder Abuse in an Italian Sample

ABSTRACT

The purpose of this exploratory qualitative study was to analyze definitions of elder abuse in an Italian convenience sample. Fifty-three Italian participants (15 males, 38 females) provided examples of mild, moderate, and extreme mistreatment of older individuals by their adult children. Analyses were conducted to identify frequently mentioned types of abuse and to determine how severe they were judged to be. Also examined was the extent to which gender and age contributed to response patterns. Most examples of extreme elder abuse made reference to physical abuse and neglect, while references to psychological aggression and neglect predominated as examples of moderate and mild abuse. Examples of neglect appeared with equal frequency at all levels of severity, but physical aggression was mentioned primarily as a form of extreme abuse, and psychological aggression was mentioned more frequently in examples of moderate and mild abuse. The most frequently identified types of specific abuse were abandonment, verbal abuse, emotional abuse, and psychological neglect. When giving examples of extreme abuse, females mentioned more instances of financial exploitation than males. They also gave more examples of verbal aggression and lack of respect as instances of moderate abuse and behaviors reflecting power or control as examples of mild abuse. A statistically significant negative relationship was found between age and the number of examples given of particular types of mistreatment at each of the levels of severity of abuse.     

Russian Perspectives on Elder Abuse: An Exploratory Study

ABSTRACT

The purpose of this exploratory study was to analyze Russian perceptions of elder abuse as reflected in their examples of abusive behavior from an adult child to an aging parent. Also of interest was the possibility of gender differences in the Russian perspectives on elder abuse. The convenience sample consisted of 21 Russian participants (10 males, 10 females, and one without gender identified), who provided examples of extreme, moderate, and mild abuse from an adult child towards an aging parent. Most examples of extreme abuse were forms of physical violence. Typical examples of moderate abuse were instances of psychological aggression–particularly verbal aggression–and neglect. The most common examples of mild abuse were verbal aggression and neglect. One-way analyses of variance revealed statistically significant gender differences in the number of references to psychological aggression in general and to verbal aggression in particular in the examples of moderate abuse, with females giving more examples than males.     

Elder Abuse Detection and Intervention: A Collaborative Approach by B. Brandl,C. B. Dyer,C. J. Heisler,M. J. Otto,L. A. Stiegel,and R. W. Thomas

Mediation has recently been developed in America to help seniors deal with their disputes. Some Long Term Care Ombudsmen and their volunteers have also been trained in mediation for use in institutional conflicts. This paper suggests that elder mediation, through its voluntary, non-coercive process, has the potential for enhancing elder rights, providing an acceptable form of minimal social intervention, and contributing to the prevention of elder abuse at early stages of relational conflicts between elders and their carers.     

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.     

Mistreatment of Older People in the United Kingdom: Findings from the First National Prevalence Study

There have been few national studies of the prevalence of elder mistreatment (abuse and neglect) in private households. This article provides an overview of the UK National Prevalence Study of Elder Mistreatment that took place in 2006. It addressed 2,111 respondents in four countries who answered a face-to-face survey questionnaire. The achieved sample was weighted to be representative of the UK older population. Of respondents, 2.6% reported mistreatment by family members, close friends, or care workers. The predominant type of reported mistreatment was neglect (1.1%) followed by financial abuse (0.6%), with 0.4% of respondents reporting psychological abuse, 0.4% physical abuse, and 0.2% sexual abuse. Women were significantly more likely to have experienced mistreatment than men, but there were gender differences according to type of abuse and perpetrator characteristics. Divergent patterns were found for neglect, financial, and interpersonal abuse. Further analysis of the data indicated that the likelihood of mistreatment varied with socioeconomic position and health status.     

Family Members' Reports of Abuse in Michigan Nursing Homes

The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.     

Development of the Emergency Department Senior Abuse Identification (ED Senior AID) tool

Emergency departments (EDs) are an important health care setting for the identification of elder abuse (EA). Our objective was to develop an ED-based tool to identify EA. The initial tool included a brief cognitive assessment, questions to detect multiple domains of EA, and a physical examination. Refinement of the tool was based on input from clinical experts and nurse and patient feedback. The revised tool, which included 15 questions about EA, was then tested in an academic ED. We calculated the inter-rater reliability, sensitivity, and specificity of individual EA questions. Among ED patients age≥65 (N = 259), 17 (7%) screened positive for suspicion of EA. We identified a combination of six questions that cover the included domains of EA, demonstrated good or excellent inter-rater reliability, and had a sensitivity and specificity of 94% (95% confidence interval (CI) 71–100%) and 90% (95% CI 85–93%), respectively. These results inform a proposed screening tool for multisite validation testing.     

The Prevalence of Child Sexual Abuse among Slovak Late Adolescents

ABSTRACT

The present study aimed to assess the prevalence and characteristics of child sexual abuse (CSA) in a large-scale sample of Slovak late adolescents. Randomized cluster sampling was used to sample 2186 students in their final school year of secondary school with mean age of 18.6 years (SD = .7 years). The study employed the Child Sexual Abuse Questionnaire consisting of multiple behavior-specific questions. The prevalence of CSA was analyzed separately for three clusters of CSA and gender. The prevalence of non-contact forms of CSA was 40.6% among girls and 17.7% among boys. CSA with physical contact without penetration was reported by 30.2% girls and 11.6% boys. The prevalence of CSA with penetration was 5.6% among girls and 1.3% among boys. More than half of CSA occurred between 16 and 18 years of age. The severity of abuse was positively associated with acquaintance to the perpetrator. Roughly 43–56% disclosed the abuse to another person. The majority of disclosed CSA was revealed to peers and partners. A negligible proportion of CSA instances were reported to the police. Prevention activities should consider a broad spectrum of CSA in order to counteract tendencies to associate CSA only with unwanted sexual intercourse.     

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.     

A Family Perspective for Substance Abuse: Implications from the Literature

SUMMARY

This paper calls for researchers and treatment providers to increase their recognition of the role that family and family functioning has for understanding the incidence and impact of substance abuse. Substance abuse is identified as a family problem by exploring its occurrence within families as well as its impact on marital relationship, family violence, and child abuse and neglect. The impact of substance abuse on the roles of spouses and parents are examined, as is the impact of substance abuse on children at various developmental stages. The role of the family as participant in active substance abuse as well as a valuable treatment resource is also explored. Finally, the authors present recommendations for increasing the focus on family in substance abuse research.     

“The Abuse of Older Australians (Elder Abuse)”: Reform Activity and Imperatives

ABSTRACT

Significant national reform activity is occurring that concerns the abuse of older people by trusted others. This includes an Australian Law Reform Commission report entitled Elder Abuse – A National Legal Response (2017), and the adoption in 2019 of the first ever “National plan to respond to the abuse of older Australians (elder abuse)”. While service responses in this field largely exist at, and will continue to be provided at, state and territory level, this article considers current and needed reform initiatives in a field of increasing national government attention.

IMPLICATIONS

• The adoption of the first ever national plan concerning the abuse of older people in Australia adds significant impetus and direction for reform in this key social policy area.

• Most service and regulatory reforms aimed at improving responses to the abuse of older people will occur at state and territory level.

• The breadth of likely and necessary reforms is significant, ranging from policing practices through to guardianship law reform.

     

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.