Fractured Relationships and the Potential for Abuse of Older Men

SUMMARY

Elderly men are an understudied population in the area of abuse and neglect. The typical elder abuse or neglect victim is described as a frail woman. The National Elder Abuse Incidence Study shows men to be victims as well and at higher risk than women for abandonment, the most extreme form of neglect. A qualitative study of older widowed men did not specifically explore issues of abuse and neglect, but found several of the men experiencing alienation from one or more of their adult children. This paper explores the dynamics of these “fractured relationships” and finds several patterns that may increase an older man's risk of being neglected when his needs for support increase. Many men are not functioning in a kinkeeper role and are not attempting to repair fractured relationships. Minimizing their own feelings may prevent men from understanding the extent of alienation felt by an adult child.     

Public Opinion on Mandatory Reporting of Abuse and/or Neglect of Older Adults in Manitoba,Canada

This article discusses the results of a survey administered as part of a study titled, “Legislation and Service Provision Regarding Abuse and/or Neglect of Older Adults in Manitoba.” Public views of mandatory reporting and knowledge of legislation were investigated in the case where an older adult is living at risk of abuse and/or neglect in Manitoba, Canada. The survey data demonstrate that older respondents stated that mandatory reporting was not always preferable, except when an older adult was clearly diagnosed as incompetent and, even with no evidence, thought to be at risk. With less awareness of the topic in general, and with less contact with older adults, younger adults had much stronger views in support of mandatory reporting in all cases. Little knowledge and awareness of legislation existed in all age groups, although older adults knew more about such abuse and/or neglect than younger adults. Given the projected increase of older adults in Canada in the next 20 years, it is critical that the prevention of abuse and/or neglect and protection of older adults be addressed.     

Turkey: a pilot study of elder mistreatment in a convenience sample

Attitudes towards elder abuse were explored through a survey on International Perspectives on Family Violence and Abuse in a Turkish convenience sample of 25 females and 14 males, ranging in age from 22 to 58. Participants gave examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive from an adult child toward his or her older parent. Responses were coded into four major categories of abuse, each of which had several subcategories: psychological aggression (including the subcategories of verbal aggression, emotional abuse, disrespect, disobedience, power assertion, blame, and imprisonment), neglect (including physical neglect, psychological neglect, abandonment, and putting the older individual into a nursing home), physical aggression (including beating and hitting), and mistreatment related to goods and services (including economic demands, economic withholding, and labor). The most common examples of extreme abuse were neglect, particulary physical neglect, followed by physical abuse. At the moderate and mild levels, various forms of psychological aggression were most commonly mentioned. The only significant gender difference was that men listed more instances of verbal aggression as examples of extreme abuse than women. A positive correlation was found between age and the number of abandonment examples at the extreme level. Results were interpreted from a cultural perspective.     

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.     

Turkey: A Pilot Study of Elder Mistreatment in a Convenience Sample

ABSTRACT

Attitudes towards elder abuse were explored through a survey on International Perspectives on Family Violence and Abuse in a Turkish convenience sample of 25 females and 14 males, ranging in age from 22 to 58. Participants gave examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive from an adult child toward his or her older parent. Responses were coded into four major categories of abuse, each of which had several subcategories: psychological aggression (including the subcategories of verbal aggression, emotional abuse, disrespect, disobedience, power assertion, blame, and imprisonment), neglect (including physical neglect, psychological neglect, abandonment, and putting the older individual into a nursing home), physical aggression (including beating and hitting), and mistreatment related to goods and services (including economic demands, economic withholding, and labor). The most common examples of extreme abuse were neglect, particulary physical neglect, followed by physical abuse. At the moderate and mild levels, various forms of psychological aggression were most commonly mentioned. The only significant gender difference was that men listed more instances of verbal aggression as examples of extreme abuse than women. A positive correlation was found between age and the number of abandonment examples at the extreme level. Results were interpreted from a cultural perspective.     

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.     

Implicit theories of elder abuse in a sample of European-American descent

The purpose of this exploratory study was to examine implicit theories of elder abuse in a sample of men and women of European-American descent. Seventy-six participants, ranging in age from 17 to 79, filled out an open-ended qualitative survey asking them to give examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive in the context of an adult child-older adult parent dyad. Results indicated that various types of physical aggression and neglect (with an emphasis on physical neglect) were the most common examples of extreme abuse. Psychological aggression was the most common example of moderate abuse, and forms of psychological abuse and neglect were the most frequent examples of mild abuse. Gender differences were found, with females more often mentioning examples of neglect than males. Sexual and economic abuse did not seem to be commonly identified forms of mistreatment in implicit theories of elder abuse.     

Definitions and indicators of elder abuse: a delphi survey of APS caseworkers

Instruments designed to measure specific types of elder mistreatment are not available, but they may be warranted after an initial screen indicates abuse or risk for abuse. The purpose of this study was to evaluate definitions for different types of elder mistreatment and validate the indicators as perceived by adult protective services (APS) caseworkers' opinions. Through 351 APS research network participants, a Delphi survey was completed. A 45% return rate was achieved for round one and 40% for round two with 70 same respondents from both rounds. These types of abuse, emotional abuse, exploitation of finances and/or property, neglect, physical abuse, and sexual abuse, have some similar and some extremely different indicators that singly and together expand their definition. Instruments to measure five different types of abuse are offered for caseworker or prevalence study use.     

Competing Values in Serving Older and Vulnerable Adults: Adult Protective Services,Mandated Reporting,and Domestic Violence Programs

State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.     

Implicit Theories of Elder Abuse in a Sample of European-American Descent

ABSTRACT

The purpose of this exploratory study was to examine implicit theories of elder abuse in a sample of men and women of European-American descent. Seventy-six participants, ranging in age from 17 to 79, filled out an open-ended qualitative survey asking them to give examples of behaviors considered in their culture to be extremely abusive, moderately abusive, and mildly abusive in the context of an adult child-older adult parent dyad. Results indicated that various types of physical aggression and neglect (with an emphasis on physical neglect) were the most common examples of extreme abuse. Psychological aggression was the most common example of moderate abuse, and forms of psychological abuse and neglect were the most frequent examples of mild abuse. Gender differences were found, with females more often mentioning examples of neglect than males. Sexual and economic abuse did not seem to be commonly identified forms of mistreatment in implicit theories of elder abuse.     

The Prevalence of Elder Abuse and Neglect of Older Adults Who Access Health and Social Services in London,Ontario, Canada

It is anticipated that older adults who seek professional intervention may be more at risk of abuse and neglect. This paper reports a prevalence study that focused on older adults who accessed health and social service organizations over a three month period. Respondents ranged from 55 to 100 with a mean age of 73.8 years. Over a quarter of the sample reported at least one form of violence during their lifespan. Higher prevalence rates than in the general population were found. Attempted material abuse was most frequent, followed by verbal abuse, physical abuse, unintentional neglect, actual material abuse, and intentional neglect.     

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.     

Elder abuse and neglect

Elder abuse and neglect is a critical health care issue that must be brought to the attention of health care providers and older adults' family members. Adults older than 65 who live at home or in long-term care facilities may be at risk for abuse. Nurses should be aware of the causes, screening questions, symptoms of abuse, and resources in the community. Armed with information and a better understanding about the issue, nurses can minimize the devastating effects of abuse on older adults and their families.     

An Understanding of Abuse in the Hispanic Older Person: Assessment, Treatment, and Prevention

This article offers a discussion of abuse in the Hispanic older person population, conceptualized from within a cultural framework including assessment and treatment. Basic cultural values such as familism, marianismo, machismo, and respeto are considered essential elements to the understanding of this framework. Acculturation, migration, and socioeconomic factors are also presented as important factors in the understanding of this problem. This article emphasizes how expectations based on cultural aspects and values can unintentionally increase the risk of neglect and/or abuse. The concepts of caregiver stress and dependency widely discussed in the older person abuse literature are integrated in the discussion of older person abuse in the Hispanic.     

Uses of Guardianship as a Protective Intervention for Frail,Older Adults

The uses of guardianship as a protective intervention for frail, older adults, especially those at risk for abuse and exploitation, are examined. Findings are based on results from four projects: a model project providing guardianship services to low-income older adults; an elder abuse demonstration project; a study of judicial decisionmaking on gaurdianship and the elderly; and a survey of guardianship petitions and adjudications. The findings suggest that guardianship is not always the most effective means for meeting the needs of at-risk older adults, and guardianships do sometimes fail to protect wards from abuse and neglect. Eight recommendations for developing guardianship alternative programs are offered.     

The vulnerablility for elder abuse among a sample of custodial grandfathers: an exploratory study

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.     

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 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 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.