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 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.     

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

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.     

Fractured relationships and the potential for abuse of older men

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.     

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.     

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.     

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.     

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.     

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community

ABSTRACT

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.     

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.     

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.     

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.     

Definitions of elder abuse in an Italian sample

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.     

The Hospital Elder Assessment Team:

Elder abuse literature shows that health care professionals are aware of elder abuse/neglect laws but do not understand the requirements nor have the skills to diagnose the problem (Clark-Daniels & Daniels, 1990). Many victims of elder abuse appear in hospital emergency rooms for medical evaluation. Although 42 of the 50 states now have mandatory elder abuse/neglect reporting laws, few hospitals have responded with interdisciplinary elder protective teams in contrast to the situation with child abuse reporting laws. One exception has been the establishment of a multidisciplinary elder assessment team at Beth Israel Hospital, Boston, MA, to address the complex issues of recognition and assesssment of elders seen in the hospital who are suspected victims of abuse. Included in the mission of the team are consultation, support, and education to hospital staff about elder abuse and neglect.     

Professional Decision Making on Elder Abuse: Systematic Narrative Review

Social work and health care professionals internationally are recognizing the need to understand and respond to the abuse of older people. Policy and guidance have identified processes but definitions of key concepts remain problematic, and the literature suggests that practitioners and agencies have little insight or guidance for decision making. Nine bibliographic databases were searched for studies on professional decision making regarding abuse of older people. Relevant studies retrieved were appraised for quality using explicit criteria. The findings of the 19 articles meeting the inclusion criteria were synthesised using a structured narrative approach. Common themes identified were abuse factors, situational factors, and broader contextual factors. Abuse factors relating to risk levels and client vulnerability were central; age, gender, and health status were considered as key indicators of vulnerability. The opinion of adult protection workers about the potential effectiveness of their intervention was a factor in deciding about responding to alleged or suspected abuse. Professionals struggled with complex ethical dilemmas created by elder abuse, particularly when the victim did not want an investigation. Making objective judgements was difficult when faced with complex family and contextual factors. A structured approach to narrative synthesis of a diverse range of studies retrieved through an explicit search and inclusion process provided a useful summary of key issues for practice and identified gaps in the research literature.     

Understanding "elder abuse and neglect": a critique of assumptions underpinning responses to the mistreatment and neglect of older people

This article provides an overview of the ways in which the mistreatment and neglect of older people have come to be understood as a social problem, one which is underpinned by a variety of substantive and theoretical assumptions. It connects the process of conceptualizing elder abuse and neglect to political-economic and social evolution. The authors draw on a review of the literature, government sources, interest group websites, and their own research to provide a critical commentary illustrating how these understandings have become manifest in legislation, policies, and programs pertaining to "elder abuse and neglect" in Canada. Suggestions are provided for changes in direction for policies, programs, and research.     

Feasibility of Integrating Mental Health Screening and Services Into Routine Elder Abuse Practice to Improve Client Outcomes

This study examined law enforcement and prosecution involvement in 71 cases of elder abuse where pure financial exploitation (PFE), physical abuse (PA), neglect (Neglect), or hybrid financial exploitation (HFE) (financial exploitation co-occurring with physical abuse and/or neglect) occurred in a domestic setting. Victims of elder abuse and assigned Adult Protective Services (APS) caseworkers were systematically interviewed. Law enforcement officials were involved in 54% of the cases, and 18% of the cases were prosecuted. PA was significantly more likely to trigger a law enforcement response and to be prosecuted than Neglect or PFE. HFE involved prosecution for assault rather than financial exploitation. Generally, the victims of elder abuse were not receptive to criminal justice involvement, which appears to have a significant impact upon the level of this involvement. The reasons for this reluctance are discussed, as well as the challenges and limitations of criminal justice system involvement and related implications for policy and practice.     

Risk factors associated with elder abuse: the importance of differentiating by type of elder maltreatment

Elder abuse research rarely differentiates by the type of elder maltreatment involved when identifying risk factors. The purpose of this study was to compare risk factors across four predominant types of elder maltreatment (financial exploitation, physical abuse, neglect by others, and hybrid financial exploitation [HFE]). Data were collected from two sources: interviews with victims of substantiated elder abuse, responding adult protective services (APS) caseworkers (N = 71), and third-party informants; and a statewide database that contained all substantiated cases over a corresponding 2-year period (N = 2,142). Using chi-square (interview data) and logistic regressions (Adult Services/Adult Protective Services [ASAPS] data), significant differences across the four types of elder maltreatment were found. These two datasets provide converging evidence for the importance of differentiating by type of maltreatment when identifying risk factors for elder maltreatment and for the importance of considering both the elderly victim and the abusive individual when predicting type of elder maltreatment.     

Elder Abuse in a Land of Tradition: The Case of Israel's Arabs

ABSTRACT

This study attempted to assess the scope and nature of elder abuse and neglect in one traditional group currently undergoing change: the Arabs in Israel. One hundred and twenty-eight human service and health professionals in northern Israel were asked to report about all cases of elder abuse and neglect they had encountered for a period of 18 months prior to the study. Findings showed that overall Arab elders in Israel have a 2.5% rate of abuse and neglect (excluding self neglect). This figure is somewhat lower than that reported in the literature for either developed or developing societies. Rates were higher in urban areas, somewhat lower in suburban areas, and lowest in isolated villages. These results lend some support to modernization theories of aging and elder abuse. The profile of the abused elder is not significantly different from that of his Western counterpart. Among alleged perpetrators, however, sons and daughters-in-law rank highest, reflecting cultural patterns in some traditional societies. The article makes some early recommendations in the area of worker training and service enhancement.