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.     

New directions for management accounting

Using a general systems rationale, this paper develops a theoretical structure for approaching the problem of management accounting. The management control problem is explicated in terms of maintaining a relationship between the enterprise's structure and its environment. An enterprise's structure is composed of three elements (and their inter-relations): a decision and control subsystem; a financial funds subsystem and an operating (physical transforms) subsystem. Portrayed in these terms, the problem of management accounting is shown to require a methodology which is able to take cognizance of economic, sociological, psychological and other aspects of the enterprise system. The model described here provides a general intellectual frame of reference for ordering the problem.     

Admission to Nursing Homes in Taiwan

The population of Taiwan is facing a radical ageing process. A proportion of the growing number of people aged 65 and over is expected to need nursing home care. This research concerns the family context of decision‐making in the process of admission to a nursing home in Taiwan. Employing survey data from interviews with elderly people in nursing homes (235 interviews) and their carers/key families (265 interviews), the factors affecting their views about admission were explored. Bivariate analysis and a logistic regression model were also used to examine perceptions of alternatives to nursing home care among family members with elderly relatives in nursing homes. Most elderly people in Taiwan are cared for in their own homes by their families but, in some circumstances, entry to a nursing home seemed inevitable. This research found that the decisions were taken mainly within a family context. The adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision. Apart from the important need factors of elders, families’ views about alternatives to nursing homes were significantly influenced by their preferences. This study has important implications for long‐term care in Taiwan. It is hoped that this will be needs‐led, both by elderly people and their families.     

Interactional perspectives on the mistreatment of older and vulnerable people in long‐term care settings

This article draws on a study aimed at developing theoretical and methodological understanding of the abuse and neglect (mistreatment) of older people in long‐term care settings such as care homes and hospitals. It presents an interactionist account of mistreatment of older people in such establishments. Starting with an outline of definitional issues surrounding the topic, the allied concept of dignity is also briefly explored, and one important model described; we present dignity as the converse of mistreatment. The article argues for the potential of a positioning theory analysis of mistreatment. Positioning theory proposes that interactions are based on taking of ‘positions’, clusters of rights and duties to act in certain ways and impose particular meanings, which enable or prohibit access to certain storylines. It is argued that ‘malignant’ positioning can contribute to the creation of a climate that allows mistreatment to take place, or fails to prohibit its development. Mistreatment of people with dementia is used as an illustration, and it is argued that this is potentially generated by negative feedback loops of behaviour patterns, interpretations and malignant positioning by staff or family carers and subsequent response to these interpretations by the person with dementia. Positioning theory also allows for an explanation of the importance and impact of organizational cultures and social factors such as ageism. Individual staff members take positions, use meanings and develop storylines imbued with such factors. This understanding therefore overcomes some of the potential confusions created by concepts such as organizational or institutional abuse, removing the need to ascribe intentions and personal responsibility to such constructs. The article concludes with some suggestions for further research to develop an understanding of the kinds of cultures that allow mistreatment and consequently to inform the development of protective measures.     

Researching social care for minority ethnic older people: implications of some Scottish research

Summary The paper explores issues raised by research on patterns ofwelfare and mutual care among older Pakistani people and theirfamilies, with particular reference to their use, or lack ofuse of social care services. Qualitative interviews were conductedwith (self-defined) minority ethnic older people, professionalsin statutory services and in minority-led community-based groups.The organization of services is discussed, with special referenceto issues of power and control, the role of the voluntary (non-profit)and statutory sectors, the debate regarding the possible needfor specialist versus generic services, and the role of minority-ledinitiatives. Secondly, issues of service staffing are examined,and the dangers of marginalizing minority services and staffreviewed, especially with reference to divisions of labour inservice provision and staff's own perspectives. Thirdly, themethodological implications of the work are explores, includingissues of linguistic and cultural communication and workingwith relatively powerless social groups, whose views are sought.Examining the views of professional social care workers is alsoproblematized, with reference to their gate-keeping role. Itis argued that user perspectives are essential to the developmentof appropriate services for minority ethnic groups. In conclusion,the need to raise these issues in other work is discussed.     

A pilot study combining Go4Life® materials with an interactive voice response system to promote physical activity in older women

ABSTRACT

Telephone-based interactive voice response (IVR) systems could be an effective tool for promotion of physical activity among older women. To test IVR feasibility, we enrolled 30 older women in a 10-week physical activity intervention designed around National Institute on Aging (NIA) Go4Life® educational materials with IVR coaching. Participants (mean age = 76 years) significantly increased physical activity by a mean 79 ± 116 (SD) minutes/week (p < .001). Participants reported that the Go4Life® materials, pedometer, and IVR coaching (70% reported easy technology) were useful tools for change. This pilot study demonstrates IVR acceptability as an evidence-based physical activity program for older women.     

Ethnic Bias in California Courts: A Case Study of Chicano and Anglo Felony Defendants

This paper reports the results of a study designed to examine the possibility that Mexican-Americans charged with felonies receive biased treatment in California courts. Using data from superior courts in Fresno, California, it is shown that, when charged with similar crimes, Chicanos and Anglos in this district are given quite similar treatment–there is no observable judicial bias. In addition, this study shows a much stronger relationship between seriousness of charge and length of sentence (if guilty) than other earlier studies have. This is attributed to California's determinate sentencing law, which, it appears, forces the courts to give heavy and relatively uniform weight to legally relevant variables in sentencing.     

Hormone profiles,body mass index and aging male symptoms: results of the Androx Vienna Municipality study

Aging in the male is accompanied by steroid hormonal decline, and men may develop symptoms associated with hypogonadism. Increased awareness of ‘andropause’ in recent years has led to greater demand for hormonal assessments, resulting in a rising burden for health economics. We conducted a cross-sectional study to define men at risk for hypogonadism, in whom further hormonal investigation should be performed.

We examined 664 blue-collar workers aged 40–60 years at their workplace and determined hormonal status and body mass index (BMI). Men with an abnormal urogenital status and those on medication that might affect endocrine status were excluded from the study. All participants completed the validated Aging Male Symptom (AMS) questionnaire and obtained scores for psychological symptoms, somatovegetative symptoms, and sexual symptoms.

Multiple logistic regression analyses revealed a significantly increased risk (represented by the odds ratio) of psychological symptoms for men with low levels of testosterone and/or bioavailable testosterone (BAT). Increased BMI as well as low testosterone levels and/or low BAT levels raised the risk of somatovegetative symptoms. Each decrease of BAT by 1?ng/ml caused an approximately 1.8-fold increase of the risk (odds ratio?=?1.832, p?=?0.005). Additional independent risk factors were increased age and low luteinizing hormone (LH) level. Men aged 55 years with BMI >?28?kg/m² and with somatovegetative symptoms and moderate or severe psychological symptoms had a 7.2-fold increase in the risk of a BAT level <?1.5?ng/ml compared to men without these risk factors (p <?0.001). Sensitivity and specificity were 75% and 71%, respectively.

The AMS score combined with age and BMI provides an easy and convenient method to identify men with probable androgen deficiency who require hormonal assessment.