Journal of Elder Abuse & Neglect最新文献

Elder abuse is a form of violence that is often misunderstood and still underestimated. This kind of abuse is classified in physical abuse, psychological abuse, financial abuse, sexual abuse, neglect and self-neglect. In this study, 784 cases of dead people over 65 years of age were retrospectively analyzed: in all cases, the cause of death was determined by the autopsy. Ten cases have been classified as victims of elder abuse: 7 females and 3 males aged between 67 and 91 (average age of 78.9 years). The types of abuse were as follows: neglect: 8 cases; physical abuse: 2 cases; psychological abuse: 2 cases; financial abuse: 2 cases; self neglect: 2 cases. In three cases, the victims had been subjected to two or more types of abuse. In 5 cases the victims had a neuro-psychic decay. In cases of neglect the cause of death was due to sepsis or dehydration. In a case of physical abuse, death was traumatic and related to physical violence. In cases of self neglect, death occurred due to cardiac causes. In cases of domestic abuse, the perpetrator was in most cases the elder's son and in one case the paid caregiver. In three cases, however, the abuses were committed against elderly guests in Nursing Homes. In three cases the perpetrator was affected by psychiatric disorders. Recognizing the elder abuse is often difficult and the understanding of the phenomenon in the case of death requires an integrated analysis of the autopsy data and the anamnesis of the victim.

Older adults often rely on family and friends for care and support. Individuals providing support can take advantage of their vulnerabilities, resulting in neglect, physical, emotional, or sexual abuse, or financial exploitation. Conventional approaches, which older adults are often reluctant to pursue, utilize social service interventions, criminal justice responses, civil litigation, and case review multi-disciplinary teams. This project explored providers' perspectives on using restorative processes, alternative approaches that bring together the person harmed, the person committing the harm, and the community to address the harm and repair relationships. Researchers recruited and interviewed providers working with abused older adults, as referred by a community-based elder justice working group. Providers perceived that restorative processes have the potential to address and prevent social isolation, which often leads to elder abuse. We recommend providers explore restorative processes to address elder abuse, paying attention to implementation barriers and identifying appropriate methods for supporting and maintaining outcomes.

Elder abuse is a pervasive public health issue. The relationship between personality traits and elder abuse remains unclear. This study aims to examine the associations between neuroticism, conscientiousness, and elder abuse. Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged study of 3,157 US Chinese older adults in the greater Chicago area from 2011-2013. Elder abuse included psychological, physical, and sexual abuse, financial exploitation, and caregiver neglect. The assessments of neuroticism and conscientiousness were derived from the NEO Five-Factor Inventory. Logistic regression was used. Higher neuroticism (score range: 6-30, OR = 1.14, CI = 1.11-1.18) and lower conscientiousness (score range: 16-60, OR = 0.97, CI = 0.96-0.99) were associated with a higher risk of elder abuse. With respect to different forms of elder abuse, higher neuroticism was associated with an increased risk of psychological abuse (OR = 1.14, CI = 1.10-1.17), financial exploitation (OR = 1.03, CI = 1.00-1.07), and caregiver neglect (OR = 1.06, CI = 1.03-1.09). Higher conscientiousness was associated with a higher risk of financial exploitation (OR = 1.02, CI = 1.00-1.05). Intervention programs could reduce neuroticism and raise conscientiousness of elder abuse victims.

Multidisciplinary teams (MDTs) represent a prominent and growing form of elder abuse intervention in communities across the U.S. and around the world. Despite the proliferation and promise of MDTs as a model of elder abuse intervention, the field lacks infrastructure, including a standardized data collection strategy, to facilitate a coordinated and informed MDT effort. This commentary presents an exploratory study, which sought to examine existing strategies of case-level electronic data collection implemented by MDTs across the U.S. Using a snowball sampling strategy, we identified 11 MDTs using an electronic data collection strategy. Our analysis found a tremendous range in both the extent and nature of data collection across MDTs, yet it identified common domains of data. A standardized MDT data collection strategy would benefit several MDT stakeholders, including coordinators tracking everyday operations, funders requiring reporting, and researchers conducting large-scale comparative research to identify best MDT practices.

Positive doctor-patient relationships have been noted to be possible facilitators in the identification of elder abuse. A case from family practice is cited in which an enduring and well-appreciated relationship unintentionally set up potential for mistreatment. Considerations to factors beyond traditional elder abuse risk factors should be kept in mind.

The National Voluntary Consensus Guidelines for Adult Protective Services (APS) were released in 2016 by the Administration for Community Living. These Guidelines help standardize systems to ensure the protection of older adults and adults with disabilities against abuse, neglect, and financial exploitation. Since their release, the extent to which state APS programs are aware of and using the Guidelines is unknown. This study examined the dissemination and implementation of the Guidelines across APS programs in the US. Researchers used the Diffusion of Innovations Theory to develop a survey sent to APS directors in all states. Forty-two states responded, and results were used to select a subset of states in which to conduct in-depth interviews. Awareness of the Guidelines was widespread but varied. Reported use of the Guidelines indicates that states are working to incorporate them into their practices. Respondents identified the need for more research and training in evidence-based practices.

The current article presents the results of an exploratory research that examined 16 homicides perpetrated by grandchildren against their own grandmothers in Ghana, West Africa. The term grannicide was coined by the present author and employed in the current analysis to denote the slaying of a grandmother by her grandchildren. Data for the present study were extracted from various Ghanaian print and electronic media. Results from the analysis of data show that grannicide is gendered, with all 16 identified grannicides perpetrated by grandsons against grandmothers. Offenders typically were young and of low socioeconomic background. Victims were of advanced age, poor, and at least partially dependent on their children and grandchildren for economic, physical and social support. All the homicides occurred in the rural areas of the country, and the victims commonly shared a residence with the assailant. Witchcraft accusations were the predominant motive in grandchild-to-grandmother slayings. The killings were overwhelmingly brutal, exhibiting characteristics that criminologists call overkill. Recommendations for reducing this type of crime are offered.

Emergency Department (ED) visits provide an important but seldom realized opportunity to identify elder mistreatment. Many screening tools exist, including several that are brief and may be effective, but few have been specifically designed for or tested in EDs. In addition to the absence of validated tools, other challenges with implementing ED elder mistreatment screening include difficulty integrating anything longer than a few questions into a busy clinical encounter and resources required to respond to positive screens. The Electronic Health Record (EHR) offers a critical tool to facilitate elder mistreatment screening through required data entry and real-time monitoring of compliance and results. We describe current work in the field and recommend next steps including design and testing of a two-step screening process, implementation research to accelerate adoption, development of ED-based interventions and referral protocols for positive cases, and consideration of the important role of pre-hospital providers in case identification.

The goal of the current study was to examine the roles of communication neglect and caregiver traits (i.e., anger and hostility) in explaining caregivers' tendency to engage in abusive behaviors - specifically, whether such tendency is likely to occur in situations where caregivers perceive older care receivers displaying cognitive impairment or problem behaviors. Two hundred fifty-five informal caregivers completed an online questionnaire via Qualtrics. Treating communication neglect as the mediator, and caregiver anger and hostility as moderators, the results suggested that caregivers who perceived their older care receivers displaying problem behaviors were more likely to engage in communication neglect, which then led to psychological abuse. Moreover, the joint effects of communication neglect and caregiver anger and hostility intensified caregivers' likelihood to commit psychological abuse. These findings provide initial evidence to further investigate the importance of communication neglect and dysfunctional behaviors such as anger and hostility in explaining psychological abuse in informal caregiving for older adults.