Journal of Elder Abuse & Neglect最新文献

The Geriatric Emergency Care Applied Research (GEAR) Network (1) conducted a scoping review of the current literature on the identification of and interventions to address elder abuse among patients receiving care in emergency departments and (2) used this review to prioritize research questions for knowledge development. Two questions guided the scoping review: What is the effect of universal emergency department screening compared to targeted screening or usual practice on cases of elder abuse identified, safety outcomes, and health care utilization?; and What is the safety, health, legal, and psychosocial impact of emergency department-based interventions vs. usual care for patients experiencing elder abuse? We searched five article databases. Additional material was located through reference lists of identified publications, PsychInfo, and Google Scholar. The results were discussed in a consensus conference; and stakeholders voted to prioritize research questions. No studies were identified that directly addressed the first question regarding assessment strategies, but four instruments used for elder abuse screening in the emergency department were identified. For the second question, we located six articles on interventions for elder abuse in the emergency department; however, none directly addressed the question of comparative effectiveness. Based on these findings, GEAR participants identified five questions as priorities for future research - two related to screening, two related to intervention, and one encompassed both. In sum, research to identify best practices for elder abuse assessment and intervention in emergency departments is still needed. Although there are practical and ethical challenges, rigorous experimental studies are needed.

This brief report summarizes Adult Protective Services training provided to workers across the nation, using survey results from the National Adult Protective Services Association (NAPSA). Although most states delivered training that covered some learning objectives of NAPSA's 23 core competency training modules, there was a wide variation with some states training workers on all 23 topics, while some states did not provide training on any of the core modules. Having a well-trained APS workforce possessing core competencies to perform the job should be federal and state agencies' goal, because the quality and level of services for older people and people with disabilities should not differ based on the states they live in.

This manuscript describes a two-pronged approach to addressing elder abuse in community-residing older adults. Part 1 of the program involves briefly training community healthcare providers to screen for elder abuse and refer for services; Part 2 is an intervention program that addresses mental health impacts of elder abuse in a non-stigmatizing, non-threatening manner, and leverages telehealth for greater reach.

One of the long recognized challenges in Adult Protective Services and other human service works is the implementation of empirically validated tools into regular practice. One area where this is evident is the assessment of financial decision-making abilities in cases investigated for financial exploitation. Using the Promoting Action in Research Implementation in the Health Services (PARIHS) we examined the core aspects of evidence, facilitation and context. Further, the empirical findings of the scale usage were investigated. Over 400 APS workers were trained and certified using an online narrated training system. Over 500 scales were administered across a 12 month period, with 50% demonstrating financial decision-making deficits, and in 88% of the time the APS workers concurred with the risk rating system of the web-based system (https://olderadultnestegg.com).

Elder abuse and neglect have been reported as significant public health and societal problem in many different societies across the world. In Malaysia, older adults recorded a high prevalence of neglect compared to other types of elder abuse. There is a dearth of empirical work on elder self-neglect (ESN) among the older population in Malaysia. This paper aims to explore the mediational role of self-efficacy on the relationship between selected biopsychosocial factors and ESN among community-living older adults in Selangor, Malaysia. This study utilized a cross-sectional survey to gather data from a representative sample of 202 older adults from Selangor. A newly developed scale of 16-items of elder self-neglect (ESN) was used in this study. The results showed that self-efficacy partially mediated the association between ADL, IADL, depression, and capacity of self-care on ESN. Self-efficacy also fully mediated the association between neuroticism, life satisfaction, social network, and education on ESN. These findings provided a deeper understanding of the phenomenon of self-neglect among older Malaysian adults. The results will also serve as a useful reference for professionals and policymakers to develop uniform guidelines, protocols, or programs to handle cases of elder self-neglect in the community.

Elder abuse is a preventable problem. Presently, little is known about this phenomenon in Middle Eastern settings. The purpose of this study was to explore elder abuse in Beirut, Lebanon from different stakeholders' points of view with a focus on identifying behaviors that are considered to be abusive to older adults and predisposing factors. Focus group discussions were carried out with 88 home- and institution-based older adults, their family members and caregivers, and with 49 stakeholders (medical professionals, institution directors, government officials). Results showed that behaviors considered abusive among Lebanese participants were comparable to reports from international studies. The most commonly mentioned risk factors were history of abuse in a seemingly dysfunctional family followed by caregivers' lack of acceptance of the physical changes that accompany aging. The response to elder abuse requires a multidimensional approach that spans protective policies to increase care providers' awareness about the physiologic changes of aging as well as concerted efforts to correct misinformation about the hidden problem of elder abuse.

Background and Objectives. In testing a comprehensive decision support system for Adult Protective Services (APS), this study addressed two problems common in APS research and practice: the psychometric quality of the measures and measurement burden. Research Design and Methods. Data were generated on 1,472 APS cases over six months in two California counties using the Identification, Services and Outcomes (ISO) Matrix, a comprehensive decision support system for APS. The ISO Matrix uses Short-Forms developed from the Elder Abuse Decision Support System (EADSS). Mini-Forms were developed from the Short-Forms and tested in order to reduce measurement burden. Mini-Forms were developed on each measure using sensitivity and specificity of the items in predicting the criterion of substantiation (yes/no). Psychometric quality was addressed by estimating predictive validity and Cronbach's alpha of Short-Forms. Predictive validity and reliability were also estimated on the Mini-Forms as was their correlation with the Short-Forms. Results. On Short-Forms, good predictive validity was found for all measures except those that were very rare. Results for even shorter Mini-Forms were mixed, and some will require further research on their reliability and validity. Discussion and Implications. Short-Forms had good psychometric properties and some Mini-Forms did as well. Ongoing adoption by several California counties and Montana demonstrates the viability and sustainability of using the ISO Matrix for research and practice.

Elder abuse impacts one in six older persons globally. Most studies of elder abuse have focused on risk factors rather than protective factors, individual-level factors rather than structural factors, and developed countries rather than developing countries where resources are scarce. The current study addressed these gaps by examining whether neighborhood social cohesion and physical order could be such structural-level protective factors for older persons in India. Our cohort consisted of 541 participants aged 60 and over in the pilot wave of the Longitudinal Aging Study in India. We found that older persons with high neighborhood social cohesion were 38% less likely to experience abuse compared to older persons with low cohesion (OR = 0.62, 95% CI = 0.39-0.99). Similarly, participants with high neighborhood physical order were 48% less likely to experience abuse compared to older persons with low physical order (OR = 0.52, 95% CI = 0.32-0.83). Both models adjusted for relevant covariates. Policies supporting greater cohesion and order in communities could reap significant health benefits for older persons.

Objective: This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults.

Methods: Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed.

Results: Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression.

Conclusion and implications: The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals.

Abuse and neglect among older adults impact everyone and are recognized internationally as significant and growing public health issues. A systematic review of reviews was conducted to identify effective strategies and approaches for preventing abuse and neglect among older adults. Eligible reviews were systematic or meta-analyses; focused on the older population as reported in the publications; reviewed prevention interventions; included relevant violence and abuse outcomes; written in English; and published in a peer-reviewed journal between January 2000 and May 2020. Eleven unique reviews (12 publications) met the eligibility criteria, including one meta-analysis. Included reviews mainly focused on general abuse directed toward older adults; and educational interventions for professional and paraprofessional caregivers, multidisciplinary teams of health care and legal professionals, and families. Interventions were implemented in a variety of community and institutional settings and addressed primary, secondary, and tertiary prevention. The reviews indicated weak or insufficient evidence of effectiveness in preventing or reducing abuse, yet several promising practices were identified. Future research is needed to evaluate emerging and promising strategies and approaches to prevent abuse among older adults. Effective interventions are also needed to prevent or reduce abuse and neglect among older adults.