Abuse recognition is also complicated by older patients’ tendency to neglect self-care, Dr. Stephens says. Another barrier to identifying elder abuse is the victim’s desire to avoid burdening others with abuse issues. “Midwestern farm types don’t want to impose themselves on others,” says Dr. Stephens. Sexual abuse includes physical force, threats, or coercion to facilitate non-consensual touching, fondling, intercourse, or other sexual activities. This is particularly true with vulnerable adults who are unable to give consent or comprehend the nature of these actions.
Selection of studies
Due to heterogeneity in the study designs employed, the populations in which the interventions were conducted, and the interventions themselves, no meta‐analysis was conducted in this present review. Where data were missing, were unclear, or were not fully reported, we attempted to contact the authors of these potentially included studies for clarification and further information. Attempted contact of authors was primarily via email by searching for most recent email address through a Google search. Although stated in our protocol, we chose not to attempt contact via postal address. If we were unable to trace the authors or information was unavailable from the authors within two months of contacting them, we record the information as missing in the data extraction form.
Kalavar 2012 published data only
There were insufficient studies identified to allow all subgroup analyses to be performed as planned in the protocol for this review. Given the absence of trustworthy data or appropriate subgroups reported in these studies, no further subgroup analysis could be undertaken. A logic model was developed to capture the broad range of approaches that may be used to prevent or reduce elder abuse (Figure 1). It also articulates a range of possible short‐ and long‐term outcomes that may be used to measure the effectiveness of interventions and capture the levels where the intervention may be operating. Short‐term outcomes include participant‐, victim‐ or perpetrator‐related outcomes, such as increased knowledge, attitudes and skills, identification of abuse and elderly independent living.
Dangers Lurking in Long-term Care
The circumstances precipitating the abuse (eg, alcohol intoxication) should also be sought. Physicians are encouraged to consider routine inquiry (recommended by the American Medical Association) or routine screening for elder abuse (recommended by the Joint Commission, National Center on Elder Abuse, and National Academy of Sciences). Routine inquiry by physicians is based on increased suspicion and involves nonsystematic interviewing about possible elder abuse.
Social and financial resources of the patient should be assessed because they affect management decisions (eg, living arrangements, hiring of a professional caregiver). The examiner should inquire whether the patient has family members or friends able and willing to nurture, listen, and assist. If financial resources are adequate but basic needs are not being met, =https://ecosoberhouse.com/ the examiner should determine why.
As older adults become more physically frail, they’re less able to take care of themselves, stand up to bullying, or fight back if attacked. Mental or physical ailments can make them more trying companions for those who live with them. And they may not see or hear as well or think as clearly as they used to, leaving openings for unscrupulous people to take advantage of them. Risk factors are characteristics that may increase the likelihood of experiencing or perpetrating violence against older adults.
- Legal provisions, including mandatory reporting and adult protection statutes, have been established with the intention of increasing reporting and ending elder abuse (American Bar Association 2006).
- There are many causes for late onset domestic violence, including stresses resulting from retirement, disability, shifting roles for family members and sexual changes.
- Intervening and helping victimized older people comes at a tremendous cost to caring family members.
- It’s important to know the signs of abuse and, where they’re identified, gently share your concerns with the person you think may be being abused.
- Neither is there information about whether they are useful to reduce occurrence or recurrence of abuse.
The concept of measuring improvement in detection or reporting as opposed to the occurrence or recurrence of abuse is complicated. Nonetheless, Bartels 2005 and Teresi 2013 substance abuse in older adults included outcomes related to the detection or reporting of elder abuse. The educational intervention evaluated by Teresi 2013 was effective at improving recognition and longitudinal reporting of resident‐to‐resident abuse.
- When abuse is recognised, it seems logical that referrals need to be made early and adequate follow‐up arranged.
- The responsibilities of such care can be overwhelming and can affect the carer’s mental health.
- There are some initial efforts to gather such evidence (Ploeg 2009), but less so in developing countries.
- At older ages, mental health is shaped not only by physical and social environments but also by the cumulative impacts of earlier life experiences and specific stressors related to ageing.
Scogin 1990 published data only
The patient should be thoroughly examined, preferably at the first visit, for signs of elder abuse (see table Signs of Elder Abuse). The physician may need help from a trusted family member or friend of the patient, state adult protective services, or, occasionally, law enforcement drug addiction treatment agencies to encourage the caregiver or patient to permit the evaluation. If abuse is identified or suspected, a referral to Adult Protective Services is mandatory in most states.