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Lewis SD, Connolly MT, Kimball PF, Rogers G, Salvo E, Burnes D. Self-neglect co-occurs with and is a risk factor for elder mistreatment: An analysis of Maine Adult Protective Services Administrative Data. J Am Geriatr Soc 2024; 72:1913-1915. [PMID: 38393747 DOI: 10.1111/jgs.18818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/20/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Stuart D Lewis
- Division of General Medicine and Geriatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Marie-Therese Connolly
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | | | - Geoff Rogers
- Director of Learning and Development, Silberman School of Social Work, Hunter College, New York, New York, USA
| | - Erin Salvo
- Public Consulting Group, Boston, Massachusetts, USA
| | - David Burnes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Nobels A, De Schrijver L, Van Landuyt M, Vandeviver C, Lemmens GMD, Beaulieu M, Keygnaert I. "In the End You Keep Silent": Help-Seeking Behavior Upon Sexual Victimization in Older Adults. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:2318-2343. [PMID: 38149594 DOI: 10.1177/08862605231220017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Sexual violence is considered a prominent mental health problem. Exposure to sexual victimization during lifetime has been linked to mental health problems in old age. Research in adult victims has shown that they experience many barriers for disclosure and seeking professional help upon sexual victimization. However, information on help-seeking behavior in older victims of sexual violence is non-existent. With this study we aim for a better understanding of help-seeking behavior upon sexual violence in older adults. We used a mixed methods approach with an explanatory sequential design. Data were collected through structured face-to-face interviews with a random sample of 227 sexual violence victims of 70 years and older living in Belgium. Quantitative data were triangulated with qualitative data from 15 in-depth interviews with older victims. We found that up to 60% of older sexual violence victims never disclosed their experiences and 94% never sought professional help. Help-seeking is a complex process comprising several phases, which are affected by strong feelings of shame and self-blame, ageist premises and taboos about sexuality. In the end, most victims choose to cope on their own. Occasional disclosure only happens decades after the sexual violence took place. Older victims do not spontaneously disclose to healthcare workers but expect professionals to initiate the conversation. In conclusion, few older victims disclose or seek professional help upon sexual victimization. Healthcare professionals working with older adults need capacity building through training, screening tools, and care procedures to initiate conversation on sexual violence, and to detect signs, prevent, mitigate and respond to sexual victimization in older adults.
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Affiliation(s)
- Anne Nobels
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Lotte De Schrijver
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Vlaamse Vereniging van Klinisch Psychologen, Brussels, Belgium
| | - Mira Van Landuyt
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law, and Social Law, Ghent University, Ghent, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
- Department of Head and Skin-Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| | - Marie Beaulieu
- School of Social Work, Research Chair on Mistreatment of Older Adults and Research Center on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Center for Reproductive Health, Ghent University, Ghent, Belgium
- Women's Clinic, Ghent University Hospital, Ghent, Belgium
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3
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Giorgetti A, Pelletti G, Fiorentini C, Mazzotti MC, Fais P, Pelotti S. On tackling abuse of older people: The forensic challenges in fatal cases investigation. Leg Med (Tokyo) 2024; 67:102398. [PMID: 38237384 DOI: 10.1016/j.legalmed.2024.102398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/11/2023] [Accepted: 01/07/2024] [Indexed: 03/01/2024]
Abstract
The World Health Organization recently presented the priorities for tackling abuse of older people in a coordinated and strategic way. However, data on the forensic scenario is still lacking. In this context, the aim of the present work was to provide a comprehensive literature review of this inherently complex phenomenon in the post-mortem setting, in order to better characterize it from a forensic point of view. A comprehensive literature search was performed in three electronic databases following the PRISMA guidelines. Sociodemographic and medical data of victims and perpetrators, post-mortem data, types of abuse and risk factors were extracted from non-aggregated data. Forty-eight papers dealing with abuse in the post-mortem setting were included, with a predominance of case reports and case series. The review showed that neglect was the most common type of abuse and victims are predominantly older women who are abused in a domestic setting by trusted family member. To generate more and better data, expanded research in the forensic field requires standardized methods and the raise of professional awareness about abuse of older people.
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Affiliation(s)
- Arianna Giorgetti
- Unit of Legal Medicine, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy.
| | - Guido Pelletti
- Unit of Legal Medicine, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy.
| | - Clara Fiorentini
- Unit of Legal Medicine, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy.
| | | | - Paolo Fais
- Unit of Legal Medicine, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy.
| | - Susi Pelotti
- Unit of Legal Medicine, Department of Medical and Surgical Science, University of Bologna, Bologna, Italy.
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Burnett J, Campetti R, Froberg R, Beauchamp JE, Lees-Haggerty K. Perspectives on elder mistreatment screening and responding in emergency departments: A qualitative study with survivors. Int J Psychiatry Med 2024:912174231225765. [PMID: 38196310 DOI: 10.1177/00912174231225765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
OBJECTIVE Elder Mistreatment (EM) occurs in approximately 10% of older adults and is associated with trauma-related outcomes including depression, anxiety, post-traumatic stress disorder, and early mortality. Low screening and older adult self-reporting rates, especially within Emergency Departments represent missed opportunities for identify and mitigate future EM occurrences and consequences. To date, no studies have obtained EM survivors perspectives of EM screening and response practices in emergency departments. METHODS Semi-structured interviews with 19 EM survivors with Adult Protective Services validated EM were completed in the older adult's home. The Elder Mistreatment Emergency Department Screening and Response Tool (EM-SART) was used to guide the interview questions. All interviews were recorded, transcribed, and analyzed using qualitative thematic analyses. RESULTS The participants were mostly female (63%) and white (58%) with an average age of 74 years. Physical abuse accounted for 67% of the EM incidents. Three themes emerged indicating the survivor preference for (1) building rapport and approaching the older adult with compassion and care, (2) setting the context before asking the EM questions, and (3) allowing mutuality, collaborative work, and shared decision-making during the response. CONCLUSIONS Older adults are agreeable and willing to self-report and actively engage in the EM screening and response practices in the emergency department if trauma-informed care principles are utilized.
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Affiliation(s)
- Jason Burnett
- The University of Texas Health Science Center, Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, Houston, TX, USA
| | | | | | - Jennifer Es Beauchamp
- The University of Texas Health Science Center, Cizik School of Nursing, Houston, TX, USA
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Choi GY, Koh E, Lee EJ, Rhee S. Elder mistreatment experiences, perceptions, and help-seeking behaviors of Asian American older adults. J Elder Abuse Negl 2024; 36:41-66. [PMID: 38189152 DOI: 10.1080/08946566.2023.2301565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
This study examined the experiences and the perceptions of elder mistreatment (EM), as well as help-seeking knowledge and behaviors, particularly about Adult Protective Services (APS), among community samples of Asian American older adults, including Koreans, Chinese, and others (N = 288). Approximately 27% of the study participants experienced at least one EM incident in the past year. Between 27% and 38% of the participants reported that they were likely to seek help from APS for different types of EM. Significant differences were found across the three Asian groups in their perceptions toward EM and intention to seek help from APS in the event of EM. However, many Asian American older adults in the study did not know about APS prior to participating in the study (75.5%) and other formal sources of help (66.3%). Implications for helping professionals, particularly APS and community-based organizations serving Asian Americans, are discussed.
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Affiliation(s)
- Ga-Young Choi
- School of Social Work, California State University, Los Angeles, California, USA
| | - Eun Koh
- National Catholic School of Social Service, The Catholic University of America, Washington, USA
| | - Eun Jeong Lee
- Department of Human Services, New York City College of Technology, City University of New York, New York, New York, USA
| | - Siyon Rhee
- School of Social Work, California State University, Los Angeles, California, USA
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Santos-Rodrigues RCD, Araújo-Monteiro GKND, Dantas AMN, Beserra PJF, Morais RMD, Souto RQ. Elder abuse: a conceptual analysis. Rev Bras Enferm 2023; 76:e20230150. [PMID: 38055495 DOI: 10.1590/0034-7167-2023-0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 06/20/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to analyze the concept of elder abuse and identify its respective antecedents, attributes and consequents. METHODS this is a conceptual analysis according to Walker and Avant's proposition. The search for the concept was mediated by an integrative review in the LILACS, PubMed, CINAHL, Web of Science and BDENF databases. RESULTS as antecedents, female, family member, low social support and low income or socioeconomic conditions stand out. Attributes were threats and/or intimidation, intentional use of physical force, using resources without authorization, unwanted sexual activity, offering low insufficient amount of nutrients for older adults and not meeting older adults' affective/emotional needs. Consequents were psychological disorders, dependence on aggressors, environment of insecurity and damage/loss of human rights or human dignity. FINAL CONSIDERATIONS the phenomenon under discussion is broad and multifaceted, suggesting expansion of studies related to the theme in order to explore it in detail.
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MacNeil A, Connolly MT, Salvo E, Kimball PF, Rogers G, Lewis S, Burnes D. Use of Motivational Interviewing by Advocates in the Context of an Elder Abuse Response Intervention: The RISE Project. JOURNAL OF FAMILY VIOLENCE 2023:1-11. [PMID: 37358985 PMCID: PMC10136376 DOI: 10.1007/s10896-023-00563-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
Purpose Despite the increasing number of elder abuse and self-neglect (EASN) cases, many older adults are reluctant to engage with formal support services, such as Adult Protective Services (APS). This study examined the use of motivational interviewing (MI) by advocates, as a component of a larger EASN intervention, RISE (Repair Harm, Inspire Change, Support Connection, Empower Choice), implemented in partnership with APS. Advocates applied MI as part of RISE to help clients explore and resolve ambivalence around pursuing change and ultimately enhance service engagement. Methods This study conducted qualitative interviews and a focus group with all RISE advocates (n = 4) to understand how MI is applied in the context of an EASN intervention with older adult clients. A descriptive phenomenological approach involving two independent assessors was used to code verbatim transcripts into themes. Results Three domains were identified: (1) therapeutic relationship, which describes the importance of foundational relationship building in MI to support older adults who have experienced EASN; (2) techniques, which refers to MI strategies advocates apply and adapt in the context of EASN intervention; and (3) implementation challenges, which reflects the difficulties advocates encounter when using MI in cases of EASN. Conclusions The experiences of advocates suggest MI is a beneficial and amenable approach to help older adults who have experienced EASN navigate issues of ambivalence and explore their motivation for change. This study represents the first in-depth exploration of MI in the context of EASN intervention.
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Affiliation(s)
- Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON Canada
| | - Marie-Therese Connolly
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA USA
| | - Erin Salvo
- Maine Adult Protective Services, Augusta, ME USA
| | | | - Geoff Rogers
- Silberman School of Social Work, Hunter College, New York, NY USA
| | - Stuart Lewis
- Geisel School of Medicine, Dartmouth College, Hanover, NH USA
| | - David Burnes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON Canada
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Yan E, To L, Wan D, Xie X, Wong F, Shum D. Strategies to build more effective interventions for elder abuse: a focus group study of nursing and social work professionals in Hong Kong. BMC Geriatr 2022; 22:978. [PMID: 36536315 PMCID: PMC9762662 DOI: 10.1186/s12877-022-03682-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND One in six older adults living in communities experience abuse and neglect. Elder abuse has serious consequences for individuals, families, and society, including mortality, physical and psychological morbidities, and increased care requirements. Timely and effective interventions for elder abuse should therefore be a priority. This study used a qualitative focus group approach to address the following questions: What are the essential elements of elder abuse interventions? What can be done to improve current interventions? METHOD The 32 participants in this focus group study included social workers, medical social workers, and nurses from seven organizations who shared their knowledge and insights. All sessions were conducted online, audio-recorded, and transcribed verbatim. Three researchers with backgrounds in social work and psychology independently coded the transcripts and agreed on the themes emerging from the focus groups. RESULTS Based on the experiences of frontline helping professionals in Hong Kong, we highlighted the key factors for effective elder abuse intervention: 1) identification and assessment; 2) essential skills and attitudes; 3) elements of effective interventions; 4) collaborative efforts across disciplines and agencies; and 5) raising awareness among professionals and the public. CONCLUSIONS Training can equip frontline professionals with the necessary skills to identify elder abuse cases and to assess the risk of abuse. Effective interventions should not only address clients' safety and need for tangible support but also respect their autonomy and privacy. A client-centered, strength-based approach that involves supportive peers and addresses the complex family relationships involved can be useful. Interventions should also involve cross-discipline and cross-agency collaboration.
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Affiliation(s)
- Elsie Yan
- grid.16890.360000 0004 1764 6123Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Louis To
- grid.16890.360000 0004 1764 6123Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Debby Wan
- grid.16890.360000 0004 1764 6123Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Xiaojing Xie
- grid.16890.360000 0004 1764 6123Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Frances Wong
- grid.16890.360000 0004 1764 6123School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - David Shum
- grid.16890.360000 0004 1764 6123Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Burnes D, Connolly MT, Salvo E, Kimball PF, Rogers G, Lewis S. RISE: A Conceptual Model of Integrated and Restorative Elder Abuse Intervention. THE GERONTOLOGIST 2022:6608975. [PMID: 35705108 DOI: 10.1093/geront/gnac083] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Despite a growing number of elder abuse cases nationwide, response programs such as Adult Protective Services (APS) lack a defined, prolonged intervention phase to address these complex situations. This paper presents RISE, a model of elder abuse intervention that works alongside APS or other systems that interact with at-risk older adults. Informed by an ecological-systems perspective and adapting evidence-based modalities from other fields (including motivational interviewing, teaming, restorative justice, goal attainment scaling), the RISE model intervenes at levels of the individual older adult victim, individual harmer, their relationship, and community to address elder abuse risk and strengthen systems of support surrounding the victim-harmer dyad. The RISE model addresses an intervention gap in existing systems to better meet the needs of elder abuse victims and others in their lives, leading to more sustainable outcomes.
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Affiliation(s)
- David Burnes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | - Erin Salvo
- Office of Aging and Disability Services, Maine Department of Health and Human Services, Augusta, Maine, USA
| | | | - Geoff Rogers
- Silberman School of Social Work at Hunter College, City University of New York, New York, New York, USA
| | - Stuart Lewis
- Division of Geriatrics and Primary Care, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Chao YY, Kong D, Seo JY, Zha P, Dong X. Perceived social support and help-seeking among U.S. Chinese older adults who reported elder mistreatment. J Elder Abuse Negl 2022; 34:222-240. [PMID: 35703546 DOI: 10.1080/08946566.2022.2089938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to examine the associations between perceived social support and help-seeking among U.S. Chinese older adults who reported elder mistreatment (EM). Data were from the Population Study of Chinese Elderly in Chicago. Perceived social support and informal/formal help-seeking intentions and behaviors were measured. Descriptive statistics, multiple linear regressions, and multinomial logistic regression analyses were performed. A total of 450 participants reported EM. Mean age of the sample was 72.73 ± 8.03 years old. Perceived social support was associated with an increase in intentions of seeking help from informal sources. Compared with not seeking help, older Chinese-American adults with any EM who perceived social support were more likely to seek help from informal and formal sources. The potential role of social support in increasing help-seeking was highlighted. Culturally tailored interventions that provide social support might promote help-seeking among U.S. Chinese elder immigrants who experienced EM.
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Affiliation(s)
- Ying-Yu Chao
- School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| | - Dexia Kong
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Jin Young Seo
- School of Nursing, Hunter CollegeHunter-Bellevue, New York, New York, USA
| | - Peijia Zha
- School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| | - XinQi Dong
- Health Care Policy and Aging Research, Rutgers Institute for Health, New Brunswick, New Jersey, USA
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Simmons J, Wiklund N, Ludvigsson M. Managing abusive experiences: a qualitative study among older adults in Sweden. BMC Geriatr 2022; 22:456. [PMID: 35619083 PMCID: PMC9137123 DOI: 10.1186/s12877-022-03143-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/17/2022] [Indexed: 12/28/2022] Open
Abstract
Background Elder abuse is prevalent, and is associated with poor health outcomes. How an older adult is affected by abusive experiences is dependent on myriad factors, including aspects of the abuse itself, other life circumstances, coping strategies, and what kind of help the older adults receive to manage the experience. In this study, we sought to investigate how older adults themselves describe how they manage abusive experiences. An increased understanding of this could help to tailor society’s response to older adults suffering from abuse. Method Participants (n = 30) were recruited from patients admitted to one acute geriatric and one acute internal medicine ward at a university hospital in Sweden. Patients over the age of 65 who reported experiences of elder abuse or who reported that they were still suffering from abuse that had occurred earlier in life were included. In-depth qualitative interviews were conducted, transcribed verbatim, and analyzed using qualitative content analysis. Results The analysis resulted in five themes, three pertaining to strategies used to manage abusive experiences (self-reliant coping, restoring dignity in relation to others, and needing formal and informal help) and two pertaining to the disclosure process (inner resistance to disclosure, and external barriers and facilitators for disclosure). Conclusion Older adults were found to use a combination of different strategies to manage abusive experiences. Some were self-reliant, but older adults often managed their experiences with the help of others. Health care professionals were generally in a position to facilitate disclosure, but some participants reported poor encounters with health care. The findings indicate a need to facilitate disclosure by, for example, training professionals on issues related to elder abuse and developing more easily navigated response systems that can respond to the complex needs of older adults trying to manage abusive experiences. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03143-y.
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Affiliation(s)
- Johanna Simmons
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Nicolina Wiklund
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mikael Ludvigsson
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Psychiatry in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Ludvigsson M, Motamedi A, Westerlind B, Swahnberg K, Simmons J. Responding to Elder Abuse in GERiAtric care (REAGERA) educational intervention for healthcare providers: a non-randomised stepped wedge trial. BMJ Open 2022; 12:e060314. [PMID: 35508341 PMCID: PMC9073413 DOI: 10.1136/bmjopen-2021-060314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Elder abuse is prevalent and associated with different forms of ill health. Despite this, healthcare providers are often unaware of abusive experiences among older patients and many lack training about elder abuse. The overall aim of this study is to determine the effectiveness of an educational intervention on healthcare providers' propensity to ask older patients questions about abusive experiences. METHODS AND ANALYSIS Healthcare providers at hospital clinics and primary healthcare centres in Sweden will undergo full-day education about elder abuse between the fall of 2021 and spring of 2023. The education consists of (1) theory and group discussions; (2) forum theatre, a form of interactive theatre in which participants are given the opportunity to practise how to manage difficult patient encounters; and (3) post-training reflection on changing practices.The design is a non-randomised cluster, stepped wedge trial in which all participants (n=750) gradually transit from control group to intervention group with 6-month interval, starting fall 2021. Data are collected using the Responding to Elder Abuse in GERiAtric care-Provider questionnaire which was distributed to all clusters at baseline. All participants will also be asked to answer the questionnaire in conjunction with participating in the education as well as at 6-month and 12-month follow-up. Main outcome is changes in self-reported propensity to ask older patients questions about abuse post-intervention compared with pre-intervention. Linear mixed models including cluster as a random effect will be used to statistically evaluate the outcome. ETHICS AND DISSEMINATION The study has been approved by the Swedish Ethical Review Authority. The results will be published in peer-reviewed journals and conference proceedings. If the intervention is successful, a manual of the course content will be published so that the education can be disseminated to other clinics. TRIAL REGISTRATION NUMBER NCT05065281.
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Affiliation(s)
- Mikael Ludvigsson
- Department of Psychiatry, and Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden
- Department of Acute Internal Medicine and Geriatrics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Atbin Motamedi
- Department of Emergency Medicine in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Björn Westerlind
- Department of Geriatrics, County Hospital Ryhov, Region Jönköping County, Jonkoping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
| | - Katarina Swahnberg
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Johanna Simmons
- Department of Acute Internal Medicine and Geriatrics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
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Crowder J, Burnett C, Byon HD, Laughon K, Acierno R, Yan G, Hinton I, Teaster PB. Exploration and Comparison of Contextual Characteristics and Mistreatment Prevalence Among Older American Indian and Alaska Native Respondents: Secondary Analysis of the National Elder Mistreatment Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1456-1483. [PMID: 32478601 DOI: 10.1177/0886260520922356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Limited research on elder abuse among American Indians and Alaska Natives (AIANs) suggests a higher prevalence of abuse. Using data from the National Elder Mistreatment Study (NEMS), we compared contextual characteristics and elder mistreatment prevalence rates from a community-based sample of AIAN (n = 195) and Black (n = 437) and White (n = 5,013) respondents. There were differences in the prevalence of 16 abuse types and the 23 contextual variables. AIAN respondents had more similarities compared with Black respondents than White respondents, though differences existed. The cumulative prevalence of emotional, physical, and sexual mistreatment in the past year, neglect, and financial abuse by a family member for the AIAN group was 33%, almost double the 17.1% reported in the NEMS study. Over their lifetime, 29.7% of AIAN respondents reported experiencing two or more types of neglect, exploitation, or mistreatment. Almost one fourth of AIAN respondents reported emotional abuse since 60 years of age (the most commonly occurring abuse type)-nearly double that of White respondents. This is the first study to offer comparative prevalence of elder abuse for both AIAN older males and females that draws from a nationally representative sample. The study also provides descriptive analysis of important contextual information within the AIAN population, an underrepresented racial group in elder abuse research. Disaggregating nonmajority racial groups to examine contextual variables and the prevalence of elder mistreatment in the NEMS data set specific to AIAN respondents fills a knowledge gap. Known prevalence of various abuse typologies among AIAN elders can be useful in setting priorities for community planning and response, and in prioritization of funding for future research on causative mechanisms by abuse type, screening, and interventions at various levels. Findings may facilitate development of culturally specific evidence-based prevention and intervention practices aimed at needs specific to AIAN older adults.
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Affiliation(s)
| | | | - Ha Do Byon
- University of Virginia, Charlottesville, USA
| | | | - Ronald Acierno
- The University of Texas Health Science Center at Houston, USA
| | - Guofen Yan
- University of Virginia, Charlottesville, USA
| | | | - Pamela B Teaster
- Virginia Polytechnic Institute and State University, Blacksburg, USA
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Makaroun LK, Thorpe CT, Mor MK, Zhang H, Lovelace E, Rosen T, Dichter ME, Rosland AM. Medical and Social Factors Associated with Referral for Elder Abuse Services in a National Healthcare System. J Gerontol A Biol Sci Med Sci 2021; 77:1706-1714. [PMID: 34849854 PMCID: PMC9373957 DOI: 10.1093/gerona/glab354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Elder abuse (EA) is common and has devastating health consequences yet is not systematically assessed or documented in most health systems, limiting efforts to target healthcare-based interventions. Our objective was to examine sociodemographic and medical characteristics associated with documented referrals for EA assessment or services in a national US healthcare system. METHODS We conducted a national case-control study in US Veterans Health Administration facilities of primary care (PC)-engaged Veterans age ≥60 years who were evaluated by social work (SW) for EA-related concerns between 2010-18. Cases were matched 1:5 to controls with a PC visit within 60 days of the matched case SW encounter. We examined the association of patient sociodemographic and health factors with receipt of EA services in unadjusted and adjusted models. RESULTS Of 5,567,664 Veterans meeting eligibility criteria during the study period, 15,752 (0.3%) received services for EA (cases). Cases were mean age 74, and 54% unmarried. In adjusted logistic regression models (aOR; 95%CI), age ≥85 (3.56 v. age 60-64; 3.24-3.91), female sex (1.96; 1.76-2.21), child as next-of-kin (1.70 v. spouse; 1.57-1.85), lower neighborhood socioeconomic status (1.18 per higher quartile; 1.15-1.21), dementia diagnosis (3.01; 2.77-3.28) and receiving a VA pension (1.34; 1.23-1.46) were associated with receiving EA services. CONCLUSION In the largest cohort of patients receiving EA-related healthcare services studied to date, this study identified novel factors associated with clinical suspicion of EA that can be used to inform improvements in healthcare-based EA surveillance and detection.
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Affiliation(s)
- Lena K Makaroun
- VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA.,VA Geriatric Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh PA.,Department of Medicine, School of Medicine, University of Pittsburgh
| | - Carolyn T Thorpe
- VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA.,University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC
| | - Maria K Mor
- VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh
| | - Hongwei Zhang
- VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Elijah Lovelace
- VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Tony Rosen
- New-York Presbyterian Hospital Weill Cornell Medical College, New York, NY
| | - Melissa E Dichter
- VA Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA.,School of Social Work, Temple University Philadelphia, PA
| | - Ann-Marie Rosland
- VA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Medicine, School of Medicine, University of Pittsburgh
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15
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Pillemer K, Burnes D, Hancock D, Eckenrode J, Rosen T, MacNeil A, Lachs MS. Lack of Association of Elder Mistreatment With Mortality. J Gerontol A Biol Sci Med Sci 2021; 77:1699-1705. [PMID: 34939085 PMCID: PMC9373958 DOI: 10.1093/gerona/glab348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Prior research is limited and inconsistent on the degree to which elder mistreatment (EM) is associated with mortality. This study uses data from a 10-year, prospective, population-based study of EM to determine the adjusted effects of EM on older adult mortality, after controlling for other health and socioeconomic covariates. METHODS The New York State Elder Mistreatment Prevalence Study conducted a random-sample telephone survey of older adults (n = 4 156) in 2009 (Wave 1). The current study employs EM and covariate data from Wave 1 and data on mortality status through Wave 2 (2019). EM was operationalized both as experiencing EM and as severity of EM. The survey measured overall EM and separate subtypes (emotional, physical, and financial abuse, and neglect). RESULTS The hypothesis was not supported that abused and neglected older people would have higher rates of death over the study. Individuals who were victims of EM were no more likely to die over the following 10 years, compared with those who were not mistreated, after controlling for covariates. Furthermore, the severity of EM, as measured by the frequency of mistreatment behaviors, also was not associated with mortality risk. CONCLUSIONS The finding that self-reported EM did not raise the risk of earlier death in this sample is encouraging. Future research should work to identify factors that may moderate the relationship between EM and mortality, such as social support/isolation, quality of family relationships, or involvement with formal support service systems.
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Affiliation(s)
- Karl Pillemer
- Department of Human Development, Cornell University, Ithaca, New York, USA.,Weill Cornell Medicine, Division of Geriatrics and Palliative Medicine, New York, New York, USA
| | - David Burnes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - David Hancock
- Weill Cornell Medicine, Division of Geriatrics and Palliative Medicine, New York, New York, USA
| | - John Eckenrode
- Department of Human Development, Cornell University, Ithaca, New York, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Andie MacNeil
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Mark S Lachs
- Weill Cornell Medicine, Division of Geriatrics and Palliative Medicine, New York, New York, USA
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16
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Barriers to Help Seeking among Victims of Elder Abuse: A Scoping Review and Implications for Public Health Policy in Canada. Can J Aging 2021; 41:460-475. [PMID: 34488912 DOI: 10.1017/s0714980821000295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Elder abuse is a serious public health concern requiring immediate intervention; however, the under-reporting of elder abuse by victims to formal and informal networks remains a major obstacle. This scoping review aims to identify barriers to help seeking that older adults experiencing abuse confront. The goal is to inform public policies and practices in the Canadian context and identify research gaps in the extant literature. Seven scholarly databases were searched from which 12 articles met the inclusion criteria and were extracted for analysis. The findings from this scoping review revealed three levels at which barriers exist: individual focused, abuser/family focused, and community/culture focused barriers. The results suggest that there are several complex obstacles that older adults face when contemplating disclosure of abuse. Future research into help seeking in the Canadian context should more readily incorporate the voices of elder abuse victim-survivors to develop effective assessment strategies and responsive service provisions.
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17
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Burnes D, Hancock DW, Eckenrode J, Lachs MS, Pillemer K. Estimated Incidence and Factors Associated With Risk of Elder Mistreatment in New York State. JAMA Netw Open 2021; 4:e2117758. [PMID: 34383062 PMCID: PMC9014652 DOI: 10.1001/jamanetworkopen.2021.17758] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE Elder mistreatment is associated with major health and psychosocial consequences and is recognized by clinicians, policy makers, and researchers as a pervasive problem affecting a rapidly aging global population. OBJECTIVE To estimate the incidence of elder mistreatment and identify factors associated with the risk of new cases. DESIGN, SETTING, AND PARTICIPANTS This research is a 10-year, longitudinal, population-based, cohort study of the incidence of elder mistreatment in New York State households conducted between 2009 (wave 1) and 2019 (wave 2). At wave 1, random digit-dial (landline and cellular telephones) stratified sampling was done to recruit English-speaking and/or Spanish-speaking, cognitively intact, community-dwelling older adults (aged ≥60 years) across New York State. The current study conducted computer-assisted telephone interviews with older adults who participated in wave 1 and gave permission to be contacted again for wave 2 interviews (response rate, 60.7%). Data analysis was performed from October 2020 to January 2021. EXPOSURES Physical factors (health status, functional capacity, and age), living arrangement (coresidence), and sociocultural characteristics (sex, race/ethnicity, geocultural context, and household income). MAIN OUTCOMES AND MEASURES Ten-year incidence for overall elder mistreatment and subtypes (financial abuse, emotional or psychological abuse, physical abuse, and neglect) were measured using adapted versions of the Conflict Tactics Scale, the Duke Older Americans Resources and Services scale, and the New York State Elder Mistreatment Prevalence Study financial abuse tool. RESULTS The analytical sample included 628 older adults (mean [SD] age at wave 1, 69.20 [6.95] years; age at wave 2, 79.40 [6.93] years; 504 non-Hispanic White individuals [80.9%]; 406 women [64.6%]). Ten-year incidence rates were 11.4% (95% CI, 8.8%-14.3%) for overall elder mistreatment, 8.5% (95% CI, 6.3%-10.9%) for financial abuse, 4.1% (95% CI, 2.6%-5.7%) for emotional abuse, 2.3% (95% CI, 1.2%-3.6%) for physical abuse, and 1.0% (95% CI, 0.3%-1.8%) for neglect. Poor self-rated health at wave 1 was associated with increased risk at wave 2 of new overall mistreatment (odds ratio [OR], 2.86; 95% CI, 1.35-5.84), emotional abuse (OR, 3.67; 95% CI, 1.15-11.15), physical abuse (OR, 4.21; 95% CI, 1.14-13.70), and financial abuse (OR, 2.80; 95% CI, 1.16-6.38). Compared with non-Hispanic White participants, Black participants were at heightened risk of overall mistreatment (OR, 2.61; 95% CI, 1.16-5.70) and financial abuse (OR, 2.80; 95% CI, 1.09-6.91). A change from coresidence to living alone was associated with increased risk of financial abuse (OR, 2.74; 95% CI, 1.01-7.21). CONCLUSIONS AND RELEVANCE These findings suggest that health care visits may be important opportunities to detect older adults who are at risk of mistreatment. Race is highlighted as an important social determinant for elder mistreatment requiring urgent attention.
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Affiliation(s)
- David Burnes
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - David W Hancock
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York City, New York
| | - John Eckenrode
- Department of Human Development, Cornell University, Ithaca, New York
| | - Mark S Lachs
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York City, New York
| | - Karl Pillemer
- Department of Human Development, Cornell University, Ithaca, New York
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18
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Goodridge D, Roger KS, Walsh CA, PausJenssen E, Cewick M, Liepert C. Service providers' use of harm reduction approaches in working with older adults experiencing abuse: a qualitative study. BMC Geriatr 2021; 21:398. [PMID: 34193077 PMCID: PMC8242276 DOI: 10.1186/s12877-021-02328-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although abuse experienced by older adults is common and expected to increase, disclosure, reporting and interventions to prevent or mitigate abuse remain sub-optimal. Incorporating principles of harm reduction into service provision has been advocated as a strategy that may improve outcomes for this population. This paper explores whether and how these principles of harm reduction were employed by professionals who provide services to older adults experiencing abuse. METHODS Thematic analysis of qualitative interviews with 23 professionals providing services to older adults experiencing abuse across three Western provinces of Canada was conducted. Key principles of harm reduction (humanism, incrementalism, individualism, pragmatism, autonomy, and accountability without termination) were used as a framework for organizing the themes. RESULTS Our analysis illustrated a clear congruence between each of the six harm reduction principles and the approaches reflected in the narratives of professionals who provided services to this population, although these were not explicitly articulated as harm reduction by participants. Each of the harm reduction principles was evident in service providers' description of their professional practice with abused older adults, although some principles were emphasized differentially at different phases of the disclosure and intervention process. Enactment of a humanistic approach formed the basis of the therapeutic client-provider relationships with abused older adults, with incremental, individual, and pragmatic principles also apparent in the discourse of participants. While respect for the older adult's autonomy figured prominently in the data, concerns about the welfare of the older adults with questionable capacity were expressed when they did not engage with services or chose to return to a high-risk environment. Accountability without termination of the client-provider relationship was reflected in continuation of support regardless of the decisions made by the older adult experiencing abuse. CONCLUSIONS Harm reduction approaches are evident in service providers' accounts of working with older adults experiencing abuse. While further refinement of the operational definitions of harm reduction principles specific to their application with older adults is still required, this harm reduction framework aligns well with both the ethical imperatives and the practical realities of supporting older adults experiencing abuse.
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Affiliation(s)
- Donna Goodridge
- College of Medicine, University of Saskatchewan, Saskatoon, Canada.
| | - Kerstin Stieber Roger
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | - Marina Cewick
- Faculty of Education, University of Manitoba, Winnipeg, Canada
| | - Carla Liepert
- Faculty of Social Work, University of Calgary, Calgary, Canada
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19
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Cevik C, Ozdemir R, Koran N, Agın A. Prevalence and risk factors for elder abuse: A community-based cross-sectional study from North West Turkey. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01423-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Elman A, Rosselli S, Burnes D, Clark S, Stern ME, LoFaso VM, Mulcare MR, Breckman R, Rosen T. Developing the Emergency Department Elder Mistreatment Assessment Tool for Social Workers Using a Modified Delphi Technique. HEALTH & SOCIAL WORK 2020; 45:110-121. [PMID: 31984415 PMCID: PMC8454199 DOI: 10.1093/hsw/hlz040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/22/2019] [Accepted: 04/10/2019] [Indexed: 05/12/2023]
Abstract
Elder mistreatment is common and has serious consequences. The emergency department (ED) may provide a unique opportunity to detect this mistreatment, with social workers often asked to take the lead in assessment and intervention. Despite this, social workers may feel ill-equipped to conduct assessments for potential mistreatment, due in part to a lack of education and training. As a result, the authors created the Emergency Department Elder Mistreatment Assessment Tool for Social Workers (ED-EMATS) using a multiphase, modified Delphi technique with a national group of experts. This tool consists of both an initial and comprehensive component, with 11 and 17 items, respectively. To our knowledge, this represents the first elder abuse assessment tool for social workers designed specifically for use in the ED. The hope is that the ED-EMATS will increase the confidence of ED social workers in assessing for elder mistreatment and help ensure standardization between professionals.
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21
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Pak M. The prevalence and associated risk factors of elder abuse among older people applied to the family health center in the rural district of Turkey. SOCIAL WORK IN HEALTH CARE 2020; 59:236-256. [PMID: 32208962 DOI: 10.1080/00981389.2020.1740377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 06/10/2023]
Abstract
In this study, face-to-face interviews were conducted with older people who applied to the family health center (N = 152) in the traditional rural district of Turkey. Although the prevalence rate was 23%, the mean value of "Characteristics of the elder that make him or her vulnerable to abuse" subscale (X̄ = .37) was highest among other subscales. The mean values for "Characteristics of potentially abusive situations" (X̄ = .06) and "Overt violation of personal rights and direct abuse" (X̄ = .05) were quite low. The majority of the elder abuse prevalence was composed of participants who were vulnerable to elder abuse. The rural area makes older individuals vulnerable to abuse. Also, risk factors associated with elder abuse in rural areas were interaction with family (p = .000), interaction with neighbors/friends (p = .001), chronic diseases (p = .002), psychiatric diseases (p = .007), gender and marital status (p = .008), and additional income (p = .028), respectively. The only predictor of elder abuse in rural areas was family interaction. There was a significant negative relationship between rural elder abuse and family interaction (T= -4.239, p < .001).
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Affiliation(s)
- Melike Pak
- Department of Social Work, Atatürk University, Erzurum, Turkey
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22
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Aminalroaya R, Alizadeh-Khoei M, Hormozi S, Sharifi F, Taati F. Screening for elder abuse in geriatric outpatients: reliability and validity of the Iranian version Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST). J Elder Abuse Negl 2020; 32:84-96. [PMID: 32008473 DOI: 10.1080/08946566.2020.1719564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The present research seeks the notion of the appropriateness of "Hwalek-Sengstock Elder Abuse Screening Test (H-S/East)", and psychometric properties to analyses cultural aspects of elder abuse in the Iranian community dwellers referred to clinics. In this cross-sectional validation study 364 participants, 60 years and over were selected from outpatient' clinics. The SF-36, GDS-15, and AMT scores were used for concurrent validity. The Brief Abuse Screen for the Elderly (BASE) scale was examined to determine the sensitivity and specificity of the Iranian version H-S/East. The elder abuse rate in participants was 29.4% based on cutoff ≥4, while a significant correlation was found in Iranian version H-S/EAST with depression and SF-36 subscale MCS at P < .01, and four factors observed. Optimal cutoff ≥4 obtained with 82.8% sensitivity and 84.5% specificity. It seems the Iranian version of H-S/East demonstrates concurrent validity and fair reliability in elderly outpatients, while construct validity should be carried out in the Iranian elder illiterate population and other languages/cultures.
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Affiliation(s)
- Reyhaneh Aminalroaya
- Clinical Gerontology & Geriatric Department, Medical School, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Alizadeh-Khoei
- Clinical Gerontology & Geriatric Department, Medical School, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakar Hormozi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Taati
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Truong C, Burnes D, Alaggia R, Elman A, Rosen T. Disclosure among victims of elder abuse in healthcare settings: a missing piece in the overall effort toward detection. J Elder Abuse Negl 2019; 31:181-190. [PMID: 30880608 DOI: 10.1080/08946566.2019.1588182] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Elder abuse remains a largely hidden problem in our society and only a small minority of victims are connected to formal support/protective services. Healthcare settings have been identified as a critical milieu to uncover cases of elder abuse; however, under-detection in these settings is a major issue. Victimization disclosure is an important component within the overall detection effort, yet it has received little attention in the elder abuse literature. Drawing on relevant literature from other domains of family/interpersonal violence, this article highlights the disclosure process, as well as disclosure barriers, facilitators, and competencies to consider when working with older adults.
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Affiliation(s)
- Carol Truong
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - David Burnes
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Ramona Alaggia
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
| | - Alyssa Elman
- b Department of Emergency Medicine , Weill Cornell Medicine College/New York-Presbyterian , New York , NY , USA
| | - Tony Rosen
- b Department of Emergency Medicine , Weill Cornell Medicine College/New York-Presbyterian , New York , NY , USA
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