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At least 19 recordsLinked to original sources
PubMed1991

Elder abuse.

Elder abuse encompasses physical, psychological, and financial abuse and also includes the violation of an individual's rights, or social abuse. Detection of elder abuse is often obstructed by the denial or shame of the abused older adult and the denial or improper assessment by health care professionals. The ethical struggle professionals face when they suspect abuse may also impede assessment or intervention. Preliminary data on etiologic factors related to elder abuse suggest that misinformation, the caregiver's lack of understanding of the needs of older adults, social isolation, a history of dysfunctional family relationships, and the psychopathologic factors of the caregiver are salient factors for understanding elder abuse. In addition, caregiver burden related to the care of the impaired elder and other external life events is a risk factor for elder abuse. Self-neglect is the type of elder abuse most often reported and the most difficult to handle, because older adults have a right to refuse services. Home care providers often face practical and ethical dilemmas in cases of self-neglect. When making an assessment for elder abuse, it is best to use a multidisciplinary approach. In addition to physical indicators (bruises, malnutrition, fractures), attention must be paid to the social, family, and sexual history of the patient. The psychological history of the patient and caregiver is also important. Reporting laws exist in all states, and health care practitioners must become familiar with the laws in their states. Awareness of elder abuse by professionals working in home care is essential, because the failure to detect abuse can interfere with interventions and in some cases lead to death.

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PubMedDate not supplied

Elder abuse.

Elder abuse has received increasing attention over the past decade as a common problem with serious consequences for the health and wellbeing of old people. Our aim is to assist clinicians by summarising recent international research and clinical findings about elder abuse, and to assess their quality, relevance, and feasibility for health-care providers in clinical practice. This seminar includes issues of definition and frequency of elder abuse and a summary of major known risk factors. The advantages and disadvantages of screening for elder abuse are discussed. We review clinical manifestations and diagnosis of elder abuse, and propose a protocol for medical assessment of a patient with confirmed or suspected abuse. Suggestions for treatment are offered on the basis that elder abuse is multifactorial and needs individual medical and social intervention strategies, preferably in the context of a multidisciplinary team.

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PubMedDate not supplied

Vulnerable in a safe place: institutional elder abuse.

Elder abuse in institutions is a slippery concept. Besides inherent difficulties in operationalizing definitions of elder abuse, it is well-recognized that under-reporting and methodological problems in research studies have created a knowledge base that is far from definitive. There is, however, much that can be gleaned from the literature and translated into clinical practice. Environmental factors, including both interpersonal and institutional dimensions, may contribute significantly to risk for elder abuse. A number of client characteristics such as physical impairment, social isolation, cognitive status, and aggression also appear to increase the potential for elder abuse. While professional caregivers have not yet been extensively studied in terms of their role in elder abuse, burnout, lack of training, excessive workload demands, and other stressors may be implicated as factors contributing to abusive behaviour.

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PubMed2005

Vertebral artery laceration mimicking elder abuse.

Elder abuse was first described almost 30 years ago. Today, approximately 1 in 25 elders is abused each year in the United States. A newly described form of domestic violence, the incidence of elder abuse will surely increase as the elderly population grows. Physical abuse/inflicted trauma is generally considered the most extreme form of elder mistreatment and includes blunt trauma, sexual assault, traumatic alopecia, and burns. Elder homicide is usually due to gunshot wounds, blunt trauma, stab wounds, or asphyxia. However, the difficult aspect of assessing the possible elder abuse homicide victim is delineating such inflicted trauma from accidental trauma. We report the case of a 94-year-old "demented" male, who reportedly fell out of his wheelchair. He was transported to a local emergency room, where he became unresponsive during examination. He experienced respiratory distress and was pronounced dead shortly thereafter. At autopsy, he had periorbital contusions and a midline abrasion between the eyes, with underlying supraorbital contusion. The skull, brain, and spinal cord were unremarkable for signs of trauma. The major traumatic finding was in the neck region. Neck dissection revealed hemorrhage extending from the base of the skull to the level of T-1 and anteriorly about the soft tissues, strap muscles, and vasculature. The strap muscles were individually examined and were free of hemorrhage. The carotid arteries and jugular veins were unremarkable. The larynx, hyoid, and thyroid were intact, with only surrounding hemorrhage. Further examination revealed a horizontal fracture of the C5 vertebral body and a medial laceration of the left vertebral artery at the C5 level; subarachnoid hemorrhage was absent. What initially appeared to be trauma to the neck, worrisome for strangulation or blunt force trauma, was a large retropharyngeal hematoma from the left vertebral artery laceration. Traumatic rupture of the vertebral artery usually occurs at the C1 and C2 levels, with resultant subarachnoid hemorrhage. This is an especially vulnerable location since it is where the artery turns and then enters the skull. Associated injuries include spinal cord transection or contusion, brachial plexus injury, pharyngoesophageal injury, and vertebral fractures. Retropharyngeal hemorrhage may result from deep neck infection, tumor, and trauma. Hemorrhage associated with trauma often involves flexion of the cervical spine, followed by hyperextension. The accumulation of blood slowly impinges on the pharynx/larynx and vasculature structures. The exact injuries and etiology of the hemorrhage must be determined to distinguish strangulation from blunt force trauma. The presentation of signs and symptoms can be helpful in assessing the decedent; however, in the practice of forensic pathology such a history is more often lacking.

Accidental Falls↗
PubMed2005

[Elderly abuse].

Elderly abuse is still far too much ignored. A better understanding of this problem allows us to a better answer proposing an appropriate coping as well as a preventing action. This article describe this society phenomenon with is worth looking at by every health professional. Identifying such situation as elderly abuse is a very tricky process, anyway, some risk factors bound to the victims, the authors or environment can lead us to watch situations that can need to be surrounded. Elderly abuse includes physical, psychological, financial, civilian, medical abuse and neglecting. One of the reasons of the taboo around the problem is the victim's silence connected to their fears and feelings and also the circle's attitude. An acute perception of this phenomenon can lead to adequate prevention and coping. In these conditions, the " Centre d'Aide aux Personnes Agées Maltraitées" (CAPAM) can develop its listening attitude as well as pluridisciplinar team actions.

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PubMed1989

Shedding light on elder abuse.

Elder abuse as a social problem has become the focus of nursing research only in the past decade. As information about the incidence and prevalence of spousal and child abuse came to light, data emerged regarding dependent elderly being abused by adult caregivers, often their children. Documenting and defining elder abuse has been problematic because of a lack of consensual definition and the social stigma surrounding the problem. Standardized assessment methods are still lacking. Nursing research studies focusing on abuse have begun to clarify the variables of abuse and have helped to describe potentially abusive family caregivers. These studies have laid the groundwork for generating theory that will be useful to practitioners to identify and intervene in this family violence arena.

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PubMed2003

Ethical dilemmas of reporting suspected elder abuse.

Elder abuse reporting laws exist in every state to protect elderly people being abused physically or emotionally, suffering from neglect, or experiencing financial exploitation. Support groups for caregivers of elderly individuals may help prevent elder abuse by reducing caregiver stress and linking caregivers to community services. Using case illustrations, the authors raise the dilemmas that group facilitators face when deciding whether to report a group member suspected of abusing his or her elder care recipient. The ethical concerns of reporting or withholding a report are discussed, and recommendations to assist facilitators in this complex decision process are presented.

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PubMed2003

Ethical dilemma: is this elder abuse?

Elder abuse, neglect, and exploitation are major problems today (Marshall, Benton, & Brazier, 2000). Most elder abuse occurs at home and is committed by spouses, children, or other family members. Abuse may go undetected until observant professionals intervene ( AOA, 1998). Sometimes the abuse is a continuation of existing dysfunctional family dynamics. More often, however, the abuse is a result of changes brought about by an older person's growing dependency and need for increased care.

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PubMed1993

Elder abuse.

Elder abuse is a tragedy both for the individual and for society because it occupies a pivotal position in the family life cycle of violence. Great variety exists among victims, abusers, and situations; thus, no single model is adequate to explain cause and direct treatment. Primary care physicians must be alert to the possibility of elder abuse in their patients and aware of resources within their community for managing cases once identified. Federal laws and regulations must take a proactive, long-term approach to the solution of this problem and must respect the autonomy of competent elderly patients.

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PubMed1990

Elder abuse.

Elder abuse is an under-recognised cause of morbidity in the elderly. The frail elderly with multiple physical and psychiatric problems living with a relative who may also have a physical or psychiatric problem are particularly at risk. Although increased awareness of the problem and a high index of suspicion are necessary factors to diagnose the condition, clinical pointers towards diagnosis are available. Treatment for both victim and "carer" should be on the basis of multi-disciplinary assessment, and may result in admission of the elderly patient to an extended-care facility.

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PubMed1996

Elder abuse.

Elder abuse takes many forms and occurs in a variety of settings; it is both under-recognised and under-reported. Despite a lack of statutory guidelines or legislation, effective management is possible. More could be done to recognise abuse, and healthcare workers need to be vigilant, paying attention to both the circumstances in which abuse occurs and its warning signs.

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PubMed2006

Elder abuse.

Elder abuse and neglect is a prevalent, underrecognized problem among today's senior citizens. Fortunately, awareness is increasing, and services are being provided to elders on a more ready basis. Still, the emergency care provider must act as a patient advocate and assume responsibility for the detection, treatment, and safe disposition of unfortunate victims.

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PubMed1996

Breaking the silence on elder abuse.

Elder abuse has been described as the silent crime-silent, but not insignificant. The magnitude of the problem for Canadians was revealed in a national survey of 2,000 randomly selected seniors residing in private dwellings: four per cent of respondents reported some form of abuse. The perpetrators were usually people in positions of trust, such as family members or caregivers.

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PubMed1996

The association of elder abuse and substance abuse in the Illinois Elder Abuse System.

This article explores the role of abuser substance abuse in 552 cases of substantiated elder abuse in Illinois. When the abuser was identified as having a substance abuse (SA) problem, the type of elder abuse substantiated was more likely to involve either physical or emotional abuse than neglect or financial exploitation. Abusers with SA problems were more frequently men and children of their victims, and less likely to be caregivers. Abuser SA was associated with victim SA. Cases involving abusers with SA problems were more likely to be evaluated by case workers as having a high potential risk for future abuse. Elder abuser case workers should be trained to identify both victim and abuser SA and appropriate intervention strategies.

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PubMed2002

How well prepared are Texas dental hygienists to recognize and report elderly abuse?

The elderly are the nation's fastest-growing population, and the number of elder abuse victims has reached epidemic proportions. In Texas, dentists and dental hygienists are mandated by law to report suspected abuse. This study surveyed Texas dental hygienists regarding elder abuse education received in dental hygiene school and post-graduation. Respondents were also asked to self-assess their knowledge level in recognizing the six types of elder abuse and to answer questions regarding Texas law and mandatory reporting of abuse. A survey designed for this study was mailed to 780 Texas licensed dental hygienists, representing 10 percent of the Texas dental hygiene population. Respondents were selected using a computer-generated random sample. A second mailing was sent to nonrespondents to prevent response bias. Results were analyzed using Statistical Programs for Social Scientists (SPSS). Over one-half of the respondents (56 percent) stated that abuse education was not part of their dental hygiene school curriculum. Only 46 percent of the respondents who replied that abuse education had been included in the curriculum were educated on elder abuse. A majority of respondents stated they lacked knowledge in recognizing the six types of elder abuse, and 81 percent of respondents reported being unknowledgeable about reporting elder abuse. The current status of elder abuse education in dental hygiene programs and post-graduation is insufficient. Dental hygienists have an obligation to become knowledgeable in recognizing and reporting elder abuse in order to provide complete care for their patients.

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PubMed1997

Detecting and managing elder abuse: challenges in primary care. The Research Subcommittee of the Elder Abuse and Self-Neglect Task Force of Hamilton-Wentworth.

OBJECTIVE: To determine family physicians' perceptions of barriers and strategies in the effective detection and appropriate management of abused elderly people. DESIGN: Questionnaire survey; the protocol included an advance notification letter and 3 follow-up mailings. SETTING: Regional Municipality of Hamilton-Wentworth, Ont. PARTICIPANTS: All active nonspecialist physicians who reported seeing elderly patients in their practices were eligible for inclusion. Fifty health service organization (HSO) physicians were randomly selected from among those listed with the HSO Mental Health Program, and 200 fee-for-service physicians were randomly selected from the Canadian Medical Directory. Of the 189 eligible physicians 122 returned completed questionnaires, a response rate of 65%. OUTCOME MEASURES: Physicians' ratings of the importance of potential barriers in assisting older people experiencing abuse and of the usefulness of strategies for dealing with elder abuse. RESULTS: Physicians identified the following barriers as fairly or very important: denial of abuse, resistance to intervention, not knowing where to call for help, lack of protocols to assess and respond to abuse, lack of guidelines about confidentiality, fear of reprisal, and lack of knowledge of the prevalence and definition of elder abuse. Strategies deemed to be helpful included a single agency to call, a directory of services, a list of resource people, an educational package, guidelines for detection and management, reimbursement for time spent on legal matters, continuing education, revision of fee structure and a central library of resources on elder abuse. CONCLUSION: Although the physicians perceived numerous barriers to their detection and management of elder abuse, they identified many strategies that could be implemented at a local level. Preparation of an algorithm to help physicians is the next phase of this work.

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