Screening for elder abuse in hospitalized older adults with dementia

When older adults with dementia are hospitalized for psychiatric treatment, which elder abuse screen to use is questionable. This article reviews screens to identify desirable characteristics. For clinician completion, the Elder Assessment Instrument and the Brief Abuse Screens for the Elderly are recommended. For the older adult, the brief Hwalek-Sengstock Elder Abuse Screening Test is suitable. The Modified Conflict Tactics Scale, which can be used by both the older adult and the nonprofessional caregiver, has many of the recommended characteristics. Research is necessary in the application of these screens within hospitals to detect elder abuse within this specialized population.     

Recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect

Increased interest in pursuing criminal and civil actions against alleged perpetrators of elder abuse and neglect has revealed that efforts to assist victims and hold perpetrators accountable are often hampered by the lack of knowledge about the detection and diagnosis of elder abuse and neglect and by the lack of resources for development of research and assistance in these matters. This report sets forth recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect. The recommendations were developed by a "working group" of experts representing an array of disciplines that address the problem of elder abuse and neglect pursuant to a grant project funded by the National Institute of Justice (NIJ), the research, development, and evaluation agency of the U.S. Department of Justice (DOJ). The project was conducted by the American Bar Association Commission on Law and Aging, with the assistance of the University of California, Irvine School of Medicine. This was the final project report submitted to NIJ; it has been updated to include information about the availability of reports and products from other grant projects that are discussed in the report.     

Recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect

Increased interest in pursuing criminal and civil actions against alleged perpetrators of elder abuse and neglect has revealed that efforts to assist victims and hold perpetrators accountable are often hampered by the lack of knowledge about the detection and diagnosis of elder abuse and neglect and by the lack of resources for development of research and assistance in these matters. This report sets forth recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect. The recommendations were developed by a "working group" of experts representing an array of disciplines that address the problem of elder abuse and neglect pursuant to a grant project funded by the National Institute of Justice (NIJ), the research, development, and evaluation agency of the U.S. Department of Justice (DOJ). The project was conducted by the American Bar Association Commission on Law and Aging, with the assistance of the University of California, Irvine School of Medicine. This was the final project report submitted to NIJ; it has been updated to include information about the availability of reports and products from other grant projects that are discussed in the report.     

Issues of elder care and elder abuse in the Indian context

With 7% of the population of India being elderly, two-thirds of whom live in villages and nearly a half of them in poor conditions, the care of the elderly is a difficult problem to be tackled. The dwindling of the joint family, the rise of dual-career families, a possible shift in filial piety values, the increasing life expectancy with greater chances of a prolonged old age characterized by poverty, degeneration, more empty-nest years, and dependency, have all added to the seriousness of the problem and made the elderly more susceptible than ever to abusive treatment. This paper examines these issues as well as the issue of elder abuse in light of available data and suggests some strategies to meet the problem. Also discussed are the problems, stresses, and strains of caregivers of the elderly. A greater role is envisaged for Non-Governmental Organizations (NGOs) than the state in the care of the elderly, particularly in providing support services to family caregivers.     

Perspectives on elder abuse in Greece

The sample for this exploratory qualitative study of Greek perceptions of elder abuse consisted of 43 Greek participants from urban centers and 28 Greeks from a small island village. Participants were asked to provide examples of extreme, moderate, and mild abuse from an adult child toward his/her aging parent. Half of the examples of extreme abuse were various forms of physical aggression. Predominant examples of moderate abuse were psychological abuse and neglect, and at the mild level neglect was the most highly cited category. The most frequently mentioned specific types of elder mistreatment were verbal abuse, psychological neglect, physical neglect, and hitting. There were no gender differences in the kinds of examples that participants gave or the severity they attributed to their examples. Females were more often presented as victims of abuse than males. A negative correlation was found between age and the number of physical abuse examples given overall, and as types of severe abuse.     

Child abuse in Korea

Many parents in Korea approve of discipline by the rod. In fact, physical punishment of children has been regarded in Korea as a family affair rather than a social issue. Today, however, it is winning social attention in that it can become a form of domestic or social violence that can adversely affect the whole society as well as the family and individual.     

Readability and content of elder abuse instruments

Since elder abuse was first acknowledged as a health care and social problem, incidence and prevalence of mistreatment has been assessed sparingly in the United States and other countries around the world. Standardized instruments for determining the prevalence of elder abuse have not been developed and other instruments measuring a person's function and spousal violence have been adapted for the measurement of elder abuse prevalence. The purposes of this paper are to (1) ascertain the reading grade level of the most frequently used elder abuse prevalence instrument's text and (2) determine the content validity of the instruments with respect to the types of elder abuse included in them. A review of the instruments used to measure elder abuse prevalence was completed and a questionnaire was developed to measure the reading grade level and type of elder abuse content in four instruments. The Fry Readability, Flesch Reading Ease, and McLaughlin Grading formulas were used to determine reading grade level. A questionnaire regarding content validity was sent to 69 faculty and staff in one university department and a 59% return was achieved. The Conflict Tactics Scale and the Hwalek-Sengstock Elder Abuse-Screening Test had the lowest mean score at the 6th grade reading level. Results of content analysis for types of elder abuse demonstrated none of the instruments are comprehensive. Instruments to measure the prevalence are needed which balance readability and content validity.     

An overview of elder abuse and neglect in Australia

Only relatively recently has the issue of elder abuse come to prominence in Australia. Until the late 1980s it was a hidden problem with little knowledge of its presence. Attention was drawn to elder abuse after the publication of a number of reports and research projects, allowing the development of responses at national and state levels. This paper gives an overview of the development of elder abuse as a social, legal and medical issue in Australia, and describes the diverse range of responses from the national, state and territory governments.     

Definitions of elder abuse in an Italian sample

The purpose of this exploratory qualitative study was to analyze definitions of elder abuse in an Italian convenience sample. Fifty-three Italian participants (15 males, 38 females) provided examples of mild, moderate, and extreme mistreatment of older individuals by their adult children. Analyses were conducted to identify frequently mentioned types of abuse and to determine how severe they were judged to be. Also examined was the extent to which gender and age contributed to response patterns. Most examples of extreme elder abuse made reference to physical abuse and neglect, while references to psychological aggression and neglect predominated as examples of moderate and mild abuse. Examples of neglect appeared with equal frequency at all levels of severity, but physical aggression was mentioned primarily as a form of extreme abuse, and psychological aggression was mentioned more frequently in examples of moderate and mild abuse. The most frequently identified types of specific abuse were abandonment, verbal abuse, emotional abuse, and psychological neglect. When giving examples of extreme abuse, females mentioned more instances of financial exploitation than males. They also gave more examples of verbal aggression and lack of respect as instances of moderate abuse and behaviors reflecting power or control as examples of mild abuse. A statistically significant negative relationship was found between age and the number of examples given of particular types of mistreatment at each of the levels of severity of abuse.     

Times of transition: elder abuse and neglect in Israel

The present paper addresses the advancement of research, policies, legislation, and practice experiences designed to deal with the phenomenon of elder abuse and neglect in Israel in times of transition. The paper presents a short overview of the demographic scene, reflecting population characteristics and needs that impact care giving as well as elder abuse and neglect. The developments of scientific knowledge and its accumulation, especially the empirical data from the first national survey on elder abuse and neglect are discussed. Further, legislative developments relating to four generational laws and the advancement of policies and innovative practice experiences are described and analyzed. Finally, future challenges in the field are identified.     

Bonuses,unions, and labor productivity in South Korea

Using a set of time-series (1972–1989) and cross-sectional data on eight two-digit Korean manufacturing industries, we examine the variability of South Korea’s employee bonus system and the effect of the employee bonus on productivity. A test of the variability of the bonus showed that the bonus rate (ratio of the bonus to the wage) was positively influenced by industrial output, so the bonus is not merely a disguised wage. An augmented Cobb-Douglas production function estimation shows that the bonus has a positive and significant productivity effect. Capital-intensive and laborintensive industries did not have significantly different productivity effects due to the bonus. Lastly, Korean unions reduced labor productivity and negatively affected the productivity effect of the bonus. Also, compared with the previous period, the productivity effect of the bonus has become negative since the1987 Great Labor Offensive.     

Trauma-informed care and elder abuse: a synergistic alliance

ABSTRACT

Elder abuse is a global systemic problem in which one or more traumatic or stressful life experiences directly affect older adults, their families, and communities. Despite its devastating impact, the understanding of—and response to—elder abuse has rarely been explored through a trauma-informed lens. Despite the prevalence of traumatic and stressful life experiences, research and practice are just beginning to target the intersection of elder abuse and life course trauma. This article demonstrates how knowledge about the causes, consequences, and responses to elder abuse can be integrated with the principles of trauma-informed care to improve agency and community responses to preventing or intervening with elder abuse and neglect. In order to address the ongoing problems with detection and treatment of elder abuse, we assert that instilling trauma and elder abuse informed care in organizational services and policies forms a synergistic alliance and would address many of these concerns.     

Fathers' alcohol use and spousal abuse and mothers' child abuse in multicultural families in South Korea: The mediating role of acculturation and parenting stress

There is a potential high risk for child abuse by foreign-born mothers in multicultural families in Korea, particularly given that they experience acculturation and parenting stress at the same time. Further, the risk for child abuse by foreign-born mothers may be aggravated through the high rate of alcohol abuse among Korean husbands that may increase their spousal abuse and in turn the mothers' acculturation and parenting stress. Therefore, this study examined the associations between Korean fathers' alcohol use and spousal abuse and foreign-born mothers' child abuse in multicultural families, with particular attention to investigating whether foreign-born mothers' acculturation and parenting stress mediated the associations. This study overall found that fathers' alcohol use was directly associated with their spousal abuse, and that fathers' spousal abuse was directly associated with mothers' acculturation stress and child abuse. Further, this study found a full mediation path in which fathers' alcohol use was associated with mothers' child abuse through fathers' spousal abuse. Fathers' spousal abuse was also associated with mothers' parenting stress through mothers' acculturation stress, and mothers' acculturation stress was associated with their child abuse through their parenting stress. The findings of this study provide social work implications for child abuse in multicultural families in Korea.     

Bruises on the soul: older women,domestic violence and elder abuse

This article presents an overview on the status of current knowledge concerning elder abuse and neglect, and to move to a consideration of factors from the field of domestic violence. For many years, attempts to understand the phenomenon of elder abuse remained a problem because of its complexity. This paper, however, discusses abuse and neglect at three levels--macro, mezzo, and micro: macro abuse refers to issues at a societal level; mezzo abuse refers to behaviors, attitudes, and policies inflicted on older people at the community level; micro abuse refers to issues in the domestic setting. All definitions of elderly abuse generally include physical, psychological and financial abuses and neglect. Added to these categories of abuse are sexual and social abuses. Attempts were also made to understand the dynamics of elderly abuse. Majority of the cases of abuse among elderly people happens among the females and is mostly inflicted by their spouses. Deteriorating health, thwarted hopes, expectations and plans; a diminution in capacities to function and manage; an increase in vulnerability and dependence all contribute to the development or continuation of abusive situations within intimate relationships in old age. Although gender played a major role in elderly abuse, attempts to consider it in relation to this issue remained limited. Based on the discussions presented, it was made clear that elderly abuse is comparable to domestic violence, although it is different from other forms of family violence.     

Substance abuse, suicidality, and self-esteem in South African adolescents

Associations among six different domains of self-esteem (peers, school, family, sports/athletics, body image, and global self-worth) and risk behaviors related to substance use and suicidality were investigated in a sample of South African adolescents. Students enrolled in Grades 8 and 11 at independent secondary schools in Cape Town (N = 116) completed the Self-Esteem Questionnaire (SEQ) and a questionnaire that asked about their participation in a range of risk behaviors. Logistic regression analyses indicated that particular domains of self-esteem were differentially associated with indicators of alcohol, cigarette and drug use and suicidal ideation or behaviors in adolescents. Family self-esteem showed the strongest overall pattern of associations with the risk behaviors. Overall, the findings of this study suggest that interventions which aim to protect adolescents from engaging in risk behaviors by increasing their self-esteem are likely to be most effective and cost-efficient if they are aimed at the family and school domains.     

Caregiver substance abuse among maltreated children placed in out-of-home care.

Child protective services (CPS) case records of 639 children placed in out-of-home care due to maltreatment were reviewed, and substance abuse by the child's caregiver prior to the child's placement was evaluated systematically. Based on several different sources of information, 79% of the caregivers were found to meet the criteria for caregiver substance abuse (CSA). Children with and without evidence of CSA differed on age, ethnicity, family composition, and type of maltreatment. The importance of operational specificity in defining CSA and implications for policy and service delivery are discussed.     

Developing an empirical profile for elder abuse research in Canada

The aging population of Canada and the associated caregiving demands highlight the need for elder abuse research. The objectives of this article are to provide a review of literature while identifying recommendations and directions for future research. Significant gaps in the knowledge base are identified that preclude the development of effective programming and policies. Future research directions include prevalence studies in community and institutional settings; studies on correlates, risk, and protective factors; research to clarify definitional issues and to develop psychometrically sound measurements; qualitative studies; and the need to support elder abuse research through capacity building and appropriate resource strategies.     

Exploring gender and elder abuse from the perspective of professionals

We conducted an online survey of professionals working in two Canadian provinces to learn about their knowledge of elder abuse from a gender-based perspective. A total of 169 professionals (90% women) completed a survey in either French or English. Five topic areas emerged from the analysis: the influence of gender on the risk of abuse; types of abuse detected; knowledge gaps; capacity to respond to gender-based abuse; and awareness of resources. To gain further insight into these results, we conducted three focus groups with a total of 24 professionals. Professionals held relatively little recognition of, or knowledge about, gender related to elder abuse. Our results indicate the need to develop educational and awareness raising opportunities for professionals who work with abused older adults in both French and English to identify and respond to the unique needs of older women and men.     

An exploration of senile dementia and family burden

Chronic organic brain syndrome is a disabling but little understood disease that can be viewed within a family burden perspective. Since senile dementia relates to multi-dimensional functioning and creates various levels of dependency, family burden is a major factor in the decision to institutionalize. Clinical social workers should understand the problems contributing to the burden of a family with a mentally impaired older member. A variety of interventions is possible and these interventions can be used to alleviate many problems of the family and to create a more responsive system of support.     

2015 Rosalie Wolf Memorial Award Lecture: Past,present, and future of elder abuse

ABSTRACT

This article aims to advance the global issue of elder abuse through exploring how the current body of elder abuse literature can collectively pave the way for present and future directions for research, practice, and policy.