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Lees Haggerty K, Ojelabi O, Campetti R, Myint-U A, Greenlee K. Developing a model for providing feedback to reporters of elder abuse. J Elder Abuse Negl 2024:1-19. [PMID: 38828526 DOI: 10.1080/08946566.2024.2361633] [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: 06/05/2024]
Abstract
Lack of feedback about reports made to Adult Protective Services (APS) is an important barrier to elder mistreatment reporting. To better understand barriers and facilitators to APS-reporter communication, we conducted an environmental scan of state policies and practices. We gathered publicly available information from 52 states and territories on APS administrative structure, reporting, intake, investigation, and feedback processes; performed a secondary analysis of focus groups with Emergency Medical Services providers and APS staff; and interviewed 44 APS leaders in 24 states/territories. Results revealed variation in information-sharing with reporters. Qualitative analyses revealed three overarching themes related to whether, when, and how information is shared. Results were used to develop a model illustrating factors influencing APS decisions on sharing information. This model incorporates the type of reporter (professional or nonprofessional), their relationship with the APS client (brief or ongoing), and the potential risks and benefits of sharing information with the reporter.
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Affiliation(s)
| | - Olanike Ojelabi
- U.S. Division, Education Development Center, Waltham, MA, USA
| | - Randi Campetti
- U.S. Division, Education Development Center, Waltham, MA, USA
| | - Athi Myint-U
- U.S. Division, Education Development Center, Waltham, MA, USA
| | - Kathy Greenlee
- Elder Justice Initiatives, ADvancing States, Arlington, VA, USA
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2
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Devaraj V, Rose A, Abraham VJ. Nature, prevalence, and risk factors for self-neglect among older people: a pilot study from Vellore, South India. BMC Public Health 2024; 24:948. [PMID: 38566119 PMCID: PMC10986042 DOI: 10.1186/s12889-024-18029-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/07/2024] [Indexed: 04/04/2024] Open
Abstract
Changes in demography in developing countries haves led to new issues among older rural populations, such as self-neglect which is under researched.Self-neglect identified as poor self-care, unsafe living quarters, inadequate medical care and poor utilization of services increase the odds of morbidity and mortality.Methods Our study was conducted in Kaniyambadi, a rural block in Vellore district in the state of Tamil Nadu, India. Ten villages were randomly selected. The study was conducted among people older than 60 years who were selected by random sampling using a computer-generated list. The following assessments were done: (i) A 19-item questionnaire was used to assess self-neglect, (ii) Katz index of daily living to assess functional activity, (iii) Mini Mental State Examination to evaluate cognition, (iv) Geriatric Depression Scale to identify depression, (v) Duke Social Support Index to measure social supports. Clinical data and anthropometric data were also collected. Data were entered into Epidata v3.1. All analyses were performed using SPSS v23.0.Results One hundred fourteen people above 60 years of age participated. The prevalence of self-neglect was 21.1% (95% CI 14.9%-29%); about half of the elderly population (47.38%) refused to seek or follow medical advice. Lower levels of education (OR 3.678, 95% CI 1.017 - 13.301), lower social class (OR 4.455, 95% CI 1.236 - 16.050) and functional impairment (3.643, 95% CI 1.373 - 9.668) were found to be significant factors associated with self-neglect. Though prevalence of comorbidities (70%) and depression (27%) were high, there was no statistical evidence of association with self-neglect.
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Affiliation(s)
- Vibisha Devaraj
- Christian Medical College Vellore, Vellore, Tamil Nadu, India.
| | - Anuradha Rose
- Christian Medical College Vellore, Vellore, Tamil Nadu, India
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3
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Kizir Z, Koçak HS, Kaplan Serin E. The relationship between activities of daily living and abuse in the elderly: cross-sectional study during covid 19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:639-648. [PMID: 37356059 DOI: 10.1080/09603123.2023.2228246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/16/2023] [Indexed: 06/27/2023]
Abstract
To determine the relationship between activities of daily living in the elderly and elder abuse, the research was conducted during the COVID-19 process. This study was performed as descriptive and cross -sectional. For data collection, the Standardized Mini-Mental State Examination (SMMSE), Personal Information Form, Barthel Index of Activities of Daily Living (BIADL) and Hwalek-Sengstock Elder Abuse Screening Test (HS/EAST) were used. It was determined that 43.8% of the elderly participants were moderately dependent while performing activities of daily living, and 63.4% were exposed to some kind of abuse. The HS/EAST total mean scores of elderly people who were highly dependent while performing activities of daily living were found to be higher. It was determined that as the dependency levels of the elderly in their activities of daily living increased, the rate of exposure to abuse increased.
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Affiliation(s)
- Zeynal Kizir
- Msc, Adıyaman University Eduaciton and Research Hospital, Adıyaman, Turkey
| | - Hatice Serap Koçak
- Faculty of Health Sciences, Public Health Nursing Department, Gaziantep University, Gaziantep, Turkey
| | - Emine Kaplan Serin
- Faculty of Nursing, Internal Medicine Nursing Department, Mersin University, Mersin, Turkey
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4
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Understanding Elder Abuse in India: Contributing Factors and Policy Suggestions. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09399-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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5
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Pickering CEZ, Maxwell CD, Yefimova M, Wang D, Puga F, Sullivan T. Early Stages of COVID-19 Pandemic Had No Discernable Impact on Risk of Elder Abuse and Neglect Among Dementia Family Caregivers: A Daily Diary Study. JOURNAL OF FAMILY VIOLENCE 2022; 38:1-11. [PMID: 35578604 PMCID: PMC9095055 DOI: 10.1007/s10896-022-00392-8] [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: 03/20/2022] [Indexed: 06/15/2023]
Abstract
There is widespread concern that elder abuse and neglect (EAN) incidents increased during the onset of the COVID-19 pandemic due in part to increases in risk factors. Initial reports relying on administrative systems such as adult protective services records produced mixed results regarding whether or not there was a change in EAN incidents. Using data from an ongoing longitudinal study on EAN in dementia family caregiving that started before the pandemic, we assessed the hypothesis that the pandemic is related to a change in probability of EAN and EAN protective factors. Family caregivers to persons with dementia completed two waves of 21 daily diaries, 6-months apart, assessing their daily use of EAN behaviors. The first group (n = 32) completed their first wave before the pandemic and their second wave during the pandemic. The second group (n = 32) completed both waves during the pandemic. For this cohort, the generalized linear mixed logistic model results showed inconsistent associations between the onset of COVID-19 and the probability of a caregiver engaging in elder abuse or neglect behaviors. In terms of protective factors, the use of formal services was not significantly impacted by COVID-19; however, the likelihood of receiving informal support from family and friends increased significantly during the pandemic period. Dementia family caregivers were not likely impacted negatively by initial pandemic restrictions, such as shelter-in-place orders, as anticipated. These findings contribute to our understanding of how distal, disruptive processes may influence more proximal caregiver stresses and the likelihood of EAN. Supplementary Information The online version contains supplementary material available at 10.1007/s10896-022-00392-8.
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Affiliation(s)
- Carolyn E. Z. Pickering
- School of Nursing, The University of Alabama at Birmingham, NB Room #470H | 1720 2nd Avenue South, Birmingham, AL 35294-1210 USA
| | | | - Maria Yefimova
- Office of Research, Patient Care Services, Stanford Healthcare, Stanford, CA USA
| | - Danny Wang
- School of Nursing, The University of Alabama at Birmingham, NB Room #470H | 1720 2nd Avenue South, Birmingham, AL 35294-1210 USA
| | - Frank Puga
- School of Nursing, The University of Alabama at Birmingham, NB Room #470H | 1720 2nd Avenue South, Birmingham, AL 35294-1210 USA
| | - Tami Sullivan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
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6
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Muhammad T, Meher T, Sekher TV. Association of elder abuse, crime victimhood and perceived neighbourhood safety with major depression among older adults in India: a cross-sectional study using data from the LASI baseline survey (2017-2018). BMJ Open 2021; 11:e055625. [PMID: 34907072 PMCID: PMC8671981 DOI: 10.1136/bmjopen-2021-055625] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/11/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The study aims to explore the associations of elder abuse, crime victimhood and perceived safety with depression among older adults and examine the interactive effects of sex and place of residence in those associations. DESIGN A cross-sectional study was conducted using a large survey data. SETTING AND PARTICIPANTS The study used data from the Longitudinal Ageing Study in India wave 1 (2017-2018). The effective sample size was 31 464 older adults (aged 60 years or older). PRIMARY AND SECONDARY OUTCOME MEASURES The outcome variable was major depression, calculated using Short Form Composite International Diagnostic Interview. Descriptive statistics along with bivariate and multivariate analyses were performed to fulfil the objectives. RESULTS 5.22% of the older adults (n=1587) experienced abuse in the past 1 year. 1.33% of the older individuals (n=402) were victims of a violent crime, and 14.30% (n=1886) perceived an unsafe neighbourhood. Also, 8.67% of the older adults (n=2657) were suffering from depression. Older adults who were abused had 2.5 odds of suffering from depression (adjusted OR (AOR): 2.47, CI: 1.96 to 3.10) and victims of a violent crime were 84% more likely to be depressed (AOR: 1.84, CI: 1.15 to 2.95) compared with their counterparts. Besides, older individuals who perceived as living in unsafe neighbourhood were 61% more likely to be depressed (AOR: 1.61, CI: 1.34 to 1.93) compared with their counterparts. In the interaction analysis, older women who reported abuse had higher odds of suffering from depression (AOR: 3.27; CI: 2.34 to 4.57) compared with older men who were not abused. Similar result was found in older adults reporting abuse and residing in rural areas (AOR: 3.01, CI: 2.22 to 4.07) compared with those urban residents reporting no abuse. CONCLUSIONS Healthcare providers should pay more attention to the mental health implications of elder abuse, crime victimhood and perceived safety to grasp the underlying dynamics of the symptomology of late-life depression.
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Affiliation(s)
- T Muhammad
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - Trupti Meher
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
| | - T V Sekher
- Department of Family and Generations, International Institute for Population Sciences, Mumbai, Maharashtra, India
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Motamedi A, Ludvigsson M, Simmons J. Factors associated with health care providers speaking with older patients about being subjected to abuse. J Elder Abuse Negl 2021; 34:20-37. [PMID: 34895081 DOI: 10.1080/08946566.2021.2014378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Health care providers have difficulties responding to elder abuse. This study aimed to investigate factors associated with health care providers speaking with older patients about being subjected to abuse, and what facilitating measures staff preferred to help them achieve this. A cross-sectional questionnaire survey was conducted among hospital health care providers (n = 154) in Sweden. Half of the respondents had experience of speaking about elder abuse. A high sense of professional responsibility (OR 3.23) and being less concerned about inflicting damage to the therapeutic relationship (OR 3.97) were associated with having spoken with older patients about being subjected to abuse. Written guidelines about elder abuse and a patient information sheet were the most preferred facilitating measures. Our findings indicate that increasing care providers' sense of responsibility and addressing concerns about damaging the therapeutic relationship might be important factors to target in future interventions to improve health care response to elder abuse.
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Affiliation(s)
- Atbin Motamedi
- Department of Emergency Medicine in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mikael Ludvigsson
- Department of Psychiatry in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Johanna Simmons
- Department of Acute Internal Medicine and Geriatrics in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Lee YJ, Kim Y, Park JI. Prevalence and Factors Associated With Elder Abuse in Community-Dwelling Elderly in Korea: Mediation Effects of Social Support. Psychiatry Investig 2021; 18:1044-1049. [PMID: 34500511 PMCID: PMC8600220 DOI: 10.30773/pi.2021.0156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/18/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The objectives of this study were to investigate the factors associated with elder abuse and the mediation effects of social support in a community-dwelling elderly population in Korea. METHODS This study analyzed a dataset of 10,674 individuals aged 65 years and older in Korea. Data were reviewed from a study conducted by the Korea Institute for Health and Social Affairs in 2011. RESULTS In our study, 12.6% of the elderly reported elder abuse, and 29.2% reported having depression (a score ≥8 on the short version geriatric depression scale). Our results revealed that younger age, low economic status, poor social support (odds ratio [OR]=1.448) and depression (OR=2.039) were significantly associated with elder abuse after controlling for all confounding factors. In addition, mediation analysis showed that the OR for depression was reduced from 2.124 to 2.039 after social support was controlled, which indicates that the association between depression and elder abuse is partially mediated by social support. CONCLUSION Depression and lack of social support were associated with abuse in community-dwelling Korean elderly. In particular, social support was revealed to buffer the association between depression and elder abuse.
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Affiliation(s)
- Yu Jeong Lee
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Yong Kim
- Department of Psychiatry, Presbyterian Medical Center, Jeonju, Republic of Korea
| | - Jong-Il Park
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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9
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Dash K, Breckman R, Lees-Haggerty K, Elman A, Lachs M, Stoeckle RJ, Fulmer T, Rosen T. Developing a tool to assess and monitor institutional readiness to address elder mistreatment in hospital emergency departments. J Elder Abuse Negl 2021; 33:311-326. [PMID: 34496716 DOI: 10.1080/08946566.2021.1965930] [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: 10/20/2022]
Abstract
Hospital emergency departments (EDs) lack the tools and processes required to facilitate consistent screening and intervention in cases of elder abuse and neglect. To address this need, the National Collaboratory to Address Elder Mistreatment has developed a clinical care model that ED's can implement to improve screening, referral, and linkage to coordinated care and support services for older adults who are at risk of mistreatment. To gauge ED readiness to change and facilitate adoption of the care model, we developed an organizational assessment tool, the Elder Mistreatment Emergency Department Assessment Profile (EM-EDAP). Development included a phased approach in which we reviewed evidence on best practice; consulted with multidisciplinary experts; and sought input from ED staff. Based on this formative research, we developed a tool that can be used to guide EDs in focusing on practice improvements for addressing elder mistreatment that are most responsive to local needs and opportunities.
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Affiliation(s)
- Kim Dash
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Risa Breckman
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Kristin Lees-Haggerty
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Mark Lachs
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/Ne York Presbyterian Hospital, New York, NY, USA
| | - Rebecca Jackson Stoeckle
- Health Promotion, Practice, and Innovation, US Division, Education Development Center, Waltham, MA, USA
| | - Terry Fulmer
- The John A. Hartford Foundation, New York, NY, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
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10
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Sweileh WM. Global Research Activity on Elder Abuse: A Bibliometric Analysis (1950-2017). J Immigr Minor Health 2021; 23:79-87. [PMID: 32488667 DOI: 10.1007/s10903-020-01034-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Elder abuse is an emerging worldwide public health, human right, and social priority for governments and health policy makers. The aim of the current study was to provide an in-depth quantitative analysis of literature on elder abuse published in academic journals. A bibliometric method was implemented using Scopus database for the study period from 1950 to 2017. The search strategy utilized specific keywords to retrieve relevant documents. One thousand eight hundred seventy-two documents appeared in Scopus when using the search strategy. The annual number of publications showed a fluctuating pattern in the past four decades. Publications on elder abuse originated mainly from Northern America and Western Europe. International research collaboration on elder abuse was relatively low. The mean number of authors per document was 1.4. The Journal of Elder Abuse and Neglect published almost one third of the retrieved documents. The Rush University was the most active institution and Professor Dong, X.Q. was the most active author in this field. The most frequently encountered keywords were risk factors, prevalence, intervention, prevention, dementia, and nursing homes. Physical abuse was the most common type of elder abuse studied followed by psychological and financial abuse. Elder abuse is under-researched and of limited priority in most world regions. Governments need to take into consideration preventive policies of elder abuse based on research findings.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
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Impact of Sensitization of Family Caregivers upon Treatment Compliance among Geriatric Patients Suffering from Elder Abuse and Neglect. Healthcare (Basel) 2021; 9:healthcare9020226. [PMID: 33670706 PMCID: PMC7922918 DOI: 10.3390/healthcare9020226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/01/2021] [Accepted: 02/13/2021] [Indexed: 11/21/2022] Open
Abstract
Geriatric patients in various outpatient department (OPDs) have been found to agonize from elder abuse and neglect (EAN). Such suffering imposes depressive states within individuals, which in turn affects treatment compliance. The objective of this study was to evaluate the impact of sensitization (psychotherapeutic) of family caregivers (FCGs) upon two denture treatment parameters (maintenance and treatment satisfaction) among EAN patients and compare the differences in outcome with non-abused patients. A survey of completely edentulous subjects (n = 860, aged 41–80 years) provided a sampling frame of 332 EAN patients from which 150 patients (including FCGs) fulfilling the study criteria were distributed (simple random, convenient) into two groups (Group A—control, Group B—test). FCG sensitization for subjects in Group B was performed by a clinical psychologist in 2–4 short (30 min) sessions. Demographic characteristics (frequency) were measured using a self-reported questionnaire, denture maintenance was measured using a denture hygiene index (scores), and treatment satisfaction was analyzed on a 10-point visual analog scale. Relevant data were calculated for means and absolute/relative frequencies. Any difference between two groups was estimated using an unpaired t-test while the level of relationship was determined by Karl Pearson’s test at a p-value of < 0.05. The results showed highest frequency (38.6%) for neglect, with elder neglect (EN) being most common (38.14% alone and 14% in combination). EN was found more if the FCG was a son (52%), in the age group (21–30 years), and with low education and low income (75%). Patients whose FCGs were counselled (Group B) demonstrated low denture plaque scores (mean = 1.38 ± 0.618), while demonstrating comparatively higher scores in six different parameters of treatment satisfaction. Differences between the two groups for both parameters were also found to be statistically significant. Psychotherapeutic counselling in the form of FCG sensitization brings better results of denture maintenance and treatment satisfaction.
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12
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Williams JL, Racette EH, Hernandez-Tejada MA, Acierno R. Prevalence of Elder Polyvictimization in the United States: Data From the National Elder Mistreatment Study. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:4517-4532. [PMID: 29294807 DOI: 10.1177/0886260517715604] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Elder abuse, including emotional, physical, sexual, financial, and neglectful mistreatment is widespread in the United States, with as much as 11% of community-residing older adults experiencing some form of abuse in the past year. Little data exist regarding the prevalence of polyvictimization, or experience of multiple forms of abuse, which may exacerbate negative outcomes over that of any one form of victimization in isolation. This study evaluates the prevalence of elder polyvictimization among a nationally representative sample of community-residing U.S. older adults. Data from the National Elder Mistreatment Study were examined using bivariate and logistic regression analyses. Approximately, 1.7% of older adults experienced past-year polyvictimization, for which risk factors included problems accomplishing activities of daily living (odds ratio [OR] = 2.47), low social support (OR = 1.64), and past experience of traumatic events (OR = 4.81). Elder polyvictimization is a serious problem affecting community-residing older adults with identifiable targets for intervention.
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Affiliation(s)
| | | | | | - Ron Acierno
- Medical University of South Carolina, Charleston, USA
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
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13
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Chao YY, Li M, Lu SE, Dong X. Elder mistreatment and psychological distress among U.S. Chinese older adults. J Elder Abuse Negl 2020; 32:434-452. [PMID: 32886054 DOI: 10.1080/08946566.2020.1814180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults. METHODS Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed. RESULTS Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression. CONCLUSION AND IMPLICATIONS The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals.
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Affiliation(s)
- Ying-Yu Chao
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Mengting Li
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Shou-En Lu
- School of Public Health, Rutgers, the State University of New Jersey , Piscataway, New Jersey, USA
| | - XinQi Dong
- Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
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14
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Moura LKB, Azevedo UND, Wingerter DG, Ferreira MAF, Maciel MPR, Moura RP, Silva AMD, Alves MDSCF. [Bibliometric analysis of the scientific evidence on violence perpetrated against the elderly]. CIENCIA & SAUDE COLETIVA 2020; 25:2143-2152. [PMID: 32520261 DOI: 10.1590/1413-81232020256.226322018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/12/2018] [Indexed: 11/22/2022] Open
Abstract
The scope of this study is violence perpetrated against the elderly. It aims to analyze the international scientific production on violence against the elderly. It involved bibliometric research carried out in the ISI Web of Knowledge/Web of ScienceTM database, in which the search terms "elder,"violence" or "abuse" and "health care" were used, in the period between the years 1991 and 2016. The data were analyzed considering the evolution of the annual publications, the journals with the highest number of records, the authors with the highest number of publications, the number of articles distributed by authors' country of origin, and articles with the highest impact. A total of 267 published records in 174 different journals indexed to the database in question were identified and were written by 901 authors with links to 410 institutions located in 39 countries. In the descriptive analysis of the content of the top journals on the topic and of the most cited articles there was potential for the development of the topic, since there is a need for more data on interventions in cases of violence against the elderly, with a multidisciplinary approach, as well as conducting more research on clinical manifestations, quality of life and its economic impact on the use of health services.
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Affiliation(s)
- Luana Kelle Batista Moura
- Departamento de Odontologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte. Av. Senador Salgado Filho 1787, Lagoa Nova. 59056-000, Natal, RN, Brasil.
| | - Ulicélia Nascimento de Azevedo
- Departamento de Odontologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte. Av. Senador Salgado Filho 1787, Lagoa Nova. 59056-000, Natal, RN, Brasil.
| | - Denise Guerra Wingerter
- Departamento de Odontologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte. Av. Senador Salgado Filho 1787, Lagoa Nova. 59056-000, Natal, RN, Brasil.
| | - Maria Angela Fernandes Ferreira
- Departamento de Odontologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte. Av. Senador Salgado Filho 1787, Lagoa Nova. 59056-000, Natal, RN, Brasil.
| | | | | | | | - Maria do Socorro Costa Feitosa Alves
- Departamento de Odontologia, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte. Av. Senador Salgado Filho 1787, Lagoa Nova. 59056-000, Natal, RN, Brasil.
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15
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An Ecological Perspective on Elder Abuse Interventions. INTERNATIONAL PERSPECTIVES ON AGING 2020. [DOI: 10.1007/978-3-030-25093-5_14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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16
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Mouton CP, Haas A, Karmarkar A, Kuo YF, Ottenbacher K. Elder abuse and mistreatment: results from medicare claims data. J Elder Abuse Negl 2019; 31:263-280. [PMID: 31631814 DOI: 10.1080/08946566.2019.1678544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Elder abuse and mistreatment (EM) continues to be a growing problem as the US population ages. Despite the growth, detection of EM continues to lag. However, Medicare claims data and the electronic health record might provide an opportunity to encourage better detection. We evaluated Medicare claims data from 2012-2014 for beneficiaries who had a diagnostic code for EM discharged from any types of facility. We extracted records for 10,181 individuals examining demographic characteristics, residential characteristics, residential location, type of facility providing care, disease co-morbidities, and disability-related conditions. Of our sample, most were female (65.1%), white (78.8%), over 75 years of age (52.6%), and from an urban setting (85.2%). While the greatest number were discharged from acute care settings, almost one-third were hospitalized in psychiatric hospitals (34.6%). Mood disorders (27.5%) and dementia (14.2%) were the most common primary diagnoses. Hypertension (67.7%), depression (44.6%), fluid and electrolyte disorder (43.6%), and cardiac arrhythmia (28.2%) were the most common co-morbidities. In Medicare claims data, we found unique features and co-morbidities associated with EM. These findings could be used to develop a clinical algorithm predictive of older adults requiring screening for EM.
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Affiliation(s)
- Charles P Mouton
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX
| | - Allen Haas
- Department of Preventive Medicine and Population Health
| | - Amol Karmarkar
- Department of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
| | - Yong-Fang Kuo
- Department of Preventive Medicine and Population Health
| | - Kenneth Ottenbacher
- Department of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX
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Li M, Guo M, Stensland M, Silverstein M, Dong X. Typology of Family Relationship and Elder Mistreatment in a US Chinese Population. J Am Geriatr Soc 2019; 67:S493-S498. [DOI: 10.1111/jgs.15892] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 02/17/2019] [Accepted: 02/25/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Mengting Li
- Institute for Health, Health Care Policy and Aging ResearchRutgers, The State University of New Jersey New Brunswick New Jersey
- School of NursingRutgers, The State University of New Jersey New Brunswick New Jersey
| | - Man Guo
- School of Social WorkUniversity of Iowa Iowa City Iowa
| | | | - Merril Silverstein
- Department of SociologyMaxwell School of Citizenship and Public Affairs, Syracuse University Syracuse New York
- Department of Human Development and Family ScienceDavid B. Falk College of Sport and Human Dynamics, Syracuse University Syracuse New York
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging ResearchRutgers, The State University of New Jersey New Brunswick New Jersey
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Weissberger GH, Goodman MC, Mosqueda L, Schoen J, Nguyen AL, Wilber KH, Gassoumis ZD, Nguyen CP, Han SD. Elder Abuse Characteristics Based on Calls to the National Center on Elder Abuse Resource Line. J Appl Gerontol 2019; 39:1078-1087. [PMID: 31364442 DOI: 10.1177/0733464819865685] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Characterizing the types of elder abuse and identifying the characteristics of perpetrators are critically important. This study examined the types of elder abuse reported to the National Center on Elder Abuse (NCEA) resource line. Calls were coded with regard to whether abuse was reported, types of abuse alleged, whether multiple abuse subtypes occurred, and who perpetrated the alleged abuse. Of the 1,939 calls, 818 (42.2%) alleged abuse, with financial abuse being the most commonly reported (449 calls, 54.9%). A subset of calls identified multiple abuse types (188, 23.0%) and multiple abusers (149, 18.2%). Physical abuse was most likely to co-occur with another abuse type (61/93 calls, 65.6%). Family members were the most commonly identified perpetrators (309 calls, 46.8%). This study reports the characteristics of elder abuse from a unique source of frontline data, the NCEA resource line. Findings point to the importance of supportive resources for elder abuse victims and loved ones.
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Affiliation(s)
| | | | - Laura Mosqueda
- Keck School of Medicine of USC, Los Angeles, USA.,National Center on Elder Abuse, Alhambra, CA, USA
| | - Julie Schoen
- Keck School of Medicine of USC, Alhambra, USA.,National Center on Elder Abuse, Alhambra, CA, USA
| | | | | | | | | | - S Duke Han
- Keck School of Medicine of USC, Alhambra, USA.,Keck School of Medicine of USC, Los Angeles, USA.,USC Leonard Davis School of Gerontology, Los Angeles, USA.,Rush University Medical Center, Chicago, IL, USA.,USC Dornsife College of Letters, Arts and Sciences, Los Angeles, USA
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19
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Boyle PA, Yu L, Schneider JA, Wilson RS, Bennett DA. Scam Awareness Related to Incident Alzheimer Dementia and Mild Cognitive Impairment: A Prospective Cohort Study. Ann Intern Med 2019; 170:702-709. [PMID: 30986826 PMCID: PMC9770589 DOI: 10.7326/m18-2711] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Decreased scam awareness may be an early indicator of impending Alzheimer dementia and its precursor, mild cognitive impairment, but prior studies have not systematically examined the associations between scam awareness and adverse cognitive outcomes. OBJECTIVE To test the hypothesis that low scam awareness is associated with increased risk for incident Alzheimer dementia, mild cognitive impairment, and Alzheimer disease pathology in the brain. DESIGN Prospective cohort study of aging. SETTING Community-based study in the greater Chicago metropolitan area. PARTICIPANTS 935 older persons initially free of dementia. MEASUREMENTS Scam awareness was measured via questionnaire, incident Alzheimer dementia and mild cognitive impairment were documented in detailed annual cognitive and clinical evaluations, and Alzheimer disease neuropathology was quantified after death among a subset of persons who died (n = 264). Proportional hazards models examined associations between scam awareness and incident Alzheimer dementia and mild cognitive impairment. Regression models examined associations between scam awareness and Alzheimer disease pathology, particularly β-amyloid burden and tau tangle density. RESULTS During a mean of about 6 years (SD, 2.4) of observation, 151 persons (16.1%) developed Alzheimer dementia. Low scam awareness was associated with increased risk for Alzheimer dementia (hazard ratio [HR], 1.56 [95% CI, 1.21 to 2.01]; P < 0.001), such that each 1-unit increase in scam score (indicating lower awareness) was associated with about a 60% increase in dementia risk. Low scam awareness was also associated with increased risk for mild cognitive impairment (HR, 1.47 [CI, 1.20 to 1.81]; P < 0.001). These associations persisted even after adjustment for global cognitive function. Finally, low scam awareness was associated with a higher burden of Alzheimer pathology in the brain, particularly β-amyloid (estimated increase [±SE] in β-amyloid per 1-unit increase in scam score, 0.22 ± 0.10 unit; P = 0.029). LIMITATION The measure of scam awareness used here is too weak for prediction at the individual level. CONCLUSION Low scam awareness among older persons is a harbinger of adverse cognitive outcomes and is associated with Alzheimer disease pathology in the brain. PRIMARY FUNDING SOURCE National Institute on Aging.
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Affiliation(s)
- Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois (P.A.B., L.Y., J.A.S., R.S.W., D.A.B.)
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois (P.A.B., L.Y., J.A.S., R.S.W., D.A.B.)
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois (P.A.B., L.Y., J.A.S., R.S.W., D.A.B.)
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois (P.A.B., L.Y., J.A.S., R.S.W., D.A.B.)
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois (P.A.B., L.Y., J.A.S., R.S.W., D.A.B.)
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Alipour A, Shamsalinia A, Ghaffari F, Fotokian Z. The Development and Psychometric Evaluation of a Questionnaire on the Nurses’ Recognition of Elder Abuse by Family Caregiver. Open Nurs J 2019. [DOI: 10.2174/1874434601913010066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Exploring the nurses’ recognition of elder abuse and related signs may lead to the knowledge development solutions through the In-Service programs. To develop an instrument for the assessment of nurses’ recognition of elder abuse by family caregivers within the Iranian context and psychometrically evaluate its reliability and validity.
Methods:
The sequential combination exploratory mixed methods design was used to develop the questionnaire format, which involved two sections: the quantitative and qualitative step. The qualitative step included probing the Nurses’ recognition of elder abuse by family caregivers in two steps including the literature and related tools review and semi-structured interviews with nurses. The quantitative step was accomplished in two parts. The validity of questionnaire was checked using face, content, construct, and formal validity; and the reliability was probed using cronbach’s alpha reliability. The analyzed data were categorized into 67 items (three main groups namely evident signs of abuse, elder’s potential to get abused, and family caregiver’s potential to abuse and 6 sub-groups including inadvertency, physical abuse, financial misconduct, psychological abuse, sexual abuse, and risk factors). Three components from the exploratory content analysis gained 58.8% variance totally. The cronbach’s alpha for the 3 components were 0.79, 0.76, and 0.78, respectively.
Results:
The questionnaire on the nurses’ recognition of elder abuse by family caregiver can be applied to a wide variety of settings because of the broad range of methods utilised to generate items and domains, its comprehensive consideration of the principles of elder abuse, and its initial reliability and validity.
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Abstract
Elder abuse is generally defined as the maltreatment of individuals over the age of 60, although no precise definition exists in the literature. Types of abuse include, but are not limited to, psychological/emotional, physical, sexual abuse, and financial exploitation. Certain risk factors exist leaving an individual more susceptible to abuse, and many obstacles exist preventing the elimination of abuse. There are also identifiable risk factors that increase the likelihood of perpetration of abuse. This systematic review provides an overview of the scope of the problem, types of abuse, risk factors, characteristics of abusers, and key aspects of elder abuse prevention.
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Affiliation(s)
- Astrid Botty Van Den Bruele
- Department of Surgery, University of Florida College of Medicine Jacksonville, 655 West 8th Street, Jacksonville, FL 32209, USA
| | - Moustapha Dimachk
- Department of Surgery, University of Florida College of Medicine Jacksonville, 655 West 8th Street, Jacksonville, FL 32209, USA
| | - Marie Crandall
- Department of Surgery, University of Florida College of Medicine Jacksonville, 655 West 8th Street, Jacksonville, FL 32209, USA.
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22
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Park JI. Relationship between Emotional Abuse and Depression among Community-Dwelling Older Adults in Korea. Yonsei Med J 2018; 59:693-697. [PMID: 29869468 PMCID: PMC5990673 DOI: 10.3349/ymj.2018.59.5.693] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 03/16/2018] [Accepted: 04/24/2018] [Indexed: 11/30/2022] Open
Abstract
Despite recent advances, there is little research on factors associated with emotional abuse among Korean older adults. The present study investigated the relationships between depression and emotional abuse among community-dwelling Korean older adults. We analyzed the dataset from the Survey of Living Conditions and Welfare Needs of Korean Older Persons conducted by the Korea Institute for Health and Social Affairs in 2011. Older adults (aged >65 years, n=10674) were randomly selected. Multivariate logistic regression was used to investigate factors associated with emotional abuse in terms of sociodemographic, health-related, and psychological variables, including depression using the short version of the Geriatric Depression Scale. In our study, 9.4% of the older adults reported experiencing emotional abuse in the previous year. In addition, 44.0% of those experiencing emotional abuse suffered from depression. Multiple logistic regression modeling showed that depression in older adults was independently associated with emotional abuse [odds ratio (OR)=1.788, p<0.001]. Along with depression, poor social support (OR for no social support=1.712, p<0.001) and having chronic illnesses (OR for more than 3=1.481, p<0.005) were associated an increased risk of emotional abuse. Our results showed that emotional abuse among older adults in Korea is prevalent. Our findings suggest that depression, poor social support, and having chronic illnesses are significant factors associated with emotional abuse among the Korean older adult population. Addressing these factors with preventive interventions could have significant public health implications. Further studies are warranted to gain a better understanding of emotional abuse in older Korean adults.
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Affiliation(s)
- Jong Il Park
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Korea.
- Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
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23
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Factors related to abuse of older persons by relatives with psychiatric disorders. Arch Gerontol Geriatr 2017; 68:126-134. [DOI: 10.1016/j.archger.2016.09.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 09/23/2016] [Accepted: 09/25/2016] [Indexed: 11/18/2022]
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24
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Wong JS, Waite LJ. Elder mistreatment predicts later physical and psychological health: Results from a national longitudinal study. J Elder Abuse Negl 2016; 29:15-42. [PMID: 27636657 DOI: 10.1080/08946566.2016.1235521] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Stress process theory predicts that elder mistreatment leads to declines in health, and that social support buffers its ill effects. We test this theory using nationally representative, longitudinal data from 2,261 older adults in the National Social Life Health and Aging Project. We regress psychological and physical health in 2010/2011 on verbal and financial mistreatment experience in 2005/2006 and find that the mistreated have more anxiety symptoms, greater feelings of loneliness, and worse physical and functional health 5 years later than those who did not report mistreatment. In particular, we show a novel association between financial mistreatment and functional health. Contrary to the stress buffering hypothesis, we find little evidence that social support moderates the relationship between mistreatment and health. Our findings point to the lasting impact of mistreatment on health but show little evidence of a buffering role of social support in this process.
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Affiliation(s)
- Jaclyn S Wong
- a Department of Sociology , University of Chicago , Chicago , Illinois , USA.,b NORC at the University of Chicago , Chicago , Illinois , USA
| | - Linda J Waite
- a Department of Sociology , University of Chicago , Chicago , Illinois , USA.,b NORC at the University of Chicago , Chicago , Illinois , USA
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25
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Zhang Y, Yeager VA, Hou S. The Impact of Community-Based Supports and Services on Quality of Life Among the Elderly in China: A Longitudinal Study. J Appl Gerontol 2016; 37:1244-1269. [PMID: 27496140 DOI: 10.1177/0733464816661945] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Community-based supports and services (CBSS) have been developing rapidly in China as a new way of satisfying the needs of elderly people. However, it is not clear how pervasive these services are or whether the availability of CBSS impacts quality of life. This study examines trends in CBSS and the impact of the perceived CBSS availability on self-reported quality of life among the elderly in China. We found a significant increase in perceived CBSS availability from 2005 to 2011, but the perceived availability of CBSS varies by the type of CBSS. Multivariate analyses show that home medical visits (β = .181, p = .03), psychological support (β = .332, p = .02), social and recreation activities (β = .231, p = .02), and legal consulting services (β = .271, p = .02) were each significantly associated with a good quality of life. Results from this study provide insight that can inform CBSS strategies and the development of new services for the elderly in China.
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26
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Dong X. Sociodemographic and socioeconomic characteristics of elder self-neglect in an US Chinese aging population. Arch Gerontol Geriatr 2016; 64:82-9. [PMID: 26952381 PMCID: PMC9986842 DOI: 10.1016/j.archger.2016.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 08/28/2014] [Accepted: 01/08/2016] [Indexed: 01/18/2023]
Abstract
This study aimed to examine the socio-demographic and socioeconomic characteristics associated with prevalence and severity of elder self-neglect in an U.S. Chinese older population. The PINE study is a population-based epidemiological study in the greater Chicago area. In total, 3159 Chinese older adults were interviewed from 2011 to 2013. Elder self-neglect was assessed with systematic observations of a participant's personal and home environment across five domains: hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Elder self-neglect was prevalent among older adults aged 80 years or over (mild self-neglect: 34.6% 95% CI 30.9-38.4; moderate/severe: 15.6% 95% CI 12.8-18.6), men (mild: 28.6% 95% CI 26.1-31.3; moderate/severe: 13.1% 95% CI 11.2-15.1), those with 0-6 years of education (mild: 32.2% 95% CI 29.7-34.9; moderate/severe: 12.6% 95% CI 10.8-14.5), and those with an annual personal income between $5000 and $10,000 (mild: 30.8% 95% CI 28.4-33.2; moderate/severe: 11.8% 95% CI 10.2-13.5). Older age (mild self-neglect: OR 1.02, 95% CI 1.01-1.03; moderate/severe self-neglect: OR 1.02, 95% CI 1.00-1.03) and lower education levels (mild self-neglect: OR 1.06, 95% CI 1.03-1.08; moderate/severe self-neglect: OR 1.07, 95% CI 1.04-1.09) were associated with significantly increased odds of elder self-neglect. Women (moderate/severe self-neglect: OR 0.73, 95% CI 0.58-0.93) had significantly decreased odds of moderate/severe elder self-neglect. No significant association was found between levels of income and overall elder-self-neglect of all severities. Future research is needed to examine risk/protective factors associated with elder self-neglect in U.S. Chinese older populations.
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Affiliation(s)
- XinQi Dong
- Professor of Medicine, Nursing and Behavioral Sciences, Chinese Health, Aging and Policy Program, Rush Institute for Health Aging, Nursing and Behavioral Sciences, 1645 West Jackson, Suite 675, Chicago, IL 60612, United States.
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27
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Du Mont J, Kosa D, Macdonald S, Elliot S, Yaffe M. Development of skills-based competencies for forensic nurse examiners providing elder abuse care. BMJ Open 2016; 6:e009690. [PMID: 26864579 PMCID: PMC4762096 DOI: 10.1136/bmjopen-2015-009690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE As a critical step in advancing a comprehensive response to elder abuse built on existing forensic nursing-led hospital-based programmes, we developed a list of skills-based competencies for use in an Elder Abuse Nurse Examiner curriculum. PARTICIPANTS AND SETTING Programme leaders of 30 hospital-based forensic nursing-led sexual assault and domestic violence treatment centres. PRIMARY AND SECONDARY OUTCOME MEASURES 149 verbatim recommendations for components of an elder abuse response were identified from a systematic scoping review. In 2 online Delphi consensus survey rounds, these components of care were evaluated by an expert panel for their overall importance to the elder abuse intervention under development and for their appropriateness to the scope of practice of an elder abuse nurse examiner. The components retained after evaluation were translated into skills-based competencies using Bloom's Taxonomy of Learning and, using the Nominal Group Technique, were subsequently reviewed and revised by a subset of members of the expert panel in a consensus meeting. RESULTS Of the 148 recommendations evaluated, 119 were rated as important and achieved consensus or high level of agreement. Of these, 101 were determined to be within the scope of practice of an Elder Abuse Nurse Examiner and were translated into skills-based competencies. Following review and revision by meeting experts, 47 final competencies were organised by content into 5 metacompetencies: documentation, legal and legislative issues; interview with older adult, caregiver and other relevant contacts; assessment; medical and forensic examination; and case summary, discharge plan and follow-up care. CONCLUSIONS We determined the skills-based competencies of importance to training forensic nurse examiners to respond to elder abuse in the context of a hospital-based intervention. These findings may have implications for violence and abuse treatment programmes with a forensic nursing component that are considering the provision of a dedicated response to the abuse of older women and men.
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Affiliation(s)
- Janice Du Mont
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Daisy Kosa
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Ontario, Canada
| | - Sheila Macdonald
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Ontario, Canada
| | - Shannon Elliot
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Ontario Network of Sexual Assault/Domestic Violence Treatments Centres, Toronto, Ontario, Canada
| | - Mark Yaffe
- Department of Family Medicine, St. Mary's Hospital Centre, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
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Sommerfeld DH, Henderson LB, Snider MA, Aarons GA. Multidimensional measurement within adult protective services: design and initial testing of the tool for risk, interventions, and outcomes. J Elder Abuse Negl 2015; 26:495-522. [PMID: 24848994 PMCID: PMC4226422 DOI: 10.1080/08946566.2014.917598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study describes the development, field utility, reliability, and validity of the multidimensional Tool for Risk, Interventions, and Outcomes (TRIO) for use in Adult Protective Services (APS). The TRIO is designed to facilitate consistent APS practice and collect data related to multiple dimensions of typical interactions with APS clients, including the investigation and assessment of risks, the provision of APS interventions, and associated health and safety outcomes. Initial tests of the TRIO indicated high field utility, social worker "relevance and buy-in," and inter-rater reliability. TRIO concurrent validity was demonstrated via appropriate patterns of TRIO item differentiation based on the type of observed confirmed abuse or neglect; and predictive validity was demonstrated by prediction of the risk of actual APS recurrence. The TRIO is a promising new tool that can help meet the challenges of providing and documenting effective APS practices and identifying those at high risk for future APS recurrence.
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Affiliation(s)
- David H Sommerfeld
- a Department of Psychiatry , University of California, San Diego , La Jolla , California , USA
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Dong X, Simon M. Prevalence of elder self-neglect in a Chicago Chinese population: The role of cognitive physical and mental health. Geriatr Gerontol Int 2015; 16:1051-62. [DOI: 10.1111/ggi.12598] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2015] [Indexed: 11/28/2022]
Affiliation(s)
- XinQi Dong
- Rush University Medical Center; Chicago IL USA
| | - Melissa Simon
- Northwestern University Medical Center; Chicago IL USA
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30
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Park HJ. Living with 'Hwa-byung': the psycho-social impact of elder mistreatment on the health and well-being of older people. Aging Ment Health 2015; 18:125-8. [PMID: 23815590 DOI: 10.1080/13607863.2013.814103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Elder abuse and neglect is an increasing concern that adversely affects the health and well-being of older people in most societies. The purpose of this paper is to describe the psycho-social impact of elder mistreatment on the health and well-being of older Korean people living in New Zealand. METHOD Data were collected from in-depth interviews. The lived experiences of elder abuse and neglect were studied with 10 older people who were, or who had been, mistreated in their family context. To analyse the data collected, a combined analysis approach was employed using traditional code-based techniques and a concept-mapping method. RESULTS The findings of the study show that the effects of elder mistreatment were complex and multidimensional. The older persons who were mistreated in family settings experienced a range of emotional, psychological distress and physical symptoms. Many of them identified 'Hwa-byung' (literally anger disease) as a health issue associated with suppressed emotions of anger, demoralisation, heat sensation and other somatised symptoms. CONCLUSION Elder abuse and neglect is a traumatic life event that has considerable psycho-social impacts on older people experiencing the problem. It is important to recognise the power of multidimensional challenges caused by elder mistreatment in health and well-being.
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Affiliation(s)
- Hong-Jae Park
- a School of Counselling, Human Services and Social Work, University of Auckland , Auckland , New Zealand
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Abstract
ABSTRACTThe present study evaluates a conceptual model of elder neglect within the home care arrangement that takes into consideration the older adult, his or her family members, and the home care worker. Data from 223 complete care-giving units, which consist of an older adult, a family member and a home care worker, were analysed using structural equation modelling. Overall, 31.5 per cent of the older adults, 18 per cent of the care workers and 32.3 per cent of the family members reported at least one type of elder neglect. The proposed model showed a reasonable fit to the data. There was an inverse effect from type of home care to family member's burden and elder neglect, with live-in (around the clock) care being associated with lower levels of family member burden and elder neglect compared with live-out Israeli home care (provided for several hours per week). The amount of informal assistance provided by family members was inversely related to the amount of burden reported by home care workers, with greater informal assistance being associated with lower levels of worker burden. The findings call for the important role of formal home care by demonstrating a potentially protective effect for live-in migrant home care. The study also emphasises the shared burden between formal and informal sources of care.
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Cadmus EO, Owoaje ET, Akinyemi OO. Older persons' views and experience of elder abuse in South Western Nigeria: a community-based qualitative survey. J Aging Health 2014; 27:711-29. [PMID: 25552528 DOI: 10.1177/0898264314559893] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Conventionally, existing information on elder abuse has been institution based, professionally driven, and in high-income countries. This study addresses the prevailing gap in knowledge through direct consultation of older persons in the community about their perceptions of elder abuse. METHOD Eight focus group discussions were carried out among males and females aged 60 years and above in a rural and an urban community in south western Nigeria. Data were transcribed and analyzed based on emergent themes. RESULTS Findings from the study show that the perception of abuse by the respondents included the standard typologies except sexual abuse as well as societal issues such as disrespect and lack of recognition. DISCUSSION Our study revealed a high level of awareness and experience of elder abuse among the participants in both communities. Effective social welfare and health services aided by targeted government policies are needed to improve the quality of life of the elderly.
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Dong X. Self-neglect in an elderly community-dwelling U.S. Chinese population: findings from the Population Study of Chinese Elderly in Chicago study. J Am Geriatr Soc 2014; 62:2391-7. [PMID: 25439674 PMCID: PMC4270854 DOI: 10.1111/jgs.13140] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study aimed to examine the prevalence of self-neglect and its specific behaviors in an elderly community-dwelling U.S. Chinese population through a population-based cohort study (PINE Study) in the greater Chicago area. Community-dwelling population of older Chinese adults were interviewed from 2011 to 2013 (n = 3,159). The personal and home environment of participants was rated based on prevalence of hoarding behavior, personal hygiene, repairs needed on the home, sanitary condition of the home, and adequacy of utilities. Prevalence estimates were presented according to self-reported quality of life (QOL). It was found that the prevalence of self-neglect was 18.2% for mild self-neglect and 10.9% for moderate to severe self-neglect. Unsanitary conditions (17.0%) was the most prevalent, followed by need for home repair (16.3%), hoarding behavior (14.9%), poor personal hygiene (11.3%), and inadequate utilities (4.2%). The prevalence of elder self-neglect of all severities and of all types was higher in older adults with fair or poor QOL than in those with good or very good QOL. Poorer QOL was significantly associated with greater risk of self-neglect of all severities (mild self-neglect: odds ratio (OR) = 1.93, 95% confidence interval (CI) = 1.26-2.96, P < .001; moderate to severe self-neglect: OR = 3.58, 95% CI = 1.79-7.13, P < .001) and specific personal and environmental hazards. The study's authors conclude that elder self-neglect is prevalent, especially in elderly adults with poorer QOL. Future research is needed to examine risk and protective factors associated with elder self-neglect.
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Affiliation(s)
- XinQi Dong
- Rush University Medical Center, Chicago, Illinois
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Dong X, Simon M. Association between Elder Abuse and Metabolic Syndromes: Findings from the Chicago Health and Aging Project. Gerontology 2014; 61:389-98. [PMID: 25471532 DOI: 10.1159/000368577] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 09/22/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Elder abuse and metabolic syndromes are both important public health issues and are associated with increased morbidity and mortality. This study aimed to examine the associations between elder abuse and risk for metabolic syndromes. METHODS The Chicago Health and Aging Project (CHAP) cohort is a population-based study (n = 4,586). We identified 676 participants with some form of elder abuse reported to a social services agency. The primary independent variable was elder abuse reported to a social services agency. Outcomes were metabolic syndrome as categorized by World Health Organization (WHO), American Heart Association (AHA) and International Diabetes Federation (IDF) criteria. Bivariate and logistic regression analyses were used to assess the association between elder abuse and different definitions of metabolic syndromes. RESULTS In the bivariate analyses, elder abuse victims were more likely than those without elder abuse to have metabolic syndromes [22.4 vs. 10.7% (WHO), 50.7 vs. 40.0% (AHA) and 47.7 vs. 33.5% (IDF)]. After adjusting for potential confounding factors, elder abuse was associated with an increased risk for metabolic syndromes according to WHO [OR, 3.95 (2.86-5.47)], AHA [OR, 2.03 (1.56-2.64)] and IDF [OR, 2.55 (1.97-3.29)] criteria. Interaction term analyses indicate that the association between elder abuse and metabolic syndromes may be moderated by sociodemographic characteristics but not by health-related or psychosocial factors. CONCLUSION Elder abuse is associated with an increased risk for metabolic syndromes. Research is needed to examine the association between elder abuse and cardiovascular disease.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Ill., USA
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Leddy MA, Farrow VA, Schulkin J. Obstetrician-Gynecologists' Knowledge, Attitudes, and Practice Regarding Elder Abuse Screening. Womens Health Issues 2014; 24:e455-64. [DOI: 10.1016/j.whi.2014.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 04/03/2014] [Accepted: 04/21/2014] [Indexed: 11/27/2022]
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Dong X, Simon M, Beck T, Evans D. Decline in cognitive function and elder mistreatment: findings from the Chicago Health and Aging Project. Am J Geriatr Psychiatry 2014; 22:598-605. [PMID: 24821287 PMCID: PMC9942679 DOI: 10.1016/j.jagp.2012.11.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 10/29/2012] [Accepted: 11/07/2012] [Indexed: 01/18/2023]
Abstract
OBJECTIVE This study aimed to examine the longitudinal association between decline in cognitive function and elder mistreatment (EM). METHODS Chicago Health and Aging Project (CHAP) is an epidemiologic study conducted in a geographically defined community (N = 6,159). We identified 143 CHAP participants who had longitudinal cognitive data and EM reported to social services agency. The primary predictor was cognitive function, which was assessed using the Mini-Mental State Examination (MMSE), the Symbol Digit Modalities Test (Perceptual Speed), and both immediate and delayed recall of the East Boston Memory Test (Episodic Memory). An index of global cognitive function scores was derived by averaging z scores of all tests. Logistic regression models were used to assess the association of cognitive function domains and risk for EM. RESULTS After adjusting for potential confounders, every one-point decline in global cognitive function (odds ratio [OR]: 1.57 [1.21-2.03]), MMSE (OR: 1.07 [1.03-1.10]), Episodic Memory (OR: 1.46 [1.14-1.86]), and Perceptual Speed (OR: 1.05 [1.02-1.07]) scores were associated with increased risk for EM. Lowest tertiles in global cognitive function (OR: 2.71 [1.49-4.88]), MMSE (OR: 2.02 [1.07-3.80]), Episodic Memory (OR: 2.70 [1.41-5.16]), and Perceptual Speed (OR: 4.41 [2.22-8.76]) scores were associated with increased risk for EM. CONCLUSION Decline in global cognitive function, MMSE, and Perceptual Speed scores were associated with increased risk for EM.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Melissa Simon
- Department of Preventive Medicine and OB/GYN, Northwestern University Medical Center, Chicago, IL
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Denis Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
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Ayalon L. Reports of Elder Neglect by Older Adults, Their Family Caregivers, and Their Home Care Workers: A Test of Measurement Invariance. J Gerontol B Psychol Sci Soc Sci 2014; 70:432-42. [DOI: 10.1093/geronb/gbu051] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 04/13/2014] [Indexed: 11/14/2022] Open
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Dong X, Chen R, Simon MA. Elder abuse and dementia: a review of the research and health policy. Health Aff (Millwood) 2014; 33:642-9. [PMID: 24711326 PMCID: PMC9950800 DOI: 10.1377/hlthaff.2013.1261] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Older adults with dementia may be at high risk for abuse, but the topic has not been well studied. We conducted a literature review to examine the relationships between elder abuse and dementia. We found that psychological abuse was the most common form of abuse among older adults, with estimates of its prevalence ranging from 27.9 percent to 62.3 percent. Physical abuse was estimated to affect 3.5-23.1 percent of older adults with dementia. We also found that many older adults experienced multiple forms of abuse simultaneously, and the risk of mortality from abuse and self-neglect may be higher in older adults with greater levels of cognitive impairment. We summarize programs and policies related to the abuse of older adults with dementia, including adult protective services, mandatory elder abuse reporting, and the Long-Term Care Ombudsman Program. We also summarize aspects of the National Alzheimer's Project Act, the Older Americans Act, and the Elder Justice Act. In spite of a recent increase in research and policy developments on elder abuse, challenges such as insufficient funding, limited knowledge about elder abuse, a lack of funding for the implementation of federal and state programs relevant to elder abuse and dementia, and a lack of dementia-specific training for front-line health care staff persist. Stronger programs targeting the well-being of older adults with dementia are needed.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging and the director of its Chinese Health, Aging, and Policy Program; and an associate professor of medicine, nursing, and behavioral sciences at Rush University Medical Center, in Chicago, Illinois. He also serves as senior policy and research adviser at the Administration on Aging/ Administration for Community Living
| | - Ruijia Chen
- Chinese Health, Aging, and Policy Program, Rush Institute for Healthy Aging
| | - Melissa A. Simon
- Departments of Obstetrics and Gynecology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine; and director of patient navigation at the Robert H. Lurie Comprehensive Cancer Center, both at Northwestern University, in Chicago
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Strasser S, King P, Payne B, O'Quin K. Elder abuse: what coroners know and need to know. J Elder Abuse Negl 2013; 25:242-53. [PMID: 23627430 DOI: 10.1080/08946566.2012.751826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article presents findings from a survey examining knowledge of elder abuse among Georgia's coroners. More than half of the 116 respondents indicated that they know "almost nothing" or "a little" about distinguishing signs of physical abuse from signs of aging (54%) and mandatory reporting laws and related elder abuse statutes (63%). When asked the frequency with which older adult cases were referred to the medical examiner, 49% indicated "rarely if ever." Study findings reveal specific opportunities for enhancing training efforts aimed at coroners, who play a critical role in the identification of elder abuse.
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Affiliation(s)
- Sheryl Strasser
- Institute of Public Health, Georgia State University, Atlanta, Georgia 30302, USA.
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Dong X, Simon MA. Urban and rural variations in the characteristics associated with elder mistreatment in a community-dwelling Chinese population. J Elder Abuse Negl 2013; 25:97-125. [PMID: 23473295 DOI: 10.1080/08946566.2013.751811] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study compares the urban and rural differences in characteristics associated with elder mistreatment (EM) in a Chinese population. A cross-sectional study of 269 urban and 135 rural participants aged 60 years or greater was performed. Among those with EM, rural participants were more likely to be women, have lower levels of education and income, have lower levels of health status and quality of life, have worse change in recent health, and have lower levels of psychosocial well-being. Both higher levels of depressive symptoms and lower levels of social support were associated with increased risk of EM.
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Affiliation(s)
- Xinqi Dong
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
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Dong X, Simon MA. Association between reported elder abuse and rates of admission to skilled nursing facilities: findings from a longitudinal population-based cohort study. Gerontology 2013; 59:464-72. [PMID: 23816799 DOI: 10.1159/000351338] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 04/15/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Elder abuse is common and is a frank violation of an older adult's fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). METHODS A prospective population-based study conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to the social services agency for elder abuse. The primary predictor was elder abuse reported to the social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. RESULTS The average annual rate of SNF for those without elder abuse was 0.14 (0.58) and for those with elder abuse was 0.66 (1.63). After adjusting for sociodemographic and socioeconomic variables, medical comorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR 4.60 (2.85-7.42)). Psychological abuse (RR 2.31 (1.17-4.56)), physical abuse (RR 2.36 (1.19-4.66)), financial exploitation (RR 2.81 (1.53-5.17)) and caregiver neglect (RR 4.73 (3.03-7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with a higher rate of SNF stay longer than 30 days (RR 6.27 (3.68-10.69)). CONCLUSION Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had a differential association with an increased rate of admission to SNF.
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Affiliation(s)
- Xinqi Dong
- Chinese Health, Aging and Policy Program, Rush Institute for Health Aging, Rush University Medical Center, Chicago, Ill., USA.
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Dong X, Simon MA. Association between elder abuse and use of ED: findings from the Chicago Health and Aging Project. Am J Emerg Med 2013; 31:693-8. [PMID: 23399343 PMCID: PMC9950799 DOI: 10.1016/j.ajem.2012.12.028] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 12/18/2012] [Accepted: 12/21/2012] [Indexed: 01/18/2023] Open
Abstract
PURPOSE This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of emergency department (ED) utilization in a community-dwelling population. METHODS A population-based study is conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6674 participants in the Chicago Health and Aging Project, 106 participants were reported to a social services agency for suspected elder abuse. The primary predictor was elder abuse reported to a social services agency. The outcome of interest was the annual rate of ED utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. RESULTS The average annual rate of ED visits for those without elder abuse was 0.7(1.4) and, for those with reported elder abuse, was 2.1(3.2). After adjusting for sociodemographics, socioeconomic variables, medical comorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of ED utilization (RR, 2.33 [1.60-3.38]). Psychological abuse (RR, 1.98[1.29-3.00]), financial exploitation (RR, 1.59 [1.01-2.52]) and caregiver neglect (RR, 2.04 [1.38-2.99]) were associated with increased rates of ED utilization, after considering the same confounders. Interaction terms suggest the association between elder abuse and ED utilization is not mediated through medical comorbidities, cognitive and functional impairment, or psychosocial distress. CONCLUSION Elder abuse was associated with increased rates of ED utilization in this community population. Specific subtypes of elder abuse had differential association with increased rate of ED utilization.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612, USA,Corresponding author. Tel.: +1 312 942 3350; fax: +1 312 942 2861. (X. Dong)
| | - Melissa A. Simon
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL 60601, USA
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Dong X, Simon M, Evans D. Elder self-neglect is associated with increased risk for elder abuse in a community-dwelling population: findings from the Chicago Health and Aging Project. J Aging Health 2013; 25:80-96. [PMID: 23223207 PMCID: PMC9950786 DOI: 10.1177/0898264312467373] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE We examined the relationship between self-neglect and risk for subsequent elder abuse report to social services agency. METHOD Population-based cohort study conducted Chicago. Primary predictor was elder self-neglect at baseline without concurrent elder abuse. Cox proportional hazard models were used to assess independent associations of elder self-neglect with the risk of subsequent elder abuse using time-varying covariate analyses. RESULTS Of 10,333 participants, 1,460 were reported for self-neglect and 180 were reported for elder abuse. The median time from self-neglect to elder abuse was 3.5 years. In multivariable analyses, elder self-neglect was associated with increased risk for subsequent elder abuse (odds ratio, OR, 1.75[1.18-2.59]). Elder self-neglect was also associated with increased risk for subsequent caregiver neglect (OR, 2.09[1.24-3.52]), financial exploitation (OR, 1.73[1.01-2.95]), and multiple forms of elder abuse (HR, 2.06[1.22-3.48]). CONCLUSION Elder self-neglect report is associated with increased risk for subsequent elder abuse report to social services agency.
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Affiliation(s)
- XinQi Dong
- Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612, USA.
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Tredal I, Soares JJF, Sundin Ö, Viitasara E, Melchiorre MG, Torres-Gonzales F, Stankunas M, Lindert J, Ioannidi-Kapolou E, Barros H. Alcohol use among abused and non-abused older persons aged 60–84 years: An European study. DRUGS-EDUCATION PREVENTION AND POLICY 2013. [DOI: 10.3109/09687637.2012.751087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dong X, Simon MA. Association between elder self-neglect and hospice utilization in a community population. Arch Gerontol Geriatr 2013; 56:192-8. [PMID: 22770866 PMCID: PMC3495081 DOI: 10.1016/j.archger.2012.06.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
Abstract
Elder self-neglect is associated with substantial 1-year mortality. However, hospice utilization among those with self-neglect remain unclear. The objective of this study is to quantify the prospective relation between self-neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8669 participants in the Chicago Health and Aging Project, a subset of 1438 participants was reported to social services agency for suspected elder self-neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of self-neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who self-neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10-2.81). Greater self-neglect severity (mild: (HR, 2.12 (1.61-2.79); moderate: (HR, 2.36 (1.95-2.84); severe: (HR, 4.66 (2.98-7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between self-neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, self-neglect was associated with shorter length of stay in hospice (PE, -0.27, SE, 0.12, p<0.02) and shorter time from hospice admission to death (PE, -0.32, SE, 0.13, p<0.01). Elder self-neglect was associated with increased risk of hospice use in this community population. Elder self-neglect is associated with shorter length of stay in hospice care and shorter time from hospice admission to death.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Medicine, Nursing, and Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, United States.
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Abstract
Elder abuse, sometimes called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse; neglect (caregiver neglect and self-neglect); and financial exploitation. Evidence suggests that one in 10 older adults experiences some form of elder abuse, but only one in 25 cases is reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy addressing the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow and Health and Aging Policy Fellow working with the Administration on Community Living (ACL) (previously known as the Administration on Aging) for the last 2 years, I will describe the major functions of the ACL and highlight two major pieces of federal legislation: The Older Americans Act and the Elder Justice Act. I will also highlight major research gaps and future policy relevant research directions for the field of elder abuse.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois 60612, USA.
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Abstract
Elder abuse, sometimes called elder mistreatment or elder maltreatment, includes psychological, physical, and sexual abuse; neglect (caregiver neglect and self-neglect); and financial exploitation. Evidence suggests that one in 10 older adults experiences some form of elder abuse, but only one in 25 cases is reported to social services agencies. At the same time, elder abuse is associated with significant morbidity and premature mortality. Despite these findings, there is a great paucity in research, practice, and policy addressing the pervasive issues of elder abuse. Through my experiences as a American Political Sciences Association Congressional Policy Fellow and Health and Aging Policy Fellow working with the Administration on Community Living (ACL) (previously known as the Administration on Aging) for the last 2 years, I will describe the major functions of the ACL and highlight two major pieces of federal legislation: The Older Americans Act and the Elder Justice Act. I will also highlight major research gaps and future policy relevant research directions for the field of elder abuse.
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Affiliation(s)
- XinQi Dong
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois 60612, USA.
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Dong X, Simon M, Evans D. Decline in physical function and risk of elder abuse reported to social services in a community-dwelling population of older adults. J Am Geriatr Soc 2012; 60:1922-8. [PMID: 23002901 DOI: 10.1111/j.1532-5415.2012.04147.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the longitudinal association between decline in physical function and risk of elder abuse. DESIGN Prospective population-based study. SETTING Geographically defined community in Chicago. PARTICIPANTS One hundred forty-three Chicago Health and Aging Project (CHAP) participants who had elder abuse reported to a social services agency from 1993 to 2010 were identified. PARTICIPANTS The primary independent variable was objectively assessed physical function using decline in physical performance testing (tandem stand, measured walk, and chair stand). Secondary independent variables were assessed using decline in self-reported Katz, Nagi, and Rosow-Breslau scale scores. Dependent variables were reported and confirmed elder abuse and specific subtypes of elder abuse (physical, psychological, caregiver neglect, and financial exploitation). Logistic regression models were used to assess the association between decline in physical function measures and risk of elder abuse. RESULTS After adjusting for potential confounders, decline in physical performance testing (odds ratio (OR) = 1.13, 95% confidence interval (CI) = 1.06-1.19), Katz impairment (OR = 1.29, 95% CI = 1.15-1.45), Nagi impairment (OR = 1.30, 95% CI = 1.13-1.49), and Rosow Breslau impairment (OR = 1.42, 95% CI = 1.15-1.74) was associated with greater risk for elder abuse. The lowest tertile of physical performance testing (OR = 4.92, 95% CI = 1.39-17.46) and the highest tertiles of Katz impairment (OR = 3.99, 95% CI = 2.18-7.31), Nagi impairment (2.37, 95% CI = 1.08-5.23), and Rosow Breslau impairment (OR = 2.85, 95% CI = 1.39-5.84) were associated with greater risk of elder abuse. CONCLUSION Decline in objectively assessed physical function and self-reported physical function are associated with greater risk for elder abuse.
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Affiliation(s)
- Xinqi Dong
- Rush University Medical Center, Chicago, IL 60612, USA.
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Dong X, Simon M, Evans D. A population-based study of physical function and risk for elder abuse reported to social service agency: findings from the Chicago health and aging project. J Appl Gerontol 2012; 33:808-30. [PMID: 25231755 DOI: 10.1177/0733464812459371] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We examined the association between physical function and the risk for reported elder abuse. In the Chicago Health and Aging Project (N = 8,932), 238 participants had reported elder abuse. The independent variable was objectively assessed physical function using both directly observed physical performance testing and self-reported physical function (Katz activity of daily living scale, Nagi physical activity scale, and Rosow Breslau mobility scales). Outcomes were elder abuse and specific subtypes of elder abuse. After adjusting for confounders, lower levels of physical performance testing (OR, 2.71[1.58-4.64]), Katz impairment (OR, 1.84[1.29-2.59]), Nagi impairment (OR, 1.65[1.15-2.37]) and Rosow Breslau (OR, 1.76[1.26-2.47]) were associated with increased risk for elder abuse. Lowest levels of physical performance testing were associated with increased risk for psychological abuse (OR, 2.69[1.27-5.71]), caregiver neglect (OR, 2.66[1.22-5.79]), and financial exploitation (OR, 2.35 [1.21-4.55]). Our results may have important implications to healthcare professional, social services and other disciplines to prevent and treat elder abuse.
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Affiliation(s)
- XinQi Dong
- Rush University Medical Center, Chicago, IL, USA
| | - Melissa Simon
- Northwestern University Medical Center, Chicago, IL, USA
| | - Denis Evans
- Rush University Medical Center, Chicago, IL, USA
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