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Iborra-Marmolejo I, Aded-Aniceto C, Moret-Tatay C, Bernabé-Valero G, Jorques-Infante MJ, Beneyto-Arrojo MJ. Unmasking Elder Abuse: Depression and Dependency in the Post-Pandemic Era. Healthcare (Basel) 2024; 12:1476. [PMID: 39120179 PMCID: PMC11311356 DOI: 10.3390/healthcare12151476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 08/10/2024] Open
Abstract
The aim of this study was to analyze elder abuse in people over 65 years of age and its relationship with some risk factors-depression symptoms, dependency, gender and age-in the Spanish population. METHODS A battery of questionnaires was administered to a sample of 167 participants electronically (M = 72.42; SD = 6.46), including the Abbreviated Yesavage Scale to assess depression, the Katz Index for Basic Activities of Daily Living to assess dependency, and the American Medical Association and the Canadian Task Force Questionnaire to assess suspicion of abuse. RESULTS A prevalence of 40.72% of suspected abuse, of 5.99% of established depression, and of 1.20% of severe dependence was obtained. The prevalence of abuse was higher in the population with dependency (75%) than without dependency (37%). In the case of depression, the prevalence of abuse was 70% for people with established depression and 35.4% for people without depression. CONCLUSION Women have higher rates of abuse than men, although this difference is not statistically significant. The same occurs with age. Nevertheless, having established depression and dependency are confirmed risk factors for suffering abuse.
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Affiliation(s)
- Isabel Iborra-Marmolejo
- Meb Lab, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la Ilustración 2, Burjassot, 46100 Valencia, Spain; (C.A.-A.); (C.M.-T.); (G.B.-V.); (M.J.B.-A.)
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Alonso-Moreno FJ, Llisterri Caro JL, Martínez Altarriba MC, Segura-Fragoso A, Martín-Sánchez V, Miravet Jiménez S, Velilla Zancada S, Martínez García FV, Micó Pérez RM, Cinza Sanjurjo S, Sánchez Sánchez B. Prevalence of suspected abuse of non-institutionalized older people treated in primary care. PRESENCIA study. Semergen 2024; 50:102263. [PMID: 38838584 DOI: 10.1016/j.semerg.2024.102263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES To determine the prevalence of suspected abuse of non-institutionalised elderly people and the associated variables. PATIENTS AND METHOD Observational, descriptive, cross-sectional, multicentre study in patients aged 65 years or older, non-institutionalised, consecutively selected in primary care (PC). The EASI questionnaires (Suspected Elderly Abuse Index), the EAI questionnaire (Suspected Abuse Index in patients with cognitive impairment), the Barthel index, and the EUROQOL-5D questionnaire were used with patients, and the CASE questionnaire and the Zarit test were used with caregivers. Socio-demographic, health, and quality of life variables were analysed in all patients. RESULTS Eight hundred four patients were included, mean age 78.9±7.9 years, 58.3% women. The prevalence of suspected abuse was 11.3% (95% CI: 9.1%-13.9%). Suspected abuse was more frequent in women than in men (14.4% vs. 7.1%; odds ratio (OR)=1.97; 95% CI=1.1-3.4; p=0.016) and in those who lived with two or more people compared to those who lived alone (18.4% vs. 7.3%; OR=2.42; 95% CI=1.1-5.0; p=0.017). Among older patients, the lower their dependency, the lower the prevalence of suspected abuse (30.0% in highly dependent vs. 8.7% in non-dependent: p-trend=0.006); and the better the perceived health status, the lower the prevalence of suspected abuse (29.6% in poor health status vs. 6.9% in optimal health status; p-trend=<0.001). Among caregivers, the prevalence of suspected abuse was 20.4% (95% CI=12.8%-28.0%). A trend of higher prevalence of suspected abuse could be observed with higher scores on the CASE questionnaire (56.3% at high risk and 9.6% with no risk of abuse; p-trend=0.007). In the case of the ZARIT questionnaire with scores below 47, the prevalence of suspected abuse was 9.1%, and for scores above 55, it was 52.6% (p-trend<0.001). CONCLUSIONS The results of the PRESENCIA study show that approximately 1 in 10 patients aged ≥65 meet the criteria for suspected abuse. The probability of abuse increases in women, in patients with greater dependency and in patients with poorer perceived health status. Caregivers with greater overload and greater risk presented a greater suspicion of elder abuse.
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Affiliation(s)
| | | | | | - A Segura-Fragoso
- Universidad de Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - V Martín-Sánchez
- Institute of Biomedicine, University of Leon, Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Spain
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Lázaro Del Nogal M, Fernández Alonso C. [Elder abuse: a challenge for all health professionals]. Semergen 2024; 50:102262. [PMID: 38824785 DOI: 10.1016/j.semerg.2024.102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024]
Affiliation(s)
- M Lázaro Del Nogal
- Servicio de Geriatría, Hospital Clínico San Carlos, Madrid, España; Comisión contra la Violencia, Hospital Clínico San Carlos, Madrid, España
| | - C Fernández Alonso
- Comisión contra la Violencia, Hospital Clínico San Carlos, Madrid, España; Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España.
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Alcañiz-Garrán M, García-Sanjuán S, Ramos-Pichardo JD, Sanjuán-Quiles A, Montejano-Lozoya R. The experiences of older individuals providing care to older dependents: A phenomenological study in Spain. PLoS One 2021; 16:e0255600. [PMID: 34351991 PMCID: PMC8341577 DOI: 10.1371/journal.pone.0255600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Non-professional care provided in domestic settings by a family member or someone from the close environment and without a connection to a professional care service, is increasingly assumed by older people, mainly the spouses of those requiring care. The aim of this study was to describe the experience of older people providing care at home to older dependents. METHODS A qualitative study was carried out to describe and explore the experience of older people, caregivers of dependent older people in the home. RESULTS Four themes emerged as a result of the analysis: interpersonal relationships established in the caregivers' immediate environment; the need and request for public and private resources; consequences of providing care during old age; and adaptation to the circumstance of being a caregiver during old age. Older people who provide home-based care, experience their situation as stressful, feel that it limits their daily life, deprives them of their freedom, and affects their interpersonal relationships and social activities. DISCUSSION Older caregivers learn quickly and can manage the skills issues. The volume of work is their challenge. Interpersonal relationships are altered depending on the length of time spent together and the demand for care. Public services and benefits are not adapted to the demands of caregivers or dependent persons.
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Affiliation(s)
| | - S. García-Sanjuán
- Health Sciences Faculty, Nursing Department, University of Alicante, Alicante, Spain
| | | | - A. Sanjuán-Quiles
- Health Sciences Faculty, Nursing Department, University of Alicante, Alicante, Spain
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Carmona-Torres JM, Carvalhal R, Gálvez-Rioja RM, Ruiz-Gandara Á, Goergen T, Rodríguez-Borrego MA. Elder Abuse in the Iberian Peninsula and Bolivia: A Multicountry Comparative Study. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:4303-4326. [PMID: 29294793 DOI: 10.1177/0886260517713712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The objective of this study is to determine the prevalence of abuse of vulnerable older persons in the family and community environment in the following regions-Spain (Andalusia-Córdoba), Portugal (Azores), and Bolivia (Santa Cruz de la Sierra)-and to identify risk factors and delineate a profile of abused older persons. For this, a descriptive cross-sectional study was conducted. The sample consisted of people in the age group 65 years plus living in the catchment areas of health centers. The following were used as instruments to collect data: the medical record of the patients of relevant health centers, Mini-Mental State Examination (MMSE), daily activities autonomy test, adaptability, partnership, growth, affection, and resolve (APGAR) familiar test, The Elder Abuse Suspicion Index (EASI) and the Social Work Evaluation Form. Multivariable logistic regression was performed to identify factors associated with abuse. Suspected abuse was identified in 6.9% of the elderly who participated in the study in Spain, 39% in Bolivia, and 24.5% in Azores. In all areas, studied psychological abuse was the most common type of abuse. In conclusion, although the prevalence of abuse to older people in the family and community environment differs in the areas studied, it is present in all countries and the data are comparable with other developing and European countries. The profile of the abused older persons appears to be similar in all countries.
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Affiliation(s)
- Juan Manuel Carmona-Torres
- Maimónides Institute for Biomedical Research of Córdoba, Spain
- University of Castilla-La Mancha, Ciudad Real, Spain
| | | | | | | | | | - Mª Aurora Rodríguez-Borrego
- Maimónides Institute for Biomedical Research of Córdoba, Spain
- University of Córdoba, Spain
- University Hospital Reina Sofía, Córdoba, Spain
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Yon Y, Mikton C, Gassoumis ZD, Wilber KH. The Prevalence of Self-Reported Elder Abuse Among Older Women in Community Settings: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2019; 20:245-259. [PMID: 29333977 DOI: 10.1177/1524838017697308] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The abuse of older women appears to be a significant problem. Developing a better understanding of the extent of the problem is an important step toward preventing it. We conducted a global systematic review and meta-analysis of existing prevalence studies, in multiple languages, that occurred in the community settings from inception to June 26, 2015, in order to determine the extent of abuse against women aged 60 years and over. To disentangle the wide variations in prevalence estimates, we also investigated the associations between prevalence estimates and studies' demographic and methodological characteristics. A total of 50 studies were included in the meta-analysis. The combined prevalence for overall elder abuse in the past year was 14.1% (95% confidence interval (CI) [11.0, 18.0]). Pooled prevalence for psychological abuse was 11.8% (95% CI [9.2%, 14.9%]), neglect was 4.1% (95% CI [2.7%, 6.3%]), financial abuse was 3.8% (95% CI [2.5%, 5.5%]), sexual abuse was 2.2% (95% CI [1.6%, 3.0%]), and physical abuse was 1.9% (95% CI [1.2%, 3.1%]). The studies included in the meta-analysis for overall abuse were heterogeneous indicating that significant differences among the prevalence estimates exist. Significant associations were found between prevalence estimates and the following covariates: World Health Organization-defined regions, countries' income classification, and sample size. Together, these covariates explained 37% of the variance. Although robust prevalence studies are sparse in low- and middle-income countries, about 1 in 6, or 68 million older women experience abuse worldwide. More work is needed to understand the variation in prevalence rates and implications for prevention.
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Affiliation(s)
- Yongjie Yon
- 1 Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Christopher Mikton
- 2 Department of Social Sciences, University of the West of England, Bristol, United Kingdom
| | - Zachary D Gassoumis
- 1 Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Kathleen H Wilber
- 1 Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Aranda Rubio Y, Fernández Rodríguez AM, Aranda Rubio L, Socorro García A. [Gender violence: when the aggressor is a patient with dementia. About clinical case]. Rev Esp Geriatr Gerontol 2018; 53:365-366. [PMID: 30249363 DOI: 10.1016/j.regg.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 05/09/2018] [Accepted: 05/25/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Yanira Aranda Rubio
- Departamento Geriatría, Hospital Central de la Cruz Roja, San José y Santa Adela, Madrid, España.
| | | | - Laura Aranda Rubio
- Departamento Geriatría, Hospital Central de la Cruz Roja, San José y Santa Adela, Madrid, España
| | - Alberto Socorro García
- Departamento Geriatría, Hospital Central de la Cruz Roja, San José y Santa Adela, Madrid, España
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Orfila F, Coma-Solé M, Cabanas M, Cegri-Lombardo F, Moleras-Serra A, Pujol-Ribera E. Family caregiver mistreatment of the elderly: prevalence of risk and associated factors. BMC Public Health 2018; 18:167. [PMID: 29357866 PMCID: PMC5778739 DOI: 10.1186/s12889-018-5067-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 01/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The detection of elder mistreatment is emerging as a public health priority; however, abusive behaviors exercised by caregivers are little known and rarely detected among primary health care professionals. This study aims to estimate the prevalence of risk of abuse against community-residing elderly with moderate to severe dependency whose caregivers are relatives. In addition, we aim to describe the association between such a risk and socio-demographic variables, cognitive and dependency state of the victim, and the scale of the caregiver's anxiety, depression, and burden. METHODS Cross-sectional study developed in 72 Primary Health Care teams from Barcelona, Spain. Participants were caregivers and their dependent care recipients (N = 829). Home interviews included the Caregiver Abuse Screen (CASE); self-reported abuse from care recipient; activities of daily living and cognitive state of the care recipient; anxiety and depression in caregivers and Caregiver Burden Scale. The relationship prior to the dependency, positive aspects of caregiving, and social support for the caregiver were also assessed. Multivariate analysis was performed using logistic regression with risk of abuse as dependent variable. RESULTS Caregivers were mainly women (82.8%) with a mean age of 63.3 years. Caregivers and care recipients lived in the same household in 87.4% of cases, and 86.6% had enjoyed a good previous relationship. Care recipients were women (65.6%), with a mean age of 84.2 years, and 64.2% had moderate to severe cognitive impairment. CASE demonstrated a prevalence of 33.4% (95% CI: 30.3-36.7) of abuse risk by the caregiver. Logistic regression showed as statistically significant: caregiver burden (OR = 2.75; 95% CI: 1.74-4.33), caregiver anxiety (OR = 2.06; 95% CI: 1.40-3.02), caregiver perception of aggressive behavior in the care recipient (OR = 7.24; 95% CI: 4.99-10.51), and a bad previous relationship (OR = 4.66; 95% CI: 1.25-17.4). CONCLUSIONS Prevalence of risk of abuse is high among family caregivers. Our study has found risk factors in family caregivers that are preventable to an extent, namely: anxiety and feelings of burden. It is essential to become aware of these risk factors and their causes to intervene and help primary as well secondary prevention.
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Affiliation(s)
- Francesc Orfila
- Institut Universitari d'Investigació en Atenció Primaria Jordi Gol (IDIAP Jordi Gol), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain. .,Gerència Territorial Barcelona Ciutat. Institut Catala de la Salut, Balmes 22, 08007, Barcelona, Spain.
| | - Montserrat Coma-Solé
- Centre d'Atenció Primària Les Planes. Gerència Territorial Metropolitana Sud. Institut Catala de la Salut, 08970, Sant Joan Despí, Spain
| | - Marta Cabanas
- Consorci Sanitari de Barcelona, Esteve Terradas, 30, 08023, Barcelona, Spain
| | - Francisco Cegri-Lombardo
- Centre d'Atenció Primària Sant Martí. Gerència Territorial Barcelona Ciutat. Institut Catala de la Salut, Fluvià, 211, 08020, Barcelona, Spain
| | - Anna Moleras-Serra
- Institut Universitari d'Investigació en Atenció Primaria Jordi Gol (IDIAP Jordi Gol), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain
| | - Enriqueta Pujol-Ribera
- Institut Universitari d'Investigació en Atenció Primaria Jordi Gol (IDIAP Jordi Gol), Gran Via de les Corts Catalanes, 587, 08007, Barcelona, Spain.,Gerència Territorial Barcelona Ciutat. Institut Catala de la Salut, Balmes 22, 08007, Barcelona, Spain.,Universitat Autònoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain
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Carmona-Torres JM, Carvalhal-Silva RM, Viera-Mendes MH, Recio-Andrade B, Goergen T, Rodríguez-Borrego MA. Elder abuse within the family environment in the Azores Islands. Rev Lat Am Enfermagem 2017. [PMCID: PMC5614239 DOI: 10.1590/1518-8345.1871.2932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: to dimension abuse against vulnerable adults within the family and community
environment in the Azores Islands, identify risk factors for abuse and describe
the profile of an abused elder. Method: descriptive cross-sectional study. Random sampling. The instruments used were:
clinical histories of the users, Mini-Mental State Examination, Index of
Independence in Basic Activities of Daily Living, Family APGAR Scale, Elder Abuse
Suspicion Index and Social Work Assessment Form. Descriptive statistical analysis
was used for qualitative and quantitative variables and multiple logistic
regression was used to identify factors associated with elder mistreatment. Results: abuse suspicion was identified in 24.5% of elderly participants. Psychological
abuse was the most common type of abuse and sons were the main abusers. Conclusion: being a woman and belonging to a dysfunctional family is associated with an
increased risk of becoming a victim of abuse; the high level of domestic violence
against the elderly in the Azores Islands is in line with the rest of
Portugal.
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Yon Y, Mikton CR, Gassoumis ZD, Wilber KH. Elder abuse prevalence in community settings: a systematic review and meta-analysis. LANCET GLOBAL HEALTH 2017; 5:e147-e156. [DOI: 10.1016/s2214-109x(17)30006-2] [Citation(s) in RCA: 370] [Impact Index Per Article: 52.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 10/25/2016] [Accepted: 11/16/2016] [Indexed: 01/12/2023]
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Gómez Martínez C, Hernández Morante JJ, Carrasco Martínez E, García Belzunce A, Nicolás Alarcón V. [Factors associated with non-institutional abuse in nursing homes]. Rev Esp Geriatr Gerontol 2016; 51:317-322. [PMID: 27130151 DOI: 10.1016/j.regg.2016.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 12/22/2015] [Accepted: 01/18/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Abuse in elderly has dimensions not yet sufficiently explored. Particularly, little is known about the abuse or mistreatment suffered by old people in nursing homes, but where the origin is not, at least initially, institutional, since is perpetrated by external social agents not related to the nursing home. The lack of data in this area has led us to conduct this exploratory study, with the aim of assessing the prevalence of this non-institutional abuse. MATERIAL AND METHODS The Elder Abuse Suspicion Index was administered to a total of 286 subjects belonging to the nursing homes from the «Mensajeros de la Paz» Association of Murcia. Cases of suspected abuse were referred to the social workers to confirm the diagnosis. RESULTS Initially, 53 subjects (18.5%) suffered any kind of abuse, which was reduced to only 26 cases after one year. On the other hand, abuse appeared after admission in 20 subjects (7%). Precisely, this 7% might present what we called non-institutional abuse. Economic abuse was the most prevalent, followed by psychological, neglect, physical, and sexual abuse. The data showed a significant interaction between the different types of abuse. CONCLUSIONS Our data provides evidence of a new scenario that must be addressed in a professional and social context, considering the environment where this mistreatment takes place. Health and social professionals must be sensitive to this reality, and should be informed and trained about the different ways to dignify the care of the elderly.
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Affiliation(s)
- Carmelo Gómez Martínez
- Asociación Mensajeros de la Paz, Murcia, España; Facultad de Enfermería, Universidad Católica de Murcia, Murcia, España.
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