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Patterson T, Hobbs L, Brown E, Barak Y. Sexual Assault in Older-Age Adults: Criminal Justice Response in New Zealand. J Aging Soc Policy 2023:1-16. [PMID: 38007620 DOI: 10.1080/08959420.2023.2284575] [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: 11/29/2022] [Accepted: 06/19/2023] [Indexed: 11/27/2023]
Abstract
There is growing recognition that older persons, both male and female, may experience sexual assault. One clearly identified gap in the body of scientific literature is examination of the criminal justice response for older adults who have been sexually assaulted. This retrospective age-group comparative data analysis examines publicly available population and police statistics for 2018 to describe rates (per 100,000) of reported sexual assault across adult age categories (young adult, n = 748; adult, n = 1,478; middle age, n = 290; older adult, n = 58) and compare (using Chi-square bivariate analysis) the criminal justice response to sexual assault for these adult age categories in New Zealand (NZ). Sexual assault was perpetrated against victims across all age and sex groups examined. The rate of reported sexual assault against older adults was significantly lower after the age of 65 years (7.90 per 100,000) compared to younger adults aged 20-64 years (87.57 per 100,000). Across age categories no difference was found in the proportion of cases proceeded to court action. This study raises awareness of the topic of sexual assault perpetrated against older persons and shows that a substantial number of older adults experience sexual assault in cases that do not result in court action. It points to the need for policy-makers to consider the reporting of sexual assaults against older persons to justice services.
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Affiliation(s)
- Tess Patterson
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
- Optentia Research Focus Area, North-West University, Potchefstroom, South Africa
| | - Linda Hobbs
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Elliott Brown
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Yoram Barak
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
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2
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Band-Winterstein T, Goldblatt H, Lev S, Harel D. Forms of sexual assault against older women in the context of acquaintance relationships: An intersectional perspective. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2330-e2339. [PMID: 34850479 DOI: 10.1111/hsc.13672] [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: 03/21/2021] [Revised: 11/14/2021] [Accepted: 11/22/2021] [Indexed: 06/13/2023]
Abstract
This study addresses forms of sexual assault against women in late life (SAWLL) from an intersectional perspective, focusing on acquaintance relationships. Qualitative research was conducted, using in-depth interviews with 18 welfare and healthcare professionals who treated sexual assault survivors. Five forms (themes) emerged, relevant to the identification of SAWLL: (1) Coercive sexual assault in the context of changes brought on by old age, (2) contempt and sexual humiliation based on ageist and sexist social constructions, (3) violation of the older women's dignity in the multigenerational context, (4) life-long incestuous relationships and sexual assault against older women and (5) erotic touching and exhibitionism in caregiving relationships. The revealed forms emphasise the vulnerability of older women who are sexually assaulted in domestic relationships by perpetrators whom they know. These forms can contribute to filling the existing gap in knowledge on SAWLL and promote the visibility of sexually assaulted older women in the justice system. In addition, they can aid law enforcement, health and welfare professionals and policymakers to advance the general understanding of SAWLL as well as improve the response to this phenomenon.
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Affiliation(s)
- Tova Band-Winterstein
- Department of Gerontology, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Hadass Goldblatt
- Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | - Sagit Lev
- School of Social Work, Bar-Ilan University, Ramat-Gan, Israel
| | - Dovrat Harel
- The Drama Therapy Graduate Program, Tel Hai Academic College, Kiryat Shmona, Israel
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3
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Band-Winterstein T, Avieli H. The Lived Experience of Older Women Who Are Sexually Abused in the Context of Lifelong IPV. Violence Against Women 2021; 28:443-464. [PMID: 33818218 DOI: 10.1177/10778012211000132] [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: 11/17/2022]
Abstract
The present study explores the lived experience of older women who are sexually abused in the context of lifelong intimate partner violence (IPV). An interpretive phenomenological analysis was used, and semi-structured interviews were performed with 19 older women survivors of lifelong IPV and sexual violence. Three themes emerged: sexual violence shaping lifelong IPV, the occurrence of sexual violence in old age in the context of lifelong IPV, and cumulative insights and reflections on being a survivor of lifelong IPV and sexual violence. The transition to aging has a profound impact on the violent relationship dynamics and this should be considered in practical interventions.
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4
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Band-Winterstein T, Goldblatt H, Lev S. Breaking the Taboo: Sexual Assault in Late Life as a Multifaceted Phenomenon-Toward an Integrative Theoretical Framework. TRAUMA, VIOLENCE & ABUSE 2021; 22:112-124. [PMID: 30813855 DOI: 10.1177/1524838019832979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sexual assault (SA) in late life has been receiving growing attention over the past two decades. It is directed primarily against older women and has been the least frequently reported form of abuse. Despite the growing awareness and body of knowledge on this phenomenon, the theoretical framework is still limited. Therefore, the aim of the present article is to suggest a theoretical conceptualization of the multifaceted phenomenon of sexual assault against women in late life (SAWLL). This conceptualization has been developed through several stages: (a) identification of three grounded fields of inquiry that are relevant to SAWLL: SA, elder mistreatment, and intimate partner violence; (b) classification of SAWLL along four paths: (1) ongoing SA in the context of lifelong IPV; (2) SA beginning in old age in the family within the community, involving spouses, family members, caregivers, dating mates, and so on; (3) ongoing SA, continuing in institutions, perpetrated by family members; and (4) SA in institutions, beginning in old age, relating to staff, residents, and family members; (c) We suggest three additional theoretical perspectives: trauma, a life-course perspective, and social constructionism, which provide further in-depth knowledge for understanding SAWLL. The combination of the three abovementioned stages composes an integrative theoretical framework, addressing SAWLL as a multifaceted phenomenon.
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Affiliation(s)
- Tova Band-Winterstein
- Department of Gerontology, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Hadass Goldblatt
- Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Sagit Lev
- School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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5
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Subjective cognitive decline and elder mistreatment in Mexican community-dwelling older adults. Arch Gerontol Geriatr 2020; 92:104242. [PMID: 33010789 DOI: 10.1016/j.archger.2020.104242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 07/28/2020] [Accepted: 08/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Elder mistreatment in individuals with subjective cognitive decline is an understudied public health problem that violates human rights. DESIGN AND METHODS Cross-sectional study of 386 Mexican community-dwelling older adults. Individuals with episodic memory, executive function, language, visuospatial skills or attention cognitive complaints without low cognitive performance scores in the Mini-Mental State Examination and the Isaacs Set Test that were considered positive for subjective cognitive decline (SCD). Elder mistreatment (EM) was considered positive if any of the questions on the Geriatric Mistreatment Scale were answered affirmatively. Logistic regression models were created to test the association between SCD and EM. RESULTS After adjustments made by age, sex, education and depressive symptoms a positive association was found between SCD and EM (OR = 2.226; 95%CI = 1.296 to 3.822 ; p = 0.004). This association was observed in all subtypes of cognitive complaints except excecutive function: episodic memory (OR = 2.219 ; 95%CI = 1.321 to 3.728 ; p = 0.003), language (OR = 2.500 ; 95% CI = 1.422 to 4.396 ; p = 0.001), visuospatial (OR = 2.158 ; 95%CI = 1.162 to 4.007 ; p = 0.015), attention (OR = 2.197 ; 95%CI = 1.206 to 4.001 ; p = 0.010) and executive (OR = 1 2.062 ; 95%CI = 0.981 to 4.333 ; p = 0.056). Discussion and Implications: This study brings to light the relation between SCD and EM in a population where it has been understudied. Exploring mistreatment in older adults who experience subjective cognitive decline might help preserve their safety and create future prevention and intervention strategies.
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Chopin J, Beauregard E. Elderly Sexual Abuse: An Examination of the Criminal Event. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2020; 32:706-726. [PMID: 31010404 DOI: 10.1177/1079063219843899] [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: 06/09/2023]
Abstract
The current study investigates the modus operandi specificities for the sexual abuse against the elderly. A comparison between sex crimes against adult and elderly victims is conducted following the criminal event approach. The comparison is based on the precrime, crime, and postcrime phases of the modus operandi, operationalized through 53 variables. The sample comes from a French national police database including a total of 1,829 cases-including 130 cases of elderly sexual abuse and 1,699 cases of sexual abuse against victims aged between 18 and 45 years. Bivariate and multivariate analyses are performed to examine the differences in the two groups. Several differences are observed between the two modus operandi. Findings indicate that the precrime phase is the most important to explain these differences, and this phase of the criminal event affects the rest of the decisions taken during the crime and postcrime phases. Specifically, we have highlighted that sexual crimes against the elderly are more violent and occur more often in the victim's residence. This study suggests that offenders targeting the elderly use specific crime characteristics, and this allows to highlight practical implications in terms of investigation and offender management.
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Affiliation(s)
- Julien Chopin
- Simon Fraser University, Burnaby, British Columbia, Canada
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Krienert JL, Walsh JA. The Sexual Victimization of the Elderly: An Empirical Analysis of Officially Reported Incidents, 2007-2016. VIOLENCE AND VICTIMS 2020; 35:443-466. [PMID: 32788332 DOI: 10.1891/vv-d-19-00140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As "baby boomers" age through the lifecourse, elderly American's are projected to comprise more than 20% of the U.S. population by 2030 (Ortman, Velkoff, & Hogan, 2014). With a dramatic population increase anticipated, elder abuse and maltreatment has emerged as a focus of violence research. Elder sexual abuse is perhaps the least perceived, acknowledged, detected, and reported type of victimization (Roberto, Teaster, & Nikzad, 2007). The present work explores elder sexual abuse, drawing on 10 years (2007-2016) of officially reported incidents from National Incident Reporting System (NIBRS) data, to address several of the limitations identified by the National Research Council (2003) including: inconsistent definitions, unclear and inadequate measures, and a lack of population-based data. Results support significant differences in elder sexual abuse profiles across victim and perpetrator sex, age, race, relationship, residence, and offense type, highlighting the need to examine contextual differences in offenders, victims, and incident-based characteristics. Intervention, policy needs, and prevention are discussed.
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Affiliation(s)
- Jessie L Krienert
- Department of Criminal Justice, Illinois State University, Normal, Illinois
| | - Jeffrey A Walsh
- Department of Criminal Justice, Illinois State University, Normal, Illinois
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8
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Nobels A, Vandeviver C, Beaulieu M, Cismaru Inescu A, Nisen L, Van Den Noortgate N, Vander Beken T, Lemmens G, Keygnaert I. "Too Grey To Be True?" Sexual Violence in Older Adults: A Critical Interpretive Synthesis of Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114117. [PMID: 32526986 PMCID: PMC7312038 DOI: 10.3390/ijerph17114117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 01/18/2023]
Abstract
Sexual violence (SV) is an important public health issue with a major impact on victims and their peers, offspring and community. However, SV in older adults is under-researched. This paper aims to establish the prevalence and nature of SV in older adults in Europe, link this with existing policies and health care workers’ response to sexual health needs in older age, and critically revise the currently used frameworks in public health research. To fill this gap in the literature, we applied a Critical Interpretative Synthesis (CIS) approach. The CIS approach uses techniques from grounded theory and processes from systematic review. It allows to critically interpret key findings from both academic as well as grey literature, engendering theory refining. In the first phase of purposive sampling, we conducted a systematic review of academic sources and included 14 references. The cut-off age used to define old age varied between 60 and 70 years old among the included studies. Subsequently we added another 14 references in the second phase of theoretical sampling. We ultimately included 16 peer-reviewed articles and 12 documents from the grey literature. The CIS results demonstrate that knowledge of SV in older adults is still limited. The current research suggests that SV in older adults rarely occurs, however, prevalence rates are likely to be underestimated because of methodological shortcomings. The complexity of SV in older adults is not acknowledged in ongoing research due to the conflation of SV with other types of violence. Information on specific risk factors and about assailants committing SV in old age is absent. Policy documents dealing with sexual and reproductive health, rights and ageing make no mention of SV in older adults. In clinical practice, the sexual health needs of older adults often remain unmet. In conclusion, our findings suggest that older adults are forgotten in prevention and response to SV. Greater awareness about this topic could contribute to a revision of current policies and health care practices, leading to more tailored care for older victims of SV.
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Affiliation(s)
- Anne Nobels
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health (ICRH), Ghent University, C. Heymanslaan 10, ICRH, 9000 Ghent, Belgium;
- Correspondence: ; Tel.: +32-9-332-35-64
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, 9000 Ghent, Belgium; (C.V.); (T.V.B.)
- Research Foundation-Flanders (FWO), 1000 Brussels, Belgium
| | - Marie Beaulieu
- School of Social Work and Research Centre on Aging, University of Sherbooke, Sherbrooke, QC J1H 5N4, Canada;
| | - Adina Cismaru Inescu
- ESPRIst, Études et évaluations, University of Liège, 4000 Liège, Belgium; (A.C.I.); (L.N.)
| | - Laurent Nisen
- ESPRIst, Études et évaluations, University of Liège, 4000 Liège, Belgium; (A.C.I.); (L.N.)
| | - Nele Van Den Noortgate
- Department of Geriatrics, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium;
| | - Tom Vander Beken
- Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, 9000 Ghent, Belgium; (C.V.); (T.V.B.)
| | - Gilbert Lemmens
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium;
| | - Ines Keygnaert
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, International Centre for Reproductive Health (ICRH), Ghent University, C. Heymanslaan 10, ICRH, 9000 Ghent, Belgium;
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9
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Lee JA, Majeed-Ariss R, Pedersen A, Yusuf F, White C. Sexually assaulted older women attending a U.K. sexual assault referral centre for a forensic medical examination. J Forensic Leg Med 2019; 68:101859. [PMID: 31476524 DOI: 10.1016/j.jflm.2019.101859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/14/2019] [Accepted: 08/16/2019] [Indexed: 11/29/2022]
Abstract
There is a paucity of literature on sexual violence against older adults, particularly in the U.K. This work aims to identify and describe the characteristics of alleged sexual assault and subsequent forensic medical examination (FME) for older clients presenting to a large sexual assault referral centre (SARC) in Manchester over a ten-year period. A retrospective analysis of forensic case notes was conducted for all clients (n = 39) who had attended for an FME between 2007 and 2017, and who were aged 70 or over at the time of the alleged assault. The average age of clients was 83 years, all were white, and 95% were female. Two populations were identified: a less frail population who had been assaulted at home by an alleged stranger with greater physical violence alleged, and a frailer population, with a greater incidence of dementia (77%), who were alleged to have been assaulted by a care-giver or fellow resident in a place of care. We note the need for flexibility in the site of FME, the underrepresentation of minority populations in SARC attendees, and difficulties with description of events by clients. We identify several patterns of non-age related anogenital and body examination findings, and offer recommendations for sexual assault services on how they may better cater to older populations.
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Affiliation(s)
- Jessica A Lee
- School of Medical Sciences, University of Manchester, UK
| | - Rabiya Majeed-Ariss
- School of Healthcare, University of Leeds, UK; Manchester University Hospitals NHS Foundation Trust, UK
| | | | - Farah Yusuf
- Manchester University Hospitals NHS Foundation Trust, UK
| | - C White
- Manchester University Hospitals NHS Foundation Trust, UK.
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10
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Abner EL, Teaster PB, Mendiondo MS, Ramsey-Klawsnik H, Marcum JL, Crawford TN, Wangmo T. Victim, Allegation, and Investigation Characteristics Associated With Substantiated Reports of Sexual Abuse of Adults in Residential Care Settings. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:3995-4019. [PMID: 27754922 DOI: 10.1177/0886260516672051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this study was to identify characteristics of investigations of sexual abuse concerning vulnerable adults residing in facility settings that were associated with case substantiation. Data on 410 reports of sexual abuse were collected prospectively from Adult Protective Services (APS) and state licensure agency staff in New Hampshire, Oregon, Tennessee, Texas, and Wisconsin over a six-month period. Specifically, we examined differences between reports that were substantiated and those that were not by comparing characteristics of alleged victims, alleged perpetrators, and aspects of investigation using logistic regression. We found that a relatively low proportion of cases (18%) were substantiated overall. Compared to cases that were not substantiated, cases that were substantiated were more likely to feature nursing home residents, older victims, female victims, and allegations of physical contact between the alleged perpetrator and victim. Despite the high proportion of alleged perpetrators who were facility staff (51%) compared to resident perpetrators (25%), cases with resident-to-resident allegations of abuse were much more likely to be substantiated, accounting for 63% of substantiated cases. In light of these findings, we believe it is important that investigators are trained to handle sexual abuse cases appropriately and that they are able to investigate the case thoroughly, promptly, and with as much information as possible. It is also critical that investigators make substantiation decisions using the appropriate standard for confirmation (e.g., preponderance of the evidence, beyond a reasonable doubt, clear and convincing evidence) as state law dictates.
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11
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Bows H. Sexual Violence Against Older People: A Review of the Empirical Literature. TRAUMA, VIOLENCE & ABUSE 2018; 19:567-583. [PMID: 29333969 DOI: 10.1177/1524838016683455] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Aging and sexual violence are both established areas of research, but little attention has been paid to research into sexual violence against older people. This article presents a critical review of the literature reporting empirical research in three overlapping fields of inquiry: elder abuse, domestic violence, and sexual violence, identifying points of theoretical and methodological similarity and difference across academic disciplines. Using a range of search terms combining age, sexual violence, and elder abuse, the following databases were searched: EBSCOHOST, Ingenta-Ingenta connect, and JSTOR. In total, the databases searches returned 31 relevant articles and an additional 9 relevant articles were found through manual searches of bibliographies and Google searches, which were grouped into three categories: elder abuse, domestic violence in later life, and sexual violence against older people. Four themes common across these fields emerged: prevalence, characteristics of victims and risk factors, impacts and coping strategies, and perpetrator and assault characteristics. The findings in each area are discussed in detail, exposing gaps in knowledge and understandings of sexual violence against older women. The article ends by defining a future research agenda for this underexplored phenomenon that is of increasing importance in a context of global aging.
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Affiliation(s)
- Hannah Bows
- 1 Centre for Research into Violence and Abuse, School of Applied Social Sciences, Durham University, Durham, United Kingdom
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12
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Smith D, Cunningham N, Willoughby M, Young C, Odell M, Ibrahim J, Bugeja L. The epidemiology of sexual assault of older female nursing home residents, in Victoria Australia, between 2000 and 2015. Leg Med (Tokyo) 2018; 36:89-95. [PMID: 30469073 DOI: 10.1016/j.legalmed.2018.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/07/2018] [Accepted: 11/10/2018] [Indexed: 11/25/2022]
Abstract
Sexual assault is the least acknowledged, detected, and reported type of assault against nursing home residents. Nursing home staff are responsible for reporting suspected allegations to the police, who will contact a clinical forensic examiner to conduct a forensic medical examination. This study examined the epidemiology of sexual assaults of older women (aged 65 years and older) residing in nursing homes in Victoria, Australia, between 2000 and 2015, whose alleged incidents were referred to a clinical forensic examiner for a forensic medical examination. A retrospective analysis of alleged sexual assaults reported to the Clinical Forensic Medicine Unit at the Victorian Institute of Forensic Medicine between 1 January 2000 and 31 December 2015 was conducted. The study identified 28 forensic medical examinations performed for alleged sexual assault. The alleged victims frequently had cognitive impairments; injuries were infrequent; and alleged victims were cooperative. The forensic medical examiner responded within 72 h of reporting; and frequently noted limitations to physical examinations of the alleged victim. The actual number of sexual assaults during this period may be masked by under-reporting and, lack of identification by nursing home staff. There are many unresolved issues including: incidence, levels of reporting, nature of investigations, responses required to assist the victim, and the interventions needed to prevent sexual assault. Better data is vital. This data should be standardized, validated, reliable, and gathered prospectively across Australia and internationally.
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Affiliation(s)
- Daisy Smith
- Department of Forensic Medicine, Monash University, Southbank, Victoria 3006, Australia.
| | - Nicola Cunningham
- Victorian Institute of Forensic Medicine, Clinical Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Melissa Willoughby
- Department of Forensic Medicine, Monash University, Southbank, Victoria 3006, Australia
| | - Carmel Young
- Department of Forensic Medicine, Monash University, Southbank, Victoria 3006, Australia
| | - Morris Odell
- Victorian Institute of Forensic Medicine, Clinical Forensic Medicine, Southbank, Victoria 3006, Australia
| | - Joseph Ibrahim
- Department of Forensic Medicine, Monash University, Southbank, Victoria 3006, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria 3006, Australia
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13
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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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14
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Fang B, Yan E. Abuse of Older Persons With Dementia: A Review of the Literature. TRAUMA, VIOLENCE & ABUSE 2018; 19:127-147. [PMID: 27247138 DOI: 10.1177/1524838016650185] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In view of the rapidly aging population, increasing attention has been paid to studying persons with dementia. Factors associated with its onset, prognosis, and treatment as well as ways to support caregivers in the community have been extensively studied. Despite the fact that older persons with dementia are at higher risk of abuse compared to their cognitively unimpaired counterparts in institutions and the community, however, relatively little attention has been paid to understanding such abuse. This review summarizes the available literature on abuse of older persons with dementia. It compares methodologies used across studies and highlights the implications of using different informants, sampling strategies, and abuse subtypes in studying abuse of persons with dementia and discussed the relevant cultural considerations for research. The results of this review provide important information for researchers, policy makers, and practitioners.
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Affiliation(s)
- Boye Fang
- 1 University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Elsie Yan
- 1 University of Hong Kong, Pok Fu Lam, Hong Kong
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15
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Nobels A, Vandeviver C, Beaulieu M, Lemmens GM, Keygnaert I. Are older women forgotten in the fight against sexual violence? LANCET GLOBAL HEALTH 2018. [PMID: 29525528 DOI: 10.1016/s2214-109x(18)30074-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Anne Nobels
- International Centre for Reproductive Health, Department of Uro-Gynaecology, Ghent University, Ghent, Belgium.
| | - Christophe Vandeviver
- Department of Criminology, Criminal Law and Social Law, Ghent University, Ghent, Belgium; Research Foundation Flanders (FWO), Brussels, Belgium
| | - Marie Beaulieu
- School of Social Work and Research on Aging, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | - Ines Keygnaert
- International Centre for Reproductive Health, Department of Uro-Gynaecology, Ghent University, Ghent, Belgium
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16
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Browne KD, Hines M, Tully RJ. The differences between sex offenders who victimise older women and sex offenders who offend against children. Aging Ment Health 2018; 22:11-18. [PMID: 27367563 DOI: 10.1080/13607863.2016.1202892] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Within the literature on sex offending, much attention is paid to the distinction between those sex offenders who offend against adults and those who offend against children. In contrast, there is a paucity of research into sex offenders who offend specifically against elderly or older victims. METHOD A detailed interview and psychometric tests were conducted with a sample of 28 sex offenders who had been convicted of a sexually motivated offence against an older female. These data were compared to a sample of 23 child sex offenders. RESULTS Results indicate that amongst other significant differences between these sub-groups, men who offend against older women are generally younger, are more violent, and are more likely to use a weapon and cause injury and death compared to child sex offenders. The men who offended against children were more likely to think about and plan their offending, spend more time with the victim pre and post offence, admit sexual arousal during the offence, and admit to a sexual motivation for the offence. CONCLUSIONS This study suggests that men who sexually offend against older women and men who sexually offend against children are distinct groups. Treatment and risk management strategies should take this into account. Further exploration of this sub-group of offenders is recommended to help inform treatment and risk management strategies for sex offenders who offend against older people.
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Affiliation(s)
- K D Browne
- a Centre for Forensic and Family Psychology , The University of Nottingham , Nottingham , UK
| | - Morag Hines
- b The University of Birmingham , Birmingham , UK
| | - Ruth J Tully
- a Centre for Forensic and Family Psychology , The University of Nottingham , Nottingham , UK.,c Tully Forensic Psychology Ltd. , Nottingham , UK
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Alon S, Tuma N, Band-Winterstein T, Goldblatt H. Professionals' Awareness of Sexual Abuse in Late Life: An Exploratory Survey. J Am Psychiatr Nurses Assoc 2018; 24:53-61. [PMID: 28569089 DOI: 10.1177/1078390317712598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The sexual abuse phenomenon is considered taboo. It has been discussed, to date, mainly in relation to children and young women, with insufficient attention to sexual abuse in a late-life context. OBJECTIVES The aim of this survey was to explore professionals' awareness of elder sexual abuse (ESA). DESIGN The survey was conducted among 161 Jewish and Arab professionals from health care and social services, who worked with older adults in Israel. RESULTS Of the entire sample, 70 professionals (only 43%) reported encountering at least one to three cases of ESA. A total of 98% of the victims were women, and the primary offender was the spouse (75%). In most cases (70%), the victim reported the abuse, which was mainly sexual assault (64%). All participants (100%) noted taking action. CONCLUSION This exploratory survey indicates that professionals are partially aware of the existence of and the need to address the ESA phenomenon.
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Affiliation(s)
- Sara Alon
- 1 Sara Alon, PhD, School of Social Work, Tel-Aviv University, Ramat Aviv, Tel-Aviv, Israel
| | - Niva Tuma
- 2 Niva Tuma, RN, PhD, Rambam Health Care Campus, Haifa, Israel
| | - Tova Band-Winterstein
- 3 Tova Band-Winterstein, PhD, Department of Gerontology, University of Haifa, Haifa, Israel
| | - Hadass Goldblatt
- 4 Hadass Goldblatt, PhD, Deaprtment of Nursing, University of Haifa, Haifa, Israel
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18
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Fileborn B. Sexual Assault and Justice for Older Women: A Critical Review of the Literature. TRAUMA, VIOLENCE & ABUSE 2017; 18:496-507. [PMID: 27034325 DOI: 10.1177/1524838016641666] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article provides a critical review of current literature on the sexual assault of older women-including an exploration of the specific features and emotional and physical impacts of older women's experiences-and highlights current gaps and future directions for research, practice, and theory. A review of the literature indicates that older women constitute only a small proportion of victim/survivors. However, there is evidence to suggest that existing research underestimates the extent of this issue. Older women face particular barriers to disclosure and accessing the justice system, resulting in their experiences remaining hidden. Many of these barriers also contribute toward older women's experiences being ignored, dismissed, or downplayed by potential bystanders. These barriers are explored in depth in this article and include cultural context, ageism, cognitive and health impairments, and living in a residential care setting. Responding to, and preventing, the sexual assault of older women requires a tailored approach-and we currently lack sufficient insight to develop appropriate responses. In closing, this article considers how we might work toward achieving "justice" for older women victim/survivors.
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Affiliation(s)
- Bianca Fileborn
- 1 Australian Research Centre in Sex, Health & Society, La Trobe University, Melbourne, Australia
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Abstract
In contrast to work within the child-abuse field, polyvictimization of older adults did not become a focus of professional attention until this decade. Despite this lack of formal identification, a search of the research and practice literature revealed that prior research investigating single forms of or other elder abuse issues contained evidence of what was variously termed "multiple," "multi-faceted," "co-occurring," or "hybrid" elder abuse. A wide range of victims (1.4%-89.7%) identified in existing elder abuse studies was found to have experienced what constitutes "polyvictimization." This late-life polyvictimization evidence, the contexts in which victims are harmed, and information regarding the impact of multifaceted elder abuse are all presented and discussed in this article. Selected published cases illustrate the clinical dynamics operating in late-life polyvictimization situations.
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Affiliation(s)
- Holly Ramsey-Klawsnik
- a Klawsnik & Klawsnik Associates , Canton , MA , USA.,b National Adult Protective Services Association , Washington , DC , USA
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20
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Smith D, Bugeja L, Cunningham N, Ibrahim JE. A Systematic Review of Sexual Assaults in Nursing Homes. THE GERONTOLOGIST 2017; 58:e369-e383. [DOI: 10.1093/geront/gnx022] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Daisy Smith
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Lyndal Bugeja
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
| | - Nicola Cunningham
- Victorian Institute of Forensic Medicine, Clinical Forensic Medicine, Southbank, Victoria, Australia
| | - Joseph E Ibrahim
- Department of Forensic Medicine, Monash University, Southbank, Victoria, Australia
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21
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Research Protocol for Systematic Review and Meta-Analysis of Elder Abuse Prevalence Studies. Can J Aging 2017; 36:256-265. [PMID: 28399951 DOI: 10.1017/s0714980817000137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Elder abuse is an important public health and human rights issue, yet its true extent is not well understood. To address this, we will conduct a systematic review and meta-analysis of elder abuse prevalence studies from around the world. This protocol describes the methodological approach to be adopted for conducting this systematic review and meta-analysis. In particular, the protocol describes the search strategies and eligibility criteria to be used to identify and select studies and how data from the selected studies will be extracted for analysis. The protocol also describes the analytical approach that will be used to calculate pooled prevalence estimates and discusses the use of meta-regression to assess how studies' characteristics influence the prevalence estimates. This protocol conforms to the Preferred Reporting Items for Systematic reviews and Meta-Analysis - or PRISMA - guidelines and has been registered with the PROSPERO International Prospective Register of systematic reviews.
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22
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Hamby S, Smith A, Mitchell K, Turner H. Poly-victimization and resilience portfolios: Trends in violence research that can enhance the understanding and prevention of elder abuse. J Elder Abuse Negl 2016; 28:217-234. [PMID: 27606781 DOI: 10.1080/08946566.2016.1232182] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This literature review assesses the current state of knowledge about elder abuse and mistreatment, focusing on the lack of incorporation of all forms of elder victimization and the benefits of a poly-victimization framework. This review also includes existing knowledge on risk factors and calls for a greater focus on protective factors and a greater inclusion on family and community factors. Future research, prevention, and intervention would benefit from considering the true burden of elder victimization and a greater implementation of strengths-based approaches to programs.
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Affiliation(s)
- Sherry Hamby
- a Life Paths Appalachian Research Center and Department of Psychology , University of the South , Monteagle , Tennessee , USA
| | - Alli Smith
- a Life Paths Appalachian Research Center and Department of Psychology , University of the South , Monteagle , Tennessee , USA
| | - Kimberly Mitchell
- b Department of Psychology , University of New Hampshire , Durham , New Hampshire , USA
| | - Heather Turner
- c Department of Sociology , University of New Hampshire , Durham , New Hampshire , USA
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23
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Ernst JS, Ramsey-Klawsnik H, Schillerstrom JE, Dayton C, Mixson P, Counihan M. Informing evidence-based practice: a review of research analyzing adult protective services data. J Elder Abuse Negl 2015; 26:458-94. [PMID: 24965804 DOI: 10.1080/08946566.2013.832605] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The mission of Adult Protective Services (APS) is to protect older and vulnerable adults from abuse, neglect, and exploitation. The complexity of APS cases and the potential for life-changing interventions point to the need for research that examines and evaluates APS practices. A literature review identified 50 studies published during a 16-year period that used APS agencies, clients, data, or resources to test hypotheses regarding elder abuse. The analysis revealed promising efforts toward knowledge development about elder mistreatment and self-neglect. This article provides an overview of salient findings, notes the scarcity of studies that analyze the effectiveness of APS, and highlights the need for additional research. Lessons learned are described, and APS practitioners and researchers are urged to work collaboratively to develop key practice-related questions about APS processes and outcomes that can be tested with appropriate research methodologies.
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Affiliation(s)
- Joy Swanson Ernst
- a Department of Sociology and Social Work , Hood College , Frederick , Maryland , USA
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24
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Teaster PB, Ramsey-Klawsnik H, Abner EL, Kim S. The Sexual Victimization of Older Women Living in Nursing Homes. J Elder Abuse Negl 2015; 27:392-409. [PMID: 26331674 DOI: 10.1080/08946566.2015.1082453] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined 64 cases of sexual victimization of women ages 65+ (mean = 81) living in facilities that were investigated by APS and regulatory agencies in five states over a six-month period. Typically, abuse involved molestation (53%) and unwelcome sexual interest in the body (20%). Abilities and needs of women in substantiated and unsubstantiated cases were comparable. Resident perpetrators were more likely to be substantiated than staff or any other perpetrator (p = 0.008). Our results underscore the need to evaluate differences associated with gender, age, and residence, and to train on reporting and intervention by disciplines serving victims.
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Affiliation(s)
- Pamela B Teaster
- a Graduate Center for Gerontology , Virginia Polytechnic Institute and State University , Blacksburg , Virginia , USA
| | - Holly Ramsey-Klawsnik
- b Sociologist & Licensed Mental Health Clinician , Private Practice , Canton , Massachusetts , USA
| | - Erin L Abner
- c Department of Epidemiology and Sanders-Brown Center on Aging , University of Kentucky , Lexington , Kentucky , USA
| | - Sujee Kim
- a Graduate Center for Gerontology , Virginia Polytechnic Institute and State University , Blacksburg , Virginia , USA
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25
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Sexual Abuse of Older Residents in Nursing Homes: A Focus Group Interview of Nursing Home Staff. Nurs Res Pract 2015; 2015:716407. [PMID: 26078879 PMCID: PMC4442408 DOI: 10.1155/2015/716407] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/28/2015] [Indexed: 11/30/2022] Open
Abstract
The objective of this study was to increase knowledge of sexual abuse against older residents in nursing homes. A qualitative approach was used. Through a focus group interview with staff in nursing homes, the aim was to reveal employees' thoughts, experiences, and attitudes. Findings from the focus group interview show that sexual abuse of older residents is a taboo topic among health professionals. Acts of sexual abuse are difficult to imagine; it is hard to believe that it occurs. The fact that staff are not aware that it could happen, or have a hard time believing that it actually happens, can amplify the residents' vulnerable position as potential victims of abuse, and it makes it even more challenging to report or uncover such acts. The study highlights the need for education of all health care workers in Norway as well as more research on sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step towards addressing sexual abuse of the aged in a more appropriate way. Further research must aim to reveal more about this taboo area.
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26
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McDonald L, Hitzig SL, Pillemer KA, Lachs MS, Beaulieu M, Brownell P, Burnes D, Caspi E, Mont JD, Gadsby R, Goergen T, Gutman G, Hirst SP, Holmes C, Khattak S, Lowenstein A, Mirza RM, McNeill S, Moorhouse A, Podnieks E, Rideout R, Robitaille A, Rochon PA, Rosenberg J, Sheppard C, Tamblyn Watts L, Thomas C. Developing a Research Agenda on Resident-to-Resident Aggression: Recommendations From a Consensus Conference. J Elder Abuse Negl 2015; 27:146-67. [DOI: 10.1080/08946566.2014.995869] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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27
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Abstract
RÉSUMÉL'abus de résidents par d'autres résidents parmi de foyers de soins de longue durée (SLD) implique l'agressivité et la violence et peut avoir des conséquences graves pour tous les deux, agresseurs et victimes. Jusqu'à présent, il n'y a eu aucune tentative d'évaluer systématiquement la portée de ce problème au Canada. Pour combler cette lacune, nous avons entrepris une étude de délimitation de l'étendue pour améliorer la compréhension de l'abus chez les résidents des foyers de SLD. Nous présentons aussi un ensemble redigé de données canadiennes sur l'abus chez les résidents. On a cherché neuf bases de données bibliographiques électroniques; un total de 784 résumés a été trouvés, mais seulement 32 ont satisfait les critères d'inclusion. La majorité des documents (75 pour cent) étaient des études de cas rétro-perspectives, des études qualitatives et critiques/commentaires. Parmi eux, seuls 14 se consacrent exclusivement à l'abus parmi les résidents. L'ensemble redigé de données canadiennes suggère que l'abus des résidents par d'autres résidents représente environ un tiers des cas d'abus signalés. Afin de faire connaître cette phénomène et d'aider à diminuer son incidence, des recommandations pour la recherche future, la pratique clinique et la politique sont fournis.
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Sexual abuse of older nursing home residents: a literature review. Nurs Res Pract 2015; 2015:902515. [PMID: 25642347 PMCID: PMC4302365 DOI: 10.1155/2015/902515] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/23/2014] [Indexed: 11/17/2022] Open
Abstract
Despite an increasing literature related to elder abuse, sexual abuse of older persons in general and of vulnerable adults living in nursing homes in particular is still sparsely described. The purpose of this study was to assess the state of knowledge on the subject of sexual abuse against older nursing home residents through a literature review. Systematic searches in reference databases including Cinahl, Medline, OVID Nursing Database, ISI Web of Science, PsycINFO, Cochrane Library, and SveMed + were conducted. Through several phases of selection of the articles, using strict inclusion and exclusion criteria, six articles were chosen for a deeper examination. Findings from the review show that sexual abuse occurs in nursing homes and that both older women and men are victims of sexual abuse. Perpetrators appear mainly to be staff and other residents and mainly to be men, but also women abuse both older men and older women. Findings from the literature review show that there is a need for knowledge and further research on the topic of sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step in seriously addressing sexual abuse against older persons.
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Killick C, Taylor BJ, Begley E, Carter Anand J, O’Brien M. Older People’s Conceptualization of Abuse: A Systematic Review. J Elder Abuse Negl 2015; 27:100-20. [DOI: 10.1080/08946566.2014.997374] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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30
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Speck PM, Hartig MT, Likes W, Bowdre T, Carney AY, Ekroos RA, Haugen R, Crum J, Faugno DK. Case Series of Sexual Assault in Older Persons. Clin Geriatr Med 2014; 30:779-806. [DOI: 10.1016/j.cger.2014.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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31
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Cannell MB, Manini T, Spence-Almaguer E, Maldonado-Molina M, Andresen EM. U.S. Population Estimates and Correlates of Sexual Abuse of Community-Dwelling Older Adults. J Elder Abuse Negl 2014; 26:398-413. [DOI: 10.1080/08946566.2013.879845] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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32
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Nóbrega Pinto A, Rodrigues F, Dinis-Oliveira RJ, Magalhães T. Sexual Offenses Against Elderly People: Forensic Evaluation and Judicial Outcome. J Elder Abuse Negl 2014; 26:189-204. [DOI: 10.1080/08946566.2013.827951] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Castle N, Ferguson-Rome JC, Teresi JA. Elder abuse in residential long-term care: an update to the 2003 National Research Council report. J Appl Gerontol 2013; 34:407-43. [PMID: 24652890 DOI: 10.1177/0733464813492583] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A synthesis of the last decade of literature on elder abuse in residential long-term care (i.e., Nursing Homes and Assisted Living) is discussed. Presented are definitions of abuse, theoretical and conceptual models, prevalence rates of abuse, outcomes and costs, and sources of abuse. The synthesis represents an update to the literature in the influential 2003 National Research Council report. We identify many of the same issues and concerns exist that were surfaced in this prior report. Many theoretical and conceptual models need further elaboration. Conflicting definitions of abuse are pervasive. Rates of abuse are generally inaccurate, and probably under-reported. However, we also identify progress in many areas. An increase in empirical studies that exist in this area (although very few in Assisted Living). Other forms and types of abuse have also been identified as important, such as resident-to-resident abuse. These areas are discussed, along with potential suggestions for additional research.
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Affiliation(s)
| | | | - Jeanne A Teresi
- Columbia University Stroud Center, Faculty of Medicine and New York State Psychiatric Institute, NY, USA
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Abstract
RÉSUMÉCet article examine les développements dans le domaine de la maltraitance et de la négligence des aînés depuis la publication de Elder Abuse and Neglect in Canada (Butterworths, 1991). Les arguments présentés ici sont de deux ordres : d’abord, nous n’avons aucune idée de la taille ou de la nature du problèmes de la violence et de la négligence dans la communauté ou dans les institutions et, d’autre part, nous ne savons pas comment résoudre ces problèmes ou leurs questions connexes qui ont été masqués par la rhétorique et le recyclage de l’information pendant les 20 dernières années. C’est le temps d’avancer au-delà de la « phase de sensibilisation ». Ce à quoi nous devons nous attaquer à l’avenir est aussi évident aujourd’hui qu’il ne l’était il y a 20 ans. Notre connaissance est incomplète parce qu’il nous manque le type d’enquêtes dont le besoin se fait le plus urgent: les études de prévalence dans la communauté et les institutions, un développement théoriquement solide, et des essais cliniques randomisé pour tester à la fois nos interventions socialement et juridiquement.
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Rosen T, Lachs MS, Pillemer K. Sexual aggression between residents in nursing homes: literature synthesis of an underrecognized problem. J Am Geriatr Soc 2010; 58:1970-9. [PMID: 20840462 DOI: 10.1111/j.1532-5415.2010.03064.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Evidence exists suggesting that most sexual aggression against older adults occurs in long-term care facilities. Fellow residents are the most common perpetrators, often demonstrating inappropriate hypersexual behavior caused by dementing illness. This resident-to-resident sexual aggression (RRSA) is defined as sexual interactions between long-term care residents that, in a community setting, at least one of the recipients would be likely to construe as unwelcome and that have high potential to cause physical or psychological distress in one or both of the involved residents. Although RRSA may be common, and physical and psychological consequences for victims may be significant, this phenomenon has received little direct attention from researchers. This is a review of the existing literature and relevant related research examining elder sexual abuse and hypersexual behavior that describes the epidemiological features of this phenomenon, including risk factors for perpetrators and victims. The legitimate and recognized need for nursing home residents, even those with advanced dementing illness, to express themselves sexually makes preventing and managing sexual aggression in nursing homes more challenging. This review discusses the ethical dilemma this situation creates and the need to evaluate the capacity to consent to sexual activity of residents with dementing illness and to re-evaluate capacity as the diseases progress. Suggestions are offered for managing incidents of RRSA and for future research, including the importance of designing effective interventions.
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Affiliation(s)
- Tony Rosen
- Emergency Medicine Residency Program, New York Presbyterian Hospital, New York, New York, USA
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