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Burnett J, Wasik S, Cash D, Olson J, Medina A, Pena D, Hiner JA, Cannell MB. A collaboration between adult protective services and forensic accounting examiners to investigate complex financial exploitation: formative evaluation findings. J Elder Abuse Negl 2024; 36:310-327. [PMID: 38318820 DOI: 10.1080/08946566.2024.2315084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Financial exploitation (FE) is one of the most common reports to Adult Protective Services (APS) and the cases are often complex. Consequently, APS caseworkers report FE investigations to be among the most difficult while simultaneously reporting low confidence in productive outcomes for these investigations. This necessitates finding ways to support APS FE investigations. This paper describes the structure, process, and formative findings of a collaboration between forensic accounting examiners and APS workers to investigate complex cases of FE. Among the 77 FE cases completed, forensic examiners reviewed multiple years of financial records which included over 101,000 transactions, totaling over $213,000,000.00 in finances, and identified over $8,000,000 in questionable activity. Scores on the 8-item Client Satisfaction Questionnaire were high indicating high program satisfaction by APS workers, subject matter experts, and forensic examiners. These findings support the feasibility and acceptability of forensic accounting and APS collaborations to investigate complex cases of FE.
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Affiliation(s)
- Jason Burnett
- John P. and Kathrine G. McGovern Medical School, The Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, US
- The Texas Elder Abuse and Mistreatment Institute, Houston, Texas, US
| | - Sophia Wasik
- John P. and Kathrine G. McGovern Medical School, The Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, US
- The Texas Elder Abuse and Mistreatment Institute, Houston, Texas, US
| | | | | | - Angela Medina
- Texas Department of Family and Protective Services, Adult Protective Services, Austin, Texas, US
| | - Danielle Pena
- Texas Department of Family and Protective Services, Adult Protective Services, Austin, Texas, US
| | - Julia A Hiner
- John P. and Kathrine G. McGovern Medical School, The Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, US
- The Texas Elder Abuse and Mistreatment Institute, Houston, Texas, US
| | - M Brad Cannell
- The Texas Elder Abuse and Mistreatment Institute, Houston, Texas, US
- Department of Epidemiology and Human Genetics, The University of Texas Health Science Center at Houston, Dallas, Texas, US
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Păroşanu A, Marshall C. Responding restoratively to elder harm: lessons from a pilot scheme in Aotearoa New Zealand. J Elder Abuse Negl 2023; 35:212-227. [PMID: 37997670 DOI: 10.1080/08946566.2023.2286486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
The search for adequate ways to address elder harm and abuse has become increasingly evident in public discourse. There is a growing consensus that integrated, multi-disciplinary approaches are needed, especially because older victims are often hesitant to resort to legal interventions. This evaluation study aimed to assess the benefits and challenges of a pilot scheme in Aotearoa New Zealand employing restorative processes to respond to elder harm and to discuss implications for future practice. Thirty interviews were conducted with professionals, older persons and family members. Our findings show that restorative encounters, in particular circle processes, provided a safe environment to engage honestly with each other and for mutual understanding and trust to emerge. The collaborative relationship of key stakeholders was a notable strength of the pilot. However, the major challenge in using restorative practices was dealing adequately with long and complex histories of family conflicts.
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Affiliation(s)
- Andrea Păroşanu
- Te Ngāpara Centre for Restorative Practice, Wellington School of Business and Government, Victoria University of Wellington, Wellington, New Zealand
| | - Chris Marshall
- Te Ngāpara Centre for Restorative Practice, Wellington School of Business and Government, Victoria University of Wellington, Wellington, New Zealand
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Chen J, Zeng Y, He W, Yang J, Xu D, Li H. How Healthy Aging and Contact With Children Are Associated With Satisfaction in Middle-Aged and Older Parents in China: A Mediation Analysis. Front Public Health 2022; 10:836558. [PMID: 35359770 PMCID: PMC8963940 DOI: 10.3389/fpubh.2022.836558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/21/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives This study aims to examine the mediation role of satisfaction with children on the association between contact with children (CCT) and healthy aging among middle-aged and older parents in China. Methods Data from 9,575 parents over 45 years old were obtained from the 2018 China Health and Retirement Longitudinal Survey. A multinomial logistic regression model was applied to measure the association between contact, satisfaction, and healthy aging with potential confounders controlled. We used the Sobel-Goodman Mediation test to analyze the mediation role of satisfaction on the association between types of CCT and healthy aging. Results Parents with contact with adult children had higher satisfaction with children [for contact weekly (satisfied/unsatisfied): relative risk ratio (RRR) = 2.44, CI = 1.92-3.10] and higher healthy aging [for contact weekly (Q5/Q1): RRR = 1.41, CI = 1.13-1.77]. Satisfaction was strongly related to healthy aging [for satisfied (Q5/Q1): RRR = 3.44, CI = 2.14-5.51], and mediated 19.05% of healthy aging for weekly contact (Sobel test z = 4.338; indirect role = 0.014, CI = 0.011-0.018; direct role = 0.061, CI = 0.029-0.094). Subgroup analysis further revealed that satisfaction with contact played a partial mediating role between monthly contact and healthy aging in female and rural groups. Conclusions Monthly CCT is more appropriate for older parents. Satisfaction with children in older parents seems to act as a significant and partial mediator of the relationship between contact and healthy aging. The contribution of satisfaction to healthy aging could be important to be considered and promoted in women and rural older parents, independent of CCT.
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Affiliation(s)
- Jiangyun Chen
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China,ACACIA Labs of Southern Medical University Institute for Global Health (SIGHT) and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, China,Institute for Health Management, Southern Medical University, Guangzhou, China
| | - Yixin Zeng
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Wenjun He
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Jiao Yang
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China
| | - Dong Xu
- Center for World Health Organization (WHO) Studies and Department of Health Management, School of Health Management of Southern Medical University, Guangzhou, China,ACACIA Labs of Southern Medical University Institute for Global Health (SIGHT) and Dermatology Hospital, Southern Medical University (SMU), Guangzhou, China,Institute for Health Management, Southern Medical University, Guangzhou, China,Dong Xu
| | - Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China,*Correspondence: Haomiao Li
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Goodridge D, Roger KS, Walsh CA, PausJenssen E, Cewick M, Liepert C. Service providers' use of harm reduction approaches in working with older adults experiencing abuse: a qualitative study. BMC Geriatr 2021; 21:398. [PMID: 34193077 PMCID: PMC8242276 DOI: 10.1186/s12877-021-02328-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 06/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although abuse experienced by older adults is common and expected to increase, disclosure, reporting and interventions to prevent or mitigate abuse remain sub-optimal. Incorporating principles of harm reduction into service provision has been advocated as a strategy that may improve outcomes for this population. This paper explores whether and how these principles of harm reduction were employed by professionals who provide services to older adults experiencing abuse. METHODS Thematic analysis of qualitative interviews with 23 professionals providing services to older adults experiencing abuse across three Western provinces of Canada was conducted. Key principles of harm reduction (humanism, incrementalism, individualism, pragmatism, autonomy, and accountability without termination) were used as a framework for organizing the themes. RESULTS Our analysis illustrated a clear congruence between each of the six harm reduction principles and the approaches reflected in the narratives of professionals who provided services to this population, although these were not explicitly articulated as harm reduction by participants. Each of the harm reduction principles was evident in service providers' description of their professional practice with abused older adults, although some principles were emphasized differentially at different phases of the disclosure and intervention process. Enactment of a humanistic approach formed the basis of the therapeutic client-provider relationships with abused older adults, with incremental, individual, and pragmatic principles also apparent in the discourse of participants. While respect for the older adult's autonomy figured prominently in the data, concerns about the welfare of the older adults with questionable capacity were expressed when they did not engage with services or chose to return to a high-risk environment. Accountability without termination of the client-provider relationship was reflected in continuation of support regardless of the decisions made by the older adult experiencing abuse. CONCLUSIONS Harm reduction approaches are evident in service providers' accounts of working with older adults experiencing abuse. While further refinement of the operational definitions of harm reduction principles specific to their application with older adults is still required, this harm reduction framework aligns well with both the ethical imperatives and the practical realities of supporting older adults experiencing abuse.
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Affiliation(s)
- Donna Goodridge
- College of Medicine, University of Saskatchewan, Saskatoon, Canada.
| | - Kerstin Stieber Roger
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | - Marina Cewick
- Faculty of Education, University of Manitoba, Winnipeg, Canada
| | - Carla Liepert
- Faculty of Social Work, University of Calgary, Calgary, Canada
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Dion S, Gogia K, Elman A, Clark S, Ulrey P, Connolly MT, Lewis S, LoFaso VM, Lachs MS, Wartell J, Rosen T. Developing a rigorous, systematic methodology to identify and categorize elder mistreatment in criminal justice data. J Elder Abuse Negl 2020; 32:27-45. [PMID: 32151210 DOI: 10.1080/08946566.2020.1733725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Elder mistreatment is complex, with cases typically requiring integrated responses from social services, medicine, civil law, and criminal justice. Only limited research exists describing elder mistreatment prosecution and its impact. Researchers have not yet examined administrative prosecutorial data to explore mistreatment response, and no standardized analytic approach exists. We developed a rigorous, systematic methodologic approach to identify elder mistreatment cases in prosecutorial data from cases of crimes against victims aged ≥60. To do so, we operationalized elements of the accepted definition of elder mistreatment, including expectation of trust and vulnerability. We also designed an approach to categorize elder mistreatment cases, using the types of charges filed, into: financial exploitation, physical abuse, sexual abuse, verbal/emotional/psychological abuse, and neglect. This standardized methodological approach to identify and categorize elder mistreatment cases in prosecution data is an important preliminary step in analyzing this potentially untapped source of useful information about mistreatment response.
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Affiliation(s)
- Sarah Dion
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Kriti Gogia
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Alyssa Elman
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Sunday Clark
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Page Ulrey
- Economic Crimes Unit, King County Prosecuting Attorney's Office, Seattle, Washington, USA
| | - Marie-Therese Connolly
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Stuart Lewis
- School of Medicine, New York University, New York, New York, USA
| | - Veronica M LoFaso
- Division of Geriatrics and Palliative Care, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Mark S Lachs
- Division of Geriatrics and Palliative Care, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
| | - Julie Wartell
- Department of Urban Studies and Planning, University of California, San Diego, California, USA
| | - Tony Rosen
- Department of Emergency Medicine, Weill Cornell Medicine/NewYork-Presbyterian Hospital, New York, New York, USA
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Burnett J, Suchting R, Green CE, Cannell MB, Dyer CB. Socioecological indicators of senior financial exploitation: an application of data science to 8,800 substantiated mistreatment cases. J Elder Abuse Negl 2020; 32:105-120. [PMID: 32151209 DOI: 10.1080/08946566.2020.1737615] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Senior financial exploitation (FE) is prevalent and harmful. Its often insidious nature and co-occurrence with other forms of mistreatment make detection and substantiation challenging. A secondary data analysis of N = 8,800 Adult Protective Services substantiated senior mistreatment cases, using machine learning algorithms, was conducted to determine when pure FE versus hybrid FE was occurring. FE represented N = 2514 (29%) of the cases with 78% being pure FE. Victim suicidal ideation and threatening behaviors, injuries, drug paraphernalia, contentious relationships, caregiver stress, and burnout and victims needing assistance were most important for differentiating FE vs non-FE-related mistreatment. The inability to afford housing, medications, food, and medical care as well as victims suffering from intellectual disability disorder(s) predicted hybrid FE. This study distinguishes socioecological factors strongly associated with the presence of FE during protective service investigations. These findings support existing and new indicators of FE and could inform protective service investigation practices.
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Affiliation(s)
- Jason Burnett
- UTHealth McGovern Medical School, Division of Geriatric and Palliative Medicine, Houston, Texas, USA.,UTHealth McGovern Medical School, Texas Elder Abuse and Mistreatment Institute (TEAM), Houston, Texas, USA
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, USA
| | - Charles E Green
- Department of Psychiatry and Behavioral Sciences, UTHealth McGovern Medical School, Houston, Texas, USA.,UTHealth McGovern Medical School, Center for Clinical and Evidence-Based Medicine, Houston, Texas, USA
| | - M Brad Cannell
- UTHealth McGovern Medical School, Texas Elder Abuse and Mistreatment Institute (TEAM), Houston, Texas, USA.,Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, Dallas, Texas, USA
| | - Carmel B Dyer
- UTHealth McGovern Medical School, Division of Geriatric and Palliative Medicine, Houston, Texas, USA.,UTHealth McGovern Medical School, Texas Elder Abuse and Mistreatment Institute (TEAM), Houston, Texas, USA
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McKenna NC, Golladay KA, Holtfreter K. Integrating General Strain Theory and Trauma-Informed Principles into the Study of Older Adult Victimization. J Trauma Dissociation 2020; 21:187-200. [PMID: 31809652 DOI: 10.1080/15299732.2020.1692410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Prevalence rates for late life victimization are well-documented. The literature has expanded, in part due to the identification of elder justice as a key priority for federal funding. The interdisciplinary field of criminology has begun addressing elder victimization and its consequences, informed by General Strain Theory (GST). It is challenging to connect the findings from this research to evidence-based interventions for older victims. Trauma-informed principles (TIP) - when linked with GST - offer a means for doing so. The current review contributes to the extant literature by examining connections between these perspectives, with the goal of encouraging future research, and ultimately informing treatment for older adult victims.
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Affiliation(s)
- Nicole C McKenna
- School of Criminal Justice, University of Cincinnati, Cincinnati, Ohio, USA
| | - Katelyn A Golladay
- Department of Criminal Justice and Sociology, University of Wyoming, Laramie, Wyoming, USA
| | - Kristy Holtfreter
- School of Criminology and Criminal Justice, Arizona State University, Phoenix, Arizona, USA
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Fraga Dominguez S, Valiquette J, Storey JE, Glorney E. Elder Abuse Detection and Intervention: Challenges for Professionals and Strategies for Engagement From a Canadian Specialist Service. JOURNAL OF FORENSIC NURSING 2020; 16:199-206. [PMID: 32925515 DOI: 10.1097/jfn.0000000000000301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Elder abuse (EA) is of increasing relevance in the context of an aging society, and this has implications for detection and intervention for several types of healthcare providers, including forensic nurses. Knowledge related to EA is important as victims are likely to interact with providers, because of either existing health problems or the consequences of abuse. This article provides a brief overview of EA, followed by an outline of current detection and intervention efforts used by healthcare providers in community and hospital settings. In addition, knowledge about help-seeking and barriers to disclosure are discussed to inform healthcare provider interactions with older adults where EA is suspected or disclosed. To illustrate challenges faced by healthcare providers in this area, two cases of EA involving case management by a forensic nurse in a specialist service in Canada are presented.
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Affiliation(s)
| | | | | | - Emily Glorney
- Author Affiliations: Royal Holloway, University of London
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Daly JM, Xu Y, Jogerst GJ. Iowa Dependent Adult Abuse Prosecutions From 2006 Through 2015: Health Care Providers' Concern. J Prim Care Community Health 2017; 8:153-162. [PMID: 28142356 PMCID: PMC5932692 DOI: 10.1177/2150131916688561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: In most states, health care providers are required to report abuse. Some states provide investigation feedback/findings to the reporter. The reporters rarely know if the perpetrator is convicted. The purposes of this study are to determine the incidence of Iowa dependent adult abuse prosecutions from 2006 through 2015, the incidence of convictions, and the association between dependent adult abuse prosecutions with county census and government characteristics. Design and Methods: Through the Iowa Court Information Systems, dependent adult abuse prosecution data were purchased for a 10-year time period. County demographics were obtained through the US Census and government data were Iowa State Association of Counties and the US Department of Agriculture. Results: During 2006-2015, there were 368 dependent adult abuse prosecution cases accounting for 482 original charges. Exploitation greater than $100 was the dependent adult abuse charge most frequently cited. Within the 10 years, it accounted for 60% of the original charges. Of the 482 disposed charges, 251 (52%) of the charges were dismissed. A total of 122 (14%) counts resulted in probation, 73 resulted in prison, and 37 in jail. Conclusions: For the first time, information about dependent adult abuse prosecutions in Iowa is available. The latter 5 years, 2011 to 2015, of dependent adult abuse prosecutions are significantly higher than the first 5 years, 2006 to 2010. This project encourages health care providers to report dependent adult abuse to law enforcement if appropriate as well as adult protective services.
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Affiliation(s)
| | - Yinghui Xu
- 1 University of Iowa, Iowa City, IA, USA
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10
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Abstract
BACKGROUND Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. OBJECTIVES The objective of this review was to assess the effectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention effects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people. SEARCH METHODS We searched 19 databases (AgeLine, CINAHL, Psycinfo, MEDLINE, Embase, Proquest Central, Social Services Abstracts, ASSIA, Sociological Abstracts, ProQuest Dissertations & Theses Global, Web of Science, LILACS, EPPI, InfoBase, CENTRAL, HMIC, Opengrey and Zetoc) on 12 platforms, including multidisciplinary disciplines covering medical, health, social sciences, social services, legal, finance and education. We also browsed related organisational websites, contacted authors of relevant articles and checked reference lists. Searches of databases were conducted between 30 August 2015 and 16 March 2016 and were not restricted by language. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-randomised trials, and quasi-RCTs, before-and-after studies, and interrupted time series. Only studies with at least 12 weeks of follow-up investigating the effect of interventions in preventing or reducing abuse of elderly people and those who interact with the elderly were included. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the studies' risk of bias. Studies were categorised as: 1) education on elder abuse, 2) programmes to reduce factors influencing elder abuse, 3) specific policies for elder abuse, 4) legislation on elder abuse, 5) programmes to increase detection rate on elder abuse, 6) programmes targeted to victims of elder abuse, and 7) rehabilitation programmes for perpetrators of elder abuse. All studies were assessed for study methodology, intervention type, setting, targeted audience, intervention components and intervention intensity. MAIN RESULTS The search and selection process produced seven eligible studies which included a total of 1924 elderly participants and 740 other people. Four of the above seven categories of interventions were evaluated by included studies that varied in study design. Eligible studies of rehabilitation programmes, specific policies for elder abuse and legislation on elder abuse were not found. All included studies contained a control group, with five of the seven studies describing the method of allocation as randomised. We used the Cochrane 'Risk of bias' tool and EPOC assessment criteria to assess risk of bias. The results suggest that risk of bias across the included body of research was high, with at least 40% of the included studies judged as being at high risk of bias. Only one study was judged as having no domains at high risk of bias, with two studies having two of 11 domains at high risk. One study was judged as being at high risk of bias across eight of 11 domains.All included studies were set in high-income countries, as determined by the World Bank economic classification (USA four, Taiwan one, UK two). None of the studies provided specific information or analysis on equity considerations, including by socio-economic disadvantage, although one study was described as being set in a housing project. One study performed some form of cost-effectiveness analysis on the implementation of their intervention programmes, although there were few details on the components and analysis of the costing.We are uncertain whether these interventions reduce the occurrence or recurrence of elder abuse due to variation in settings, measures and effects reported in the included studies, some of which were very small and at a high risk of bias (low- and very low-quality evidence).Two studies measured the occurrence of elder abuse. A high risk of bias study found a difference in the post-test scores (P value 0.048 and 0.18). In a low risk of bias study there was no difference found (adjusted odds ratio (OR) =0.48, 95% 0.18 to 1.27) (n = 214). For interventions measuring abuse recurrence, one small study (n = 16) reported no difference in post-test means, whilst another found higher levels of abuse reported for the intervention arms (Cox regression, combined intervention hazard ratio (HR) = 1.78, alpha level = 0.01).It is uncertain whether targeted educational interventions improve the relevant knowledge of health professionals and caregivers (very low-quality evidence), although they may improve detection of resident-to-resident abuse. The concept of measuring improvement in detection or reporting as opposed to measuring the occurrence or recurrence of abuse is complicated. An intervention of public education and support services aimed at victims may also improve rates of reporting, however it is unclear whether this was due to an increase in abuse recurrence or better reporting of abuse.The effectiveness of service planning interventions at improving the assessment and documentation of related domains is uncertain. Unintended outcomes were not reported in the studies. AUTHORS' CONCLUSIONS There is inadequate trustworthy evidence to assess the effects of elder abuse interventions on occurrence or recurrence of abuse, although there is some evidence to suggest it may change the combined measure of anxiety and depression of caregivers. There is a need for high-quality trials, including from low- or middle-income countries, with adequate statistical power and appropriate study characteristics to determine whether specific intervention programmes, and which components of these programmes, are effective in preventing or reducing abuse episodes among the elderly. It is uncertain whether the use of educational interventions improves knowledge and attitude of caregivers, and whether such programmes also reduce occurrence of abuse, thus future research is warranted. In addition, all future research should include a component of cost-effectiveness analysis, implementation assessment and equity considerations of the specific interventions under review.
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Affiliation(s)
- Philip RA Baker
- Queensland University of TechnologySchool of Public Health and Social WorkBrisbaneQueenslandAustralia4059
| | - Daniel P Francis
- Queensland University of TechnologySchool of Public Health and Social WorkBrisbaneQueenslandAustralia4059
| | - Noran N Hairi
- University of MalayaDepartment of Social & Preventive Medicine, Faculty of MedicineJalan Lembah PantaiKuala LumpurMalaysia50603
- University of MalayaJulius Centre University of MalayaKuala LumpurMalaysia50603
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia50603
| | - Wan Yuen Choo
- University of MalayaDepartment of Social & Preventive Medicine, Faculty of MedicineJalan Lembah PantaiKuala LumpurMalaysia50603
- University of MalayaJulius Centre University of MalayaKuala LumpurMalaysia50603
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Jackson SL. All Elder Abuse Perpetrators Are Not Alike: The Heterogeneity of Elder Abuse Perpetrators and Implications for Intervention. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2016; 60:265-285. [PMID: 25326465 DOI: 10.1177/0306624x14554063] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The tendency to label all elder abuse perpetrators as the "bad guys" has diminished our ability to respond effectively. A review of the literature demonstrates that elder abuse perpetrators are in fact heterogeneous with important differences across types of abuse. A reformulation of perpetrator interventions away from a singular emphasis on prosecution to meaningful alternatives that utilize criminal justice and/or therapeutic approaches tailored to the needs of the case is needed. These interventions must incorporate the needs of both victims and perpetrators, take into consideration the type of abuse involved, acknowledge the variations in perpetrator culpability, and recognize the continuum of complexity among these cases. Without addressing these nuances, intervention and prevention efforts will be futile if not harmful.
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Jackson SL, Hafemeister TL. The Impact of Relationship Dynamics on the Detection and Reporting of Elder Abuse Occurring in Domestic Settings. J Elder Abuse Negl 2015; 27:121-45. [DOI: 10.1080/08946566.2015.1008085] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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13
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Abstract
Purpose
– The purpose of this paper was to study the vexing problem of defining financial exploitation. Advocates and practitioners in the field who have been battling financial exploitation are pleased to observe the increased attention that financial exploitation is receiving at all levels of society. With this increased attention, however, there has been a conflation of terms used to describe financial exploitation, resulting in some confusion about what constitutes financial exploitation.
Design/methodology/approach
– Fully recognizing that definitions serve different functions, this paper identifies three main purposes of a definition and then describes the myriad ways financial exploitation has been defined in the research literature, by organizations, and in civil and criminal statutes.
Findings
– Financial exploitation has been defined in multiple ways within and across categories. Furthermore, the definition has expanded over time. This paper proposes the need for greater definitional clarity around the concept of financial exploitation, and argues that at a minimum a distinction must be made between financial exploitation and financial fraud.
Originality/value
– This is the first paper to comprehensively review the myriad ways in which financial exploitation has been defined in the literature, by organizations and within state civil and criminal statutes.
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