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Melchiorre MG, Socci M, Lamura G, Quattrini S. Perceived Loneliness, Social Isolation, and Social Support Resources of Frail Older People Ageing in Place Alone in Italy. Healthcare (Basel) 2024; 12:875. [PMID: 38727432 PMCID: PMC11083615 DOI: 10.3390/healthcare12090875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
This paper presents some findings from the IN-AGE ("Inclusive ageing in place") study, which the authors carried out in 2019 in Italy. It explores the available social support resources for frail older people with functional limitations ageing in place alone, and possible links between their social isolation and perceived loneliness. The authors conducted qualitative/semi-structured interviews involving 120 participants aged 65 years and over, and used a mixed-methods analysis (quantitative/qualitative). The main results show the family as the main help resource for daily activities, but also for intimate confidences against social isolation, especially when said relatives live close. Family confidants are less present when seniors are supported by friends/neighbours or/and public services. Moreover, the family is valuable for decreasing loneliness, although not always. However, some older people feel particularly alone when they are supported by public services. Such a complex context draws attention on the need of support for frail seniors living alone and could provide insights for policymakers on adequate policies for preventing and managing loneliness and social isolation in later life. This is especially relevant when family (and other) resources are not available or scarce, also considering the opportunities offered by technology, which can help seniors remain socially connected to relatives, friends and their overall community.
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Affiliation(s)
| | - Marco Socci
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, Via Santa Margherita 5, 60124 Ancona, Italy; (M.G.M.); (G.L.); (S.Q.)
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van Houten ME, Vloet LCM, Rikkert MGMO, van de Kerkhof-van Bon B, de Rooij A, Verhoeven M, Bil WME, Lucke JA, Schoon Y, Berben SAA. ERASE: a feasible early warning tool for elder abuse, developed for use in the Dutch emergency department. BMC Emerg Med 2024; 24:52. [PMID: 38570746 PMCID: PMC10988976 DOI: 10.1186/s12873-024-00971-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Elder abuse is a worldwide problem with serious consequences for individuals and society. To effectively deal with elder abuse, a timely identification of signals as well as a systematic approach towards (suspected) elder abuse is necessary. This study aimed to develop and test the acceptability and appropriateness of ERASE (EldeR AbuSE) in the emergency department (ED) setting. ERASE is an early warning tool for elder abuse self-administered by the healthcare professional in patients ≥ 70 years. METHODS A systematic literature review was previously conducted to identify potential available instruments on elder abuse for use in the ED. Furthermore, a field consultation in Dutch hospitals was performed to identify practice tools and potential questions on the recognition of elder abuse that were available in clinical practice. Based on this input, in three subsequent rounds the ERASE tool was developed. The ERASE tool was tested in a pilot feasibility study in healthcare professionals (n = 28) working in the ED in three Dutch hospitals. A semi-structured online questionnaire was used to determine acceptability and appropriateness of the ERASE tool. RESULTS The systematic literature review revealed seven screening instruments developed for use in the hospital and/or ED setting. In total n = 32 (44%) hospitals responded to the field search. No suitable and validated instruments for the detection of elder abuse in the ED were identified. The ERASE tool was developed, with a gut feeling awareness question, that encompassed all forms of elder abuse as starting question. Subsequently six signalling questions were developed to collect information on observed signs and symptoms of elder abuse and neglect. The pilot study showed that the ERASE tool raised the recognition of healthcare professionals for elder abuse. The tool was evaluated acceptable and appropriate for use in the ED setting. CONCLUSIONS ERASE as early warning tool is guided by an initial gut feeling awareness question and six signalling questions. The ERASE tool raised the recognition of healthcare professionals for elder abuse, and was feasible to use in the ED setting. The next step will be to investigate the reliability and validity of the ERASE early warning tool.
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Grants
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
- PRJ 00697 the Dutch Ministry of Health, Welfare and Sport
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Affiliation(s)
- Miriam E van Houten
- Department of Geriatric Medicine, Radboud University Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
- Research Department of Emergency and Critical Care, School of Health Studies, Knowledge Centre of Sustainable Healthcare, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands.
- Trompetter & Partners Social Medical Expertise, Utrechtseweg 75, 3702 AA, Zeist, The Netherlands.
| | - Lilian C M Vloet
- Research Department of Emergency and Critical Care, School of Health Studies, Knowledge Centre of Sustainable Healthcare, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
- Radboud University Medical Centre, Radboud Institute for Health Sciences IQ Healthcare, P.O. Box 9101, 114, 6500 HB, Nijmegen, the Netherlands
| | - Marcel G M Olde Rikkert
- Radboudumc Alzheimer Centre, Donders Insititute of Medical Neuroscience, Department of Geriatrics, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | | | | | | | | | | | - Yvonne Schoon
- Department of Geriatrics, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 114, 6500 HB, Nijmegen, The Netherlands
| | - Sivera A A Berben
- Research Department of Emergency and Critical Care, School of Health Studies, Knowledge Centre of Sustainable Healthcare, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands.
- Radboud University Medical Centre, Radboud Institute for Health Sciences IQ Healthcare, P.O. Box 9101, 114, 6500 HB, Nijmegen, the Netherlands.
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Xu L, Sun H, Xu H, Chen X, Xu Q, Jiang H, Ren L, Wang Y, Dong C. Self-neglect among older adults admitted to a Chinese comprehensive hospital in the COVID-19 pandemic era: a cross-sectional study. J Elder Abuse Negl 2022; 34:241-258. [PMID: 35765770 DOI: 10.1080/08946566.2022.2095319] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study aims to explore the prevalence of self-neglect and associated factors among older adults admitted to the hospital in the COVID-19 pandemic context. The cross-sectional study conducted at a Chinese comprehensive hospital between January and April 2021, 452 older adults were recruited to complete the Abrams Geriatric Self-Neglect Scale, Social Support Rate Scale, FRAIL scale, Barthel index, Patient Health Questionnaire-9, and 10-item Connor-Davidson Resilience Scale. Multivariate logistic regression was used to explore the factors associated with elder self-neglect. The results showed that the prevalence of self-neglect among our sample was 30.3%. Factors that were associated with the risk of elder self-neglect included male, having multiple children (≥4), receiving infrequent visits from children, frailty, and depression. There is a need to screen for self-neglect among older adults admitted to the hospital in the COVID-19 pandemic context. Tailored interventions are warranted to improve the quality of life of older adults.
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Affiliation(s)
- Liuqing Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Geriatric Department, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing, Beijing, China
| | - Huan Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiufang Chen
- Geriatric Department, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiongying Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Jiang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liya Ren
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuxin Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Role and Characteristics of Personal Care Assistants of Frail Older People with Functional Limitations Ageing in Place in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073969. [PMID: 35409652 PMCID: PMC8997560 DOI: 10.3390/ijerph19073969] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 01/01/2023]
Abstract
When older people become frail with functional limitations, and age alone in place, caring support is fundamental for performing daily living activities. The present study aimed to explore the current role and characteristics of privately hired Personal Care Assistants (PCAs) of older people in Italy, in light of the decreasing care availability of the family and the low provision of public services. In the study “Inclusive ageing in place” (IN-AGE), 120 qualitative interviews were carried out in 2019, involving frail older people living at home in three Italian regions: Lombardy, Marche, and Calabria. A content analysis was conducted, in addition to some simple quantifications of statements. Results showed the support of PCAs in 27 cases, mainly when health issues of seniors were referred. In addition, informal and irregular employment contracts were reported. Moreover, a comparison between PCA and Domestic Home Help (DHH, 44 cases), highlighted how they even more provide very similar functions (i.e., home and personal care). The role of PCA emerged as crucial in Italy, especially in the South. Thus, to boost up home services seems necessary for allowing ageing in place, also by integrating PCAs in formal public Long-Term Care (LTC), and by providing incentive systems for regular hiring.
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A Mixed-Methods Analysis of Care Arrangements of Older People with Limited Physical Abilities Living Alone in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412996. [PMID: 34948603 PMCID: PMC8700972 DOI: 10.3390/ijerph182412996] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/25/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Older people with limited physical abilities, who live alone without cohabiting family members, need support ageing in place and to perform daily living activities. In this respect, both the available informal and formal care seem crucial. The present study aimed to explore the current role of the care arrangements of older people, especially if they have functional limitations. Qualitative interviews were carried out in 2019 within the “Inclusive ageing in place” (IN-AGE) research project, involving 120 older people who lived at home, alone, or with a private personal care assistant (PCA) in three Italian regions (Lombardy, Marche, and Calabria). A mixed-methods analysis was conducted. Results showed that support networks are still mainly made up of family members, but also of domestic home help (DHH) and PCAs, friends/neighbours, and public services, albeit the latter provide support in a residual way, while the former is not as intensive as it was in the past. Frequency and geographical/living proximity of help play a role, emerging also as a territorial differentiation. The paucity or absence of support, especially from the family, risks compromising the ability of ageing in place. It seems, thus, necessary to innovate and improve, in particular, home services, also through real formal and informal care integration.
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Cevik C, Ozdemir R, Koran N, Agın A. Prevalence and risk factors for elder abuse: A community-based cross-sectional study from North West Turkey. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01423-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Altendorf A, Draper B, Wijeratne C, Schreiber J, Kanareck D. Neglect of Older People: Touching on Forensic and Pathophysiological Aspects. THE GERONTOLOGIST 2020; 60:e449-e465. [PMID: 31348828 DOI: 10.1093/geront/gnz084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Neglect of older people is common and may result in fatal and nonfatal outcomes. Normal changes of aging and disease-related symptoms may overlap with markers of neglect and lead to under-detection. This review aims to delineate medical, psychiatric, and pathophysiological indicators in the victim-identified in forensic case reports-to point out areas of overlap and raise awareness in Health Care Professionals. RESEARCH DESIGN AND METHODS Medical and forensic databases were searched with the search terms: neglect, elder, elderly, forensic, homicide for detailed case reports on elder neglect. Cases were reviewed as to victim age, sex, medical/psychiatric diagnosis, perpetrator, victim-to-perpetrator relationship, cause of death (if fatal), location of incident, autopsy findings (if fatal), and ancillary studies. A total of 168 publications were retrieved, of these 11 publications, containing a total of 25 cases, yielded sufficient detail on each case to be included in the qualitative analysis. RESULTS Neglect is associated with poor physical, psychological, and mental health. Neglect can be a direct cause of death or contribute to a fatal outcome by exacerbating existing conditions. Red flags of neglect included malnutrition, dehydration, poor hygiene, untreated decubitus ulcers, hypothermia, contractures, and an uncooperative caregiver. However, incontrovertible evidence of neglect is not always easy to obtain due to age and disease-related changes. DISCUSSION AND IMPLICATIONS The findings document the extent and seriousness of elder neglect and highlight the importance of detailed documentation as well as collaboration between clinicians, allied health professionals, law enforcement and medical forensic services to improve patient outcomes and reduce the risk of further incidents.
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Affiliation(s)
- Annette Altendorf
- Older Persons Mental Health Service, Prince of Wales Hospital, Randwick, New South Wales
| | - Brian Draper
- Older Persons Mental Health Service, Prince of Wales Hospital, Randwick, New South Wales.,School of Psychiatry, University of New South Wales, Sydney
| | - Chanaka Wijeratne
- Sydney School of Medicine, University of Notre Dame.,Department of Aged Care Psychiatry, Prince of Wales Hospital, Randwick, New South Wales
| | - Jason Schreiber
- Clinical Forensic Medicine (CFM), Victorian Institute of Forensic Medicine (VIFM), Melbourne.,Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Daniella Kanareck
- Older Persons Mental Health Service, Prince of Wales Hospital, Randwick, New South Wales
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Zawisza K, Galas A, Tobiasz-Adamczyk B, Grodzicki T. Validity of a Self-Reported Neglect Scale Among Older Adults in Poland. THE GERONTOLOGIST 2020; 60:e117-e126. [PMID: 30874295 DOI: 10.1093/geront/gnz014] [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] [Received: 09/20/2018] [Revised: 01/10/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The purpose of the study was to create and validate a tool that could be implemented easily to recognize the presence and assess the level of neglect in community-dwelling older adults, and to provide information about the prevalence of the phenomenon in different subgroups of older adults in Poland. RESEARCH DESIGN AND METHODS The cross-sectional study of elder neglect and self-neglect was conducted in Lesser Poland in 2017. It included 2,443 face-to-face interviews with randomly selected community-dwelling individuals from among the general population (1,635), social service users (280), and hospital patients (528). Classical Test Theory and Item Response Theory (IRT) were used to build the scale, and its content and construct validity and reliability were assessed. RESULTS The Self-Reported Neglect Scale (SRNS) with a 2-factor structure (basic needs and psychological needs dimensions) was created. Results of the IRT analysis showed high item discrimination (2.7-4.8 for the first factor, 0.8-3.2 for the second). The 1-year prevalence of neglect as a percentage of nonzero values of the SRNS was estimated at 11.4%. DISCUSSION AND IMPLICATIONS The SRNS exhibited good psychometric properties. It may have promise as a tool for the assessment of neglect in epidemiological studies as well in the everyday practice of medical professionals and social workers.
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Affiliation(s)
| | - Aleksander Galas
- Department of Epidemiology, Chair of Epidemiology and Preventive Medicine
| | | | - Tomasz Grodzicki
- Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, Krakow, Poland
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Pak M. The prevalence and associated risk factors of elder abuse among older people applied to the family health center in the rural district of Turkey. SOCIAL WORK IN HEALTH CARE 2020; 59:236-256. [PMID: 32208962 DOI: 10.1080/00981389.2020.1740377] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 06/10/2023]
Abstract
In this study, face-to-face interviews were conducted with older people who applied to the family health center (N = 152) in the traditional rural district of Turkey. Although the prevalence rate was 23%, the mean value of "Characteristics of the elder that make him or her vulnerable to abuse" subscale (X̄ = .37) was highest among other subscales. The mean values for "Characteristics of potentially abusive situations" (X̄ = .06) and "Overt violation of personal rights and direct abuse" (X̄ = .05) were quite low. The majority of the elder abuse prevalence was composed of participants who were vulnerable to elder abuse. The rural area makes older individuals vulnerable to abuse. Also, risk factors associated with elder abuse in rural areas were interaction with family (p = .000), interaction with neighbors/friends (p = .001), chronic diseases (p = .002), psychiatric diseases (p = .007), gender and marital status (p = .008), and additional income (p = .028), respectively. The only predictor of elder abuse in rural areas was family interaction. There was a significant negative relationship between rural elder abuse and family interaction (T= -4.239, p < .001).
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Affiliation(s)
- Melike Pak
- Department of Social Work, Atatürk University, Erzurum, Turkey
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