Missing voices: older people's perspectives on being abused in Uganda

Experiences of the Older Adults After Being Abused: A Qualitative Meta-synthesis

Elder abuse is a global public health problem with severe social costs. Research on elder abuse has gradually increased; however, less attention has been paid to older adults' perceptions and experiences of abuse. This review aimed to integrate older adults' perceptions and experiences of abuse to provide a theoretical basis for developing interventions that meet their authentic needs. Six electronic databases were searched to include qualitative studies examining perceptions and experiences of abuse among adults aged 60 years or older, and 22 studies were included. This study used the Joanna Briggs Institute meta-aggregation approach to integrate the qualitative findings, which identified four themes: (a) changes resulting from elder abuse, (b) causes of abuse, (c) barrier factors and facilitating factors to the disclosure of abusive behavior, and (d) adopting different response strategies. The findings revealed that older adults experience persistent physical and psychological burdens and financial stress following abuse. Multiple factors influence the emergence of abuse and older adults search for help from the outside world, especially social support and perceptions of abuse. Older adults can deal with abuse by accepting the status quo or taking steps to change it. These findings have important implications for helping older adults prevent and cope with abuse experiences.

Factors associated with elder abuse and neglect in rural Uganda: A cross-sectional study of community older adults attending an outpatient clinic

BACKGROUND

Elderlies are vulnerable to abuse, and evidence suggests that one in three elderlies experience abuse. Abuse can impact the well-being of older persons, decreasing their quality of life, leading to mental health challenges, and increasing morbidity and mortality rates. Evidence on older person/elder abuse and neglect is vital to facilitate initiatives, but there are fewer studies on elder abuse and neglect in Africa, particularly in Uganda. Thus, this study aimed to determine the prevalence of different types of abuse and neglect, and their associated factors among older persons (aged 60 years and above) attending an outpatient clinic.

METHODS

In this cross-sectional study, information on sociodemographic characteristics, functional impairment using the Barthel Index, and elder abuse severity using the Hwalek-Sengstock Elder Abuse Screening Test were collected. In addition, types of abuse were assessed using questions adapted from the US National Research Council on elder mistreatment monograph. Linear and logistic regression analyses were used to determine the factors associated with elder abuse severity and the different types of abuse, respectively.

RESULTS

Overall, the prevalence of elder abuse was 89.0%. Neglect was the most common type of elder abuse (86%), followed by emotional abuse (49%), financial abuse (46.8%), physical mistreatment (25%), and sexual abuse (6.8%). About 30.4% of the abused elders experienced at least two forms of abuse. Factors associated with elder abuse severity were having a secondary level of education and physical impairment. Moderate to severe functional dependence was associated with almost all forms of abuse. Individuals who reported the presence of a perpetrator were likely to experience neglect, emotional, and physical mistreatment. However, those who reported their perpetrators to the police had a higher likelihood of experiencing emotional abuse but were less likely to experience financial abuse. Emotional abuse was also associated with age above 80 years and attaining education (primary and secondary). Physical impairment and chronic medical conditions reduced the likelihood of experiencing neglect and financial abuse, and physical abuse, respectively.

CONCLUSIONS

Uganda has a high prevalence of elder abuse and neglect. There is a need to design interventions for older adults at risk to prevent elder abuse from escalating further, where the present findings can be worthy of help.

A Model for Effective Nonverbal Communication between Nurses and Older Patients: A Grounded Theory Inquiry

Nonverbal communication is an inevitable art to be effectively mastered by nurses. Nurse nonverbal communication has many benefits when it is effective. For instance, nonverbal communication is important to convey affective and emotional information, and demonstrate respect for and build therapeutic relationships with older patients. As the older population is growing fast worldwide, effective nonverbal communication with older patients is an essential skill for nurses and will improve patients' satisfaction and the quality of care. Therefore, this article presents a model to guide effective nonverbal communication between nurses and older patients. A Grounded Theory approach guided the study. Data were collected between July 2018 and January 2020 through overt participant observations and individual interviews. Purposive and theoretical sampling were used to select 13 clinically experienced nurses, 4 nursing students, and 8 older adults. Data analysis encompassed open coding, axial coding, and selective coding. The results showed that effective nonverbal communication emerged as the co-phenomenon hinged within context and/or environment and is influenced by certain factors. This model, which is in support of person-centered communication and care, advocates for effective nonverbal communication between nurses and older patients.