Intervening to reduce elder abuse: challenges for research

Creating opportunities to improve detection of older adult abuse: a national interRAI study

Despite being recognized as a major global health issue, older adult abuse (OAA) remains largely undetected and under-reported. Most OAA assessment tools fail to capture true prevalence. Follow up of patients where abuse exposure is not easily determined is a necessity. The interRAI-HC (International Resident Assessment Instrument—Home Care) currently underestimates the extent of abuse. We investigated how to improve detection of OAA using the interRAI-HC. Analysis of 7 years of interRAI-HC data from an Aotearoa New Zealand cohort was completed. We identified that through altering the criteria for suspicion of OAA, capture rates of at-risk individuals could be nearly doubled from 2.6% to 4.8%. We propose that via adapting the interRAI-HC criteria to include the "unable to determine" whether abuse occurred (UDA) category, identification of OAA sufferers could be substantially improved. Improved identification will facilitate enhanced protection of this vulnerable population.

From Need to Policy: Community Supported Development and Implementation of the South Carolina Vulnerable Adult Guardian Ad Litem (SC VAGAL) Program

Adult guardian ad litem programs are a necessary public service to protect adults from abuse and neglect. This article describes the development and implementation of an adult guardian ad litem program. We discuss the program's impetus, pilot testing, evaluation, and implementation of the program. Our experience highlights the vital role of diverse inter-sectoral stakeholders. Furthermore, the development process highlights the need for flexibility in program development, tension negotiation among stakeholders, and engagement of aging stakeholders in nontraditional arenas.

Violência contra idosos em um município do sul de minas gerais: uma análise documental

Objetivo: analizar los casos de violencia contra ancianos en un municipio del sur de Minas Gerais (Brasil), en un periodo de 13 años. Materiales y método: estudio cuantitativo, retrospectivo, documental y analítico, que utilizó datos del Consejo Municipal del Anciano. La recolección de los datos referentes al periodo de 2004 a 2016 se dio en el primer semestre de 2017. Para el análisis de tendencia de los casos de violencia, se empleó la regresión lineal simple. Resultados: se registraron 389 denuncios; sin embargo, solo 273 caracterizaban denuncios de violencia contra el adulto mayor. En cuanto al agresor, el 39,56 % era de sexo masculino y el 43,59 % eran hijos de las víctimas. En relación con el tipo de violencia, se destacó la negligencia (34,80 %), seguida de la violencia psicológica (16,12 %) y financiera (8,79 %). Se evidenció una relación estadísticamente significativa entre el sexo de la víctima (p = 0,017), la relación entre víctima y denunciante (p < 0,001) y la relación entre víctima y agresor (p < 0,001), con el tipo de violencia. Conclusión: la violencia contra el adulto mayor en tal municipio implica, sobre todo, a los familiares de los individuos. Hay necesidad de capacitar a los profesionales que atienden estos casos y hay que elaborar una herramienta completa y estandarizada para el registro de incidencias y ampliación de investigaciones en el área, con el fin de que se implanten acciones que combatan la violencia contra el anciano.

Older adults abuse in three Brazilian cities

ABSTRACT Objective: To analyze the police reports filed by older adults who suffered abuse in order to identify the socio-demographic characteristics of victims and aggressors, type of violence, location, as well as to compare rates in three Brazilian cities in the period from 2009 to 2013. Method: Ecological study, in which 2,612 police reports registered in Police Stations were analyzed. An instrument was used to obtain data from the victim, the aggressor and the type of violence. Results: Psychological abuse predominated and most cases occurred in the older adults own home. In the cities of Ribeirão Preto and João Pessoa, the older adults presented similar rates for both gender. Regarding the standardized rates, in João Pessoa, there was a rise of this type of abuse in the two first years, and later there was a certain stability. In the city of Teresina, there was an increase, also observed in the city of Ribeirão Preto in the three first years, followed by a decrease. Conclusion: Older adults abuse is a cultural phenomenon difficult to be reported by them, since it occurs in the family context.

Complicated Dementia: Teaching Caregivers to Recognize Signs and Take the Next Steps

Older adults who exhibit extreme behaviors present a complex diagnostic and management picture for home healthcare clinicians and family caregivers. This case study describes the situation of Mrs. M, whose aggressive, combative behavior was so difficult for her children to comprehend and manage, she was secluded in a locked basement of her home. This article details assessment techniques, symptom presentation and possible diagnostic implications, as well as resources for caregivers.