Elder Abuse Detection and Intervention: Challenges for Professionals and Strategies for Engagement From a Canadian Specialist Service

Exploring undergraduate elder abuse education in nursing: a scoping review

One in six adults aged 60 and older experiences abuse annually, revealing a prevalence rate of 15.7%. However, knowledge gaps persist regarding the integration of elder abuse education into nursing curricula. The purpose of this scoping review is to fill the gap in understanding how elder abuse is currently taught to undergraduate nursing students, what methods are employed, and what impact these methods have on students' preparedness. A search across CINAHL, Google Scholar, Medline, and PubMed identified 10 relevant studies (2013-present) in English. These studies, encompassing 3,207 undergraduate nursing students, utilized diverse methodologies, focusing on undergraduate nursing education and elder abuse. Limited understanding of elder abuse among undergraduate nursing students is evident, primarily due to inadequate curriculum integration. Various teaching methods, including simulations and participative approaches, show promise in addressing this gap. This scoping review emphasizes the urgent need for enhanced elder abuse education in undergraduate nursing programs. The identified knowledge gap underscores the importance of active teaching methods, especially through simulation integration. Further research is essential to establish a robust evidence base in this critical area.

Disclosure and Reporting of Abuse Against Older Adults: Perspectives of Older Adults with Abuse Histories and Service Providers in Alberta, Canada

This exploratory qualitative study seeks to understand the barriers and facilitators of disclosure and reporting of abuse against older adults by conducting interviews with older adults with lived experience of abuse and service providers working directly with this population in Alberta, Canada. Thematic analysis revealed three key themes: (1) Barriers to disclosure and reporting of abuse; (2) Facilitators to disclosure and reporting; and (3) Key tensions between service providers' and older adults' perceptions of the disclosure and reporting process. Based on these findings, we offer recommendations to increase awareness, promote disclosure, and improve services for older adults experiencing abuse.

Managing abusive experiences: a qualitative study among older adults in Sweden

Background

Elder abuse is prevalent, and is associated with poor health outcomes. How an older adult is affected by abusive experiences is dependent on myriad factors, including aspects of the abuse itself, other life circumstances, coping strategies, and what kind of help the older adults receive to manage the experience. In this study, we sought to investigate how older adults themselves describe how they manage abusive experiences. An increased understanding of this could help to tailor society’s response to older adults suffering from abuse.

Method

Participants (n = 30) were recruited from patients admitted to one acute geriatric and one acute internal medicine ward at a university hospital in Sweden. Patients over the age of 65 who reported experiences of elder abuse or who reported that they were still suffering from abuse that had occurred earlier in life were included. In-depth qualitative interviews were conducted, transcribed verbatim, and analyzed using qualitative content analysis.

Results

The analysis resulted in five themes, three pertaining to strategies used to manage abusive experiences (self-reliant coping, restoring dignity in relation to others, and needing formal and informal help) and two pertaining to the disclosure process (inner resistance to disclosure, and external barriers and facilitators for disclosure).

Conclusion

Older adults were found to use a combination of different strategies to manage abusive experiences. Some were self-reliant, but older adults often managed their experiences with the help of others. Health care professionals were generally in a position to facilitate disclosure, but some participants reported poor encounters with health care. The findings indicate a need to facilitate disclosure by, for example, training professionals on issues related to elder abuse and developing more easily navigated response systems that can respond to the complex needs of older adults trying to manage abusive experiences.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-022-03143-y.

Development and validation of REAGERA-P, a new questionnaire to evaluate health care provider preparedness to identify and manage elder abuse

BACKGROUND

Elder abuse is prevalent and associated with morbidity but often goes unnoticed in health care. Research on the health care response to victims calls for valid measurements. This article describes the development and validation of a questionnaire to evaluate health care provider preparedness to care for older adults subjected to abuse, the REAGERA-P (Responding to Elder Abuse in GERiAtric Care - Provider questionnaire).

METHOD

REAGERA-P was developed in phase I. The questionnaire includes a case vignette, self-efficacy scales for identifying and managing elder abuse cases and cause for concern as well as organizational barriers when talking with older patients about abuse. Content validity was ensured by a review committee, and cognitive interviews were conducted to ensure face validity and to examine cognitive processes to ensure comprehension. REAGERA-P was then administered to health care providers (n = 154, response rate 99 %) to test for construct validity. Factor analysis was performed, and internal consistency was tested for the self-efficacy scales. Convergent validity was tested by investigating associations between relevant variables. Some items were revised in phase II, and new cognitive interviews were performed. Parts of the questionnaire were tested for responsiveness by administering it to medical interns (n = 31, response rate 80 %) before and after an educational intervention.

RESULTS

REAGERA-P showed good content and face validity. The factor analysis revealed two factors: one for asking questions about abuse (Cronbach's α = 0.75) and one for managing the response to the questions (Cronbach's α = 0.87). Results suggest good convergent validity for the self-efficacy scales and for questions about cause for concern and organizational barriers. The responsiveness of the self-efficacy scales was good: the mean on the scale for asking questions (range 0-30) was 15.0 before the intervention and 21.5 afterwards, the mean on the scale for managing the response (range 0-50) was 22.4 before the intervention and 32.5 afterwards.

CONCLUSION

REAGERA-P is a new questionnaire that can be used to evaluate health care provider preparedness to identify and manage cases of elder abuse, including educational interventions conducted among staff to improve health care responses to victims of elder abuse. This initial testing of the questionnaire indicates that the REAGERA-P has good validity.