Prevalence and factors associated with caregiver abuse of elderly dependents: The hidden face of family violence

Giving meaning to internalized violence throughout life by older adults living in rural areas

OBJECTIVES

to understand the meanings of violence internalized throughout life by older adults living in rural areas.

METHODS

a qualitative study, anchored in the Symbolic Interactionism theoretical framework and the Grounded Theory methodological framework in the constructivist aspect. Data collection occurred through individual interviews. Data were coded using the Atlas.ti software.

RESULTS

it was possible to identify that the context of rural areas strengthens patriarchy culture as well as contributing to violence silence and naturalization. It was also found that violence is a product of social inequality and gender inequality.

FINAL CONSIDERATIONS

older adults living in rural areas internalized the violence suffered in a unique way, and this scenario's specific aspects can increase intra-family abuse, as there is a patriarchal culture that promotes social and gender inequality.

The Evaluation of a Domestic Abuse Response Team Program in an Emergency Department

Purpose

Domestic abuse (e.g., family violence) occurs globally and increases the risk for lifelong adverse health outcomes for all members involved. Although victims of domestic abuse often refrain from seeking support due to various reasons (e.g., fear), health centers such as emergency departments (EDs) can serve as outlets for assistance. The Domestic Abuse Response Team (DART) is a program working collaboratively with a regional hospital center in Alberta, Canada, uniquely providing immediate, expert, and patient-oriented services (e.g., safety plans) to domestic abuse victims within the ED. This study aimed to evaluate the DART program by: (1) using administrative data to characterize ED and DART patient characteristics and (2) examining staff perceptions about DART's operations, effectiveness, challenges, and improvements.

Methods

A mixed-methods approach was used to collect data from April 1st, 2019 to March 31st, 2020. Quantitative data consisted of descriptive statistics on patient and staff characteristics and qualitative data was collected through two surveys to determine perceptions of the DART program.

Results

Approximately 60% of ED patients were screened for domestic abuse and 1% were referred to DART, of which 86% were female. All referrals received support within an hour and were provided patient-oriented assistance. Qualitative data revealed that the DART program offers important support to patient victims, increases comfort around dealing with domestic abuse, and decreases ED staff workloads.

Conclusions

The DART program offers valuable support to domestic abuse victims. Staff reported that DART is effective in providing victims with immediate care and services while also supporting ED staff.

Lived experience of domestic violence among men with Parkinson's disease: A qualitative study

OBJECTIVES

To explore possible forms of domestic violence suffered by men with Parkinson's disease (PD).

METHODS

A qualitative study was conducted through face-to face interviews, followed by a conceptual content analysis. Forms of violence were predetermined as code categories according to a classification of mistreatment and a lack within Maslow's hierarchy of needs. Data triangulation was performed by two researchers using the "long table" method according to Krueger & Casey.

RESULTS

Eleven men with PD were interviewed to identify experienced forms of domestic violence. Since PD, the men felt neglected by their partners, lived in the fear of the partner's reactions, described a mutual sexual and physical distance, suffered from mockeries, humiliations, physical violence, and had a feeling of abandon while facing and managing PD.

CONCLUSIONS

Domestic violence against men with PD exists and should be screened during communication with healthcare professionals.

PRACTICE IMPLICATIONS

Domestic violence has different faces and is not always identified by the victims themselves. Spouses with profiles at risk for domestic violence against men with PD should be identified. Domestic violence can be triggered by female gender, alcoholism, anxiety and depression, a low educational level, low interest in and low knowledge about PD.

Psychometric Properties of the Zarit Burden Interview in Informal Caregivers of Persons With Intellectual Disabilities

Intellectual disability leads to a loss of autonomy and a high level of dependence, requiring support from another person permanently. Therefore, it is necessary to incorporate the assessment of caregiver burden in healthcare actions, to avoid putting the health of caregivers and patients at risk. In this sense, the study aimed to analyze the internal structure of the Zarit Burden Interview (ZBI) in a sample of caregivers of people with intellectual disabilities, to provide convergent and discriminant evidence with a measure of the risk of maltreatment, and to estimate the reliability of the scores from the Classical Test Theory and the Rasch Measurement Theory. The study was instrumental. The sample consisted of 287 Peruvian informal primary caregivers of persons diagnosed with intellectual disabilities. To collect validity evidence, the internal structure (confirmatory factor analysis, CFA) and the relationship with other variables (convergent and discriminant evidence) were used, while reliability was estimated through the omega coefficient and Rasch analysis. The internal structure of the ZBI corroborated a unidimensional structure. In terms of convergent and discriminant evidence, the scale presents adequate evidence. Reliability levels were also good. Previously, the psychometric properties of the ZBI have not been studied in caregivers of people with intellectual disabilities, and it represents the first study of the scale in Peru. The results obtained will allow the use of this scale to design actions in the work with caregivers and studies to understand the psychology of the caregiver.

Violence against caregivers of older adults with chronic diseases is associated with caregiver burden and depression: a cross-sectional study

BACKGROUND

Caregivers play a vital role in caring for the aging population, however the occurrence of violence against the caregiver is an increasing area of concern. This study aimed to investigate the prevalence of violence against the primary caregivers of community dwelling older adults with chronic diseases, and to determine the factors associated with violence and its association with caregiver outcomes.

METHODS

A cross-sectional study was conducted. HITS questionnaire, the 22-item Zarit Burden Interview and Patient Health Questionnaire-9 were used to assess violence against caregiver, caregiver burden and depression, respectively.

RESULTS

Out of 123 caregivers of older adults, the overall prevalence of violence was 28.46%. Independent variables which could be the protective factors for violence against caregiver included higher ADL, older age of caregiver, and being a relative. The patient characteristic that is a potential risk factor for violence against caregiver was having cancer as a principal diagnosis. Statistically significant associations were found between violence and caregiver burden (aOR 4.94, p 0.004) and depression (aOR 7.03, p 0.006).

CONCLUSION

Violence against caregivers of older adults is not uncommon. Experiencing violence was found to be associated with caregiver outcomes including depression and caregiver burden. Therefore, this important issue must not be ignored.

Factors associated with the risk of violence against older adult women: a cross-sectional study

Objective:

to identify the factors associated with the risk of violence against older adult women.

Method:

this is a quantitative, analytical, and cross-sectional research conducted with 122 older adult females in the city of Recife, state of Pernambuco, Brazil. Data collection was carried out using validated instruments adapted to Brazil. The analysis was performed using descriptive statistics (absolute and relative frequency) and inferential statistics (Pearson’s chi- square, Spearman’s correlation test, and Multiple Logistic Regression).

Results:

there was prevalence of a risk of abuse against older adult women under 70 years of age, literate, without a stable relationship, living alone, without any work activity, and who had an income higher than the minimum wage. There is a significant association between the risk of violence among older women with a higher number of chronic health conditions (24; 77.4%), and who are less active in advanced activities (42; 70.0%). A reduction in quality of life and satisfaction with life, and the onset of depressive symptoms, increase the risk of violence.

Conclusion:

multimorbidity, low functional capacity, depressive symptoms, low quality of life and low satisfaction with life, a high number of chronic conditions, depressive symptoms, and functional dependence to perform daily activities can be conditioning factors for the emergence of abuse against older adults.

Household characteristics of persons with complex care needs in the community: A preliminary study

Aim

To identify the characteristics of households of persons with complex care needs and clarify the care period length required to resolve their primary health issues.

Design

A descriptive cross-sectional study design.

Methods

We collected registered data and nursing records from 155 households living in City A within the Tokyo Metropolis. They were designated as complex care cases by the home care and life support centre and needed a multidisciplinary approach to care from April 2018-July 2019.

Results

Most households comprised an elderly with a single adult child (N = 47, 30.3%). Mental illness and economic distress overlapped as the most common issues. The mean length of care period was 147.7 days (SD = 120.6). The log-rank test showed that single persons took significantly less time to resolve their primary health issues than elders with single-child households or single-person <65-year-old households.

Mediação de conflito: soluções propostas em atendimento a casos de violência contra a pessoa idosa

Resumo Objetivo Descrever os motivos da violência contra pessoas idosas e as soluções propostas na mediação de conflito em um ambulatório especializado em geriatria e gerontologia do Distrito Federal, Brasil, entre os anos de 2008 a 2018. Método Estudo retrospectivo, documental, descritivo, com abordagem quantitativa, desenvolvido através da análise de informações obtidas em livros-ata da unidade, com registro de reuniões de mediação de conflito de casos de violência contra a pessoa idosa. A coleta abrangeu os motivos de violência contra a pessoa idosa e as soluções propostas na mediação de conflitos. Resultado: Foram analisados 111 casos. Os principais motivos da violência foram: sobrecarga do cuidador principal (77,4%); filhos acharem que os pais idosos eram capazes de se cuidarem sozinhos (27%); ressentimento dos filhos para com o idoso (24,3%); e desconhecimento da doença do idoso (14,4%). As principais soluções propostas foram: acompanhamento regular com médico (82,8%), assistente social e/ou psicólogo (58,5%); comprometimento de todos os filhos com a divisão dos cuidados e despesas dos pais idosos (52,2%); introdução da pessoa idosa em atividades sociais da comunidade (27%); e contratação de um cuidador formal (24,3%). Conclusão A sobrecarga do cuidador foi o principal motivo de conflito encontrado e as propostas apontadas se relacionavam a maior necessidade de cuidados em saúde com a pessoa idosa e seu cuidador, acerca disto, percebeu se a importância da disponibilidade de uma equipe multidisciplinar frente as situações de violência. A mediação de conflito permitiu o estabelecimento de estratégias reais e direcionadas para alcance de resultados frente aos casos de violência.

Violência contra a pessoa idosa no município de Campinas, São Paulo, nos últimos 11 anos: uma análise temporal

Resumo Objetivo Analisar as notificações dos casos de violência contra a pessoa idosa, no período de 2009 a 2019, através de dados obtidos no Sistema de Notificação de Violência (SISNOV) no município de Campinas, Estado de São Paulo, Brasil. Método Trata-se de uma pesquisa epidemiológica de abordagem quantitativa, descritiva e tendência temporal. Para as análises das notificações seguiu-se a observação das informações de acordo com as variáveis sociodemográficas, característica da violência e de seu agressor; e no tocante a análise temporal anual: faixa etária, tipos de violência, meio de agressão e sexo do autor. Resultados 1.217 idosos sofreram agressões, sendo que deste total (69,5%) eram do sexo feminino, com predomínio na faixa etária entre 60 a 69 anos (35,8%), viúvas (37,7%) e de cor branca (64,4%). O tipo mais prevalente de violência foi a negligência (33,1%), sendo a residência (92.9%) o local de maior ocorrência. O principal autor das agressões era do sexo masculino (55,6%), o meio utilizado para praticá-la foi a força corporal (24,4%). A análise de tendência temporal evidenciou aumento de: faixa etária: 60-69 anos, violência física, meios utilizados para a sua prática: força corporal, objetos e envenenamento, e sexo do agressor: ambos. Conclusão Os resultados obtidos foram ao encontro de outras pesquisas, indicando uma tendência no perfil das vítimas e agressão, salienta-se ainda a importância desse grupo conhecer os seus direitos e serem incentivados a realizar as denúncias, bem como os profissionais de saúde, para que se elaborem políticas públicas cada vez mais eficazes para o enfrentamento dessa questão.

The prevalence and associated risk factors of elder abuse among older people applied to the family health center in the rural district of Turkey

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).

Factors associated with depressive symptoms and cognition in elderly victims of violence

ABSTRACT Objective: To identify, among elderly people victims of violence, factors associated with depressive symptoms and cognitive function. Method: This was a cross-sectional study carried out with 56 elderly people classified in situation of violence. To do so it was used the Brazil Old Age Shedule (BOAS), the Conflict Tactics Scales Form R, the Geriatric Depression Scale (GDS) and the Mini-mental State examination (MMSE). Results: Depressive symptoms were more predominant in elderly men, over 70 years old, without partner, illiterate, with no job, receiving up to 1 minimum wage and who lived alone; and the cognitive deficit prevailed in women, over 70 years old, without partner, illiterate, who did not work, receiving up to 1 minimum wage and who lived alone. Conclusion: Among the elderly population victim of violence, lack of a partner and cognitive impairment were associated to depressive symptoms; and finding themselves living alone, with no partner and being illiterate were associated to cognitive deficit.

Intervenções fisioterapêuticas direcionadas à pessoa idosa em situação de violência: uma revisão de escopo

Resumo Objetivo Identificar as intervenções fisioterapêuticas direcionadas à pessoa idosa em situação de violência. Método Trata-se de uma revisão de escopo, em que foram acessadas as seguintes bases de dados/bibliotecas/buscadores e literatura cinzenta: BVS, PubMed, Web of Science, Scopus, CINAHL, PEDro, BDTD, OpenGrey, OpenThesis, RCAAP, Portal de Teses e Dissertações da CAPES, DART-Europe E-theses Portal e Theses Canada Portal. As buscas utilizaram os descritores e palavras-chave, que foram combinados por meio dos operadores booleanos OR e AND: Fisioterapeutas, Fisioterapia, “Physical Therapists”, Physiotherapy, “Physical Therapy”, “Physical Therapy Specialty”, “Physical Therapy Modalities”, Rehabilitation, Reabilitação, “Elder Abuse”, “Maus-tratos ao Idoso”, “Physical Abuse”, “Elder Neglect”, “Aged Abuse” e “Elder Mistreatment”. Resultados Dos 601 registros encontrados, 46 foram excluídos por serem duplicados, sendo selecionados 555 para leitura dos respectivos títulos e resumos. Foram excluídas 548 publicações por não se adequarem aos critérios de inclusão, sendo pré-selecionados 7 trabalhos. Pela estratégia Snowballing um foi identificado, originando um resultado final de 8 estudos. Conclusão As intervenções fisioterapêuticas direcionadas à pessoa idosa em situação de violência compreendem: educação em saúde, medidas no estresse do cuidador, recursos comunitários, rastreamento/triagem, avaliação, identificação, plano terapêutico/reabilitação e denúncia. Diante dos achados, observa-se que, apesar da lacuna no conhecimento dessa temática, o fisioterapeuta desempenha um papel imprescindível na condução de casos de violência contra a pessoa idosa.

Profile of aggressors of older adults receiving care at a geriatrics and gerontology reference center in the Distrito Federal (Federal District), Brazil

Abstract Objective: To profile aggressors of older adults who receive care at a reference center in geriatrics and gerontology in the Distrito Federal (Federal District), Brazil, from 2008 to 2018. Method: A retrospective, documentary, descriptive study with a quantitative approach was performed, based on information obtained from the minutes book of the unit, which contained a record of mediation meetings of cases of conflict and violence against older adults, carried out by social workers, nurses and other members of the multidisciplinary team. The data collection instrument covered the sociodemographic characteristics of the aggressor, the sociodemographic and health profile of the older adults and the type of violence suffered. Result: 111 cases were analyzed. The children of the older adults were the main aggressors (72%), with a prevalence of men (62%) and the from 51 to 60 year age group (37%). The older adults who suffered violence were predominantly women (72%), almost half of whom were aged 81 to 90 years, followed by those aged 71 to 80 years (39%). A total of 16% of the older adults lived with their children or close family members. The main types of violence evidenced were negligence (56%) and psychological violence (29%), with physical violence representing 8% of cases. Conclusion: The study of the profile of the aggressor and the older adult who suffered violence reinforced the need to focus actions within family arrangements. Investigations that address those who practice violence can contribute to the promotion of public health policies and contribute to geriatric and gerontological clinical practices that combat violence against older adults.