Elder Abuse-The Current State of Research in South Africa

Cumulative Trauma Exposure and Post-Traumatic Stress Symptoms among Older Adults in South Africa: Does Post-Traumatic Growth Moderate this Link?

The study explored the interplay between PTG and PTSS in older South African adults exposed to trauma. A quantitative cross-sectional design was employed. 195 participants from a low-resourced setting in South Africa were interviewed using the UCLA Life Adversities Screener, the PTSD Checklist (DSM-5), and the PTG-Inventory. Hayes Model SPSS Macro PROCESS for moderation was used. Overall, the relationship between cumulative trauma exposure and PTSS was moderated by the PTG level (b = -0.09, SE = 0.04, p = .0113). The findings suggest that cumulative trauma exposure is a significant predictor of PTSS, and the relationship is moderated by the threshold level of PTG. Higher levels of PTG mitigated the effect of cumulative trauma exposure on PTSS.

“A frightening experience, especially at our age”: Examining the neglect and abuse of older persons in HIV prevention and care programs

Background

As the global population ages and the HIV pandemic matures, a growing number of older persons aged ≥50 years are becoming increasingly vulnerable to acquiring HIV. Unfortunately, older persons are often neglected and left out of sexual health programs and services. This study explored the experiences of older persons living with and without HIV in accessing prevention and care services and how those experiences translate into the neglect and abuse of older persons. The study also explored older people's perspectives on community responses to HIV in older people.

Methods

This qualitative analysis used data from 37 individuals who participated in focus group discussions conducted in 2017/2018 across two communities in Durban, South Africa. Using an interview guide and thematic content analysis, salient themes regarding attitudes to HIV in older persons and factors of access to HIV prevention and cares services for older persons were analyzed.

Results

The study participant's mean age was 59.6 years. Major themes emerging from the data included factors impacting HIV prevention and transmission in older people; community responses to HIV contributing to the abuse of older people, and structural drivers of abuse in older people living with HIV (OPLHIV). Knowledge about HIV and how to protect themselves from HIV was limited among participants. Older persons were frightened to acquire HIV at an older age as they feared judgment and discrimination for getting HIV at that age. OPLHIV reported frequently experiencing community stigma and poor staff attitudes and practices at health facilities, such as a triage health delivery system that fueled community stigma. Participants also experienced neglect, verbal and emotional abuse at healthcare facilities.

Conclusion

Although there were no reports of physical and sexual abuse of older persons in this study, this study shows that despite decades of HIV programs in the country, HIV-related stigma, discrimination, and disrespect of older persons remain pervasive in the community and at health facilities. As an increasing number of people age and live longer with HIV, the neglect and outright abuse of older persons need urgent policy and program interventions.

Prevalence of abuse among the elderly population of Syangja, Nepal

Background

Elder abuse is recognized as a serious public health concern and top priority aging issues. World Health Organization reported that around 1 out of 6 old people in the world experienced some form of abuse. This study was carried out to find out the prevalence of different forms of abuse among elderly Nepalese people.

Methods

The cross-sectional, quantitative analytical study was carried out among 373 elders of the Syangja district of Nepal. The study population was selected through simple, proportionate, and systematic sampling methods. Data was collected through face-to-face interviews using a structured questionnaire.

Results

The majority of participants were female (54.5%). The prevalence of elderly abuse was found to be 54.5%. The most common form of abuse among the elderly population was neglect (23.1%), psychological abuse (20.6%), physical abuse (6.5%), financial abuse (2.4%), and sexual abuse (1.9%). Elderly females were significantly more likely to experience physical and psychological abuse.

Conclusion

More than half of the elderly experienced at least one form of abuse. Neglect was found to be the most common form of abuse. The abuse was prevalent among elderly who were ill and with the habit of tobacco and alcohol consumption.

Protective effects of neighborhood community factors on elder abuse in India

Elder abuse impacts one in six older persons globally. Most studies of elder abuse have focused on risk factors rather than protective factors, individual-level factors rather than structural factors, and developed countries rather than developing countries where resources are scarce. The current study addressed these gaps by examining whether neighborhood social cohesion and physical order could be such structural-level protective factors for older persons in India. Our cohort consisted of 541 participants aged 60 and over in the pilot wave of the Longitudinal Aging Study in India. We found that older persons with high neighborhood social cohesion were 38% less likely to experience abuse compared to older persons with low cohesion (OR = 0.62, 95% CI = 0.39-0.99). Similarly, participants with high neighborhood physical order were 48% less likely to experience abuse compared to older persons with low physical order (OR = 0.52, 95% CI = 0.32-0.83). Both models adjusted for relevant covariates. Policies supporting greater cohesion and order in communities could reap significant health benefits for older persons.