[Validation of a prevention and detection procedure for physical and economic abuse of the elderly]

INTRODUCTION

The study carried out for the «Physical and economic abuse sign detection procedure for the elderly in the Basque Country» Pilotage and Validation is described. There barely exist appropriate and validated tools to assist the issue, and the existing ones are hardly adequate for people with cognitive deterioration; therefore, the issue's both visibility in our society and professional intervention are strained. The proposed procedure is a composed by screening tool that determines a likelihood of abuse and an evaluation of signs for determining the abuse practice. It is intended to be used in the social area as well as the sanitary one by any professional. It is composed of two questionnaires: one of risk-factor valuation and a second one concerning indicators based on three severity levels.

METHODOLOGY

Both quantitative and qualitative methodologies were used. The sample was made of 649 elders: 596 evaluated by the risk-factor questionnaire, 138 by the indicators questionnaire, and 85 evaluated by both; 94 professionals from several backgrounds (sanitary, social and economic) participated. Eight of the detected cases were checked by the team of experts that elaborated the procedure; the sessions were analysed after their transcription.

CONCLUSIONS

The procedure has been validated as sensitive for its goal, being equally valid for the social and health areas. It can be used by any professional, although some differences have been detected. As regards the ability to differentiate items and the final evaluation of the severity of the situation, some changes and corrections have been proposed.

[Three years experience in the detection and follow-up of violence against the elderly in a tertiary hospital]

OBJECTIVES

The Hospital Clínico San Carlos Committee against violence established a protocol in 2012 in order to detect and follow-up violence against elderly persons. This article presents the experience after 3years of its introduction, as well as an analysis comparing the differences between those younger and older than 65years of age.

MATERIAL AND METHODS

All cases were collected during years 2013, 2014, and 2015, and were divided into two groups, A and B, according to age, younger or older than 65years. Parameters studied were: gender, place of detection (emergency department, during hospital admission, or outpatient clinics), type of professional worker who detected each case (social workers, nurses, or physicians), previous history of violence, type of aggression (physical, psychological, financial), institutional procedures once aggression was confirmed, and deaths after one year of follow-up. The SPPS v.18.0 package was used for the statistical analysis.

RESULTS

A total of 172 cases were detected, of which 140 of them were included in groupA (<65years), and 32 in groupB (>65 years, 22.8%). Gender: GroupA: women: 93.5%. GroupB: women: 78.1% (P=.014). Registration site: GroupA: emergency department: 90.7%, hospital wards: 6.4%, outpatient wards: 3.0. GroupB: emergency department: 65.6%, hospital wards: 31.6%, outpatient wards: 2.8% (P=.001). Notification: GroupA: social worker: 25%, physician: 67.8%, nurse: 6.4%. GroupB: social worker: 65.2%, physician: 28.1%, nurse: 6.2% (P<.001). Previous violence history: GroupA: 62.1%. GroupB: 68.7%. Type of abuse: GroupA: physical: 56.4%, psychological: 2.8%, physical +psychological: 30.4%, physical +psychological +economic: 10.1%. GroupB: physical: 31.1%, psychological: 5.1%, neglect: 18.7%, physical +psychological: 10.1, physical +psychological +economic: 9.8, economic: 25.1 (P<.0001). Resources employed and follow-up: Injuries: Group A: 63.5%. Group B: 31.2% (P=.001). Judicial protection measures: GroupA: 12.8. GroupB: 15.6 (P=.773). Removal order: GroupA: 2.1. GroupB: 6.25 (P=.235). More than one-third of patients in groupB, and none of the patients in groupA, died in the year of follow-up.

CONCLUSIONS

There are more problems detected in the Emergency Department. There is a history of previous violence in more than half of the cases in both age groups. The profile of the victim is an elderly woman with significant physical and cognitive impairment. Economic abuse and neglect are more frequent in the elderly population. In our series, more than one-third of elderly patients who are victims of ill-treatment die each year. The hospital registry is fundamental for the detection and follow-up of abuse in the elderly.

[Prevalence of elder abuse in Spanish dwelling in community]

BACKGROUND AND OBJECTIVE

Although elder abuse is not a new phenomenon, it remains hidden. There have been carried out various preliminary studies about the prevalence of elder abuse in different countries. The aim of this study is to estimate the prevalence of suspicion of elder abuse in old persons without cognitive impairment, dwelling in community, who were attended in Primary Health Care or Social Services Centres.

PATIENTS AND METHOD

We carried out a transverse study in which 340 elders participated.

RESULTS

We found a 12.1% prevalence of suspicion of elder abuse. Psychological abuse suspicion was the most frequent type and it was very common the simultaneous presence of different types of abuse (psychological and physical and sexual). The suspicion of elder abuse was more frequent in women and spouses were responsible in a high great frequency.

CONCLUSIONS

The information obtained allows advancing in the knowledge of elder abuse in Spain, where the research about this issue is poor. However, the prevalence found neither has to be considered as a social alarm nor as a social slackness.