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	=Risk Factors=		=Risk Factors=
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-	== Caregiver Risk Factors ==
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-	Elder abuse often occurs within one’s own home, in the home of relatives, or in long term care facilities,5 usually within the context of a trust relationship.2 Older adults are commonly quite frail and depend heavily on caregivers which may result in elder abuse<ref name="ONE">Wang, J., Lin, M., Tseng, H. & Chang, W. (2009). Caregiver factors contributing to psychological elder abuse behaviour in long-term care facilities: a structural equation. International Psychogeriatrics, 21(2), 314-320. doi: 10.1017/S1041610208008211</ref> as the caregivers may be experiencing care- related stress, burden and personal problems.2 This may lead to negative emotions or actions towards the elderly individual.2,4 In one study, caregiver-related stress was strongly related to elder abuse as many individuals felt overwhelmed and strained especially if they had a limited resources or where socially isolated, making it harder to cope with the situation.<ref name="ONE">
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-	Although the personal characteristics of the elderly may be linked to abuse, risk factors related to the caregiver are more flexible and should be taken into consideration by health care providers.<ref name="ONE">
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-	Many caregiver characteristics have been reported to have a hand in the incidence of elder abuse such as the age of the caregiver, however literature has been inconsistent on this trait.<ref name="ONE"> It is also possible that caregivers of cognitively impaired elderly blame them for the situation as communication may be difficult and the caregiver may not be able to assess the older individual’s needs.2
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-	Other risk factors involving the caregiver include substance abuse (making it difficult to provide adequate care)23, having a history of violence,3 lack of social support or caregiving help2, inadequate geriatric knowledge and training, education, and hours worked in caregiving environment.<ref name="ONE">
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-	==Elderly Characteristics==
-	In addition to caregiver risk factors, There are many characteristics of the older adult that could be risk factors for elder abuse including behavioural traits, physical impairment, and cognitive impairment.4
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-	===Behavioural Risks===
-	It is important to note that elder abuse may be a reciprocal process between the caregiver and the older individual. Some older individuals may elicit provocative or aggressive behaviour (verbal or physical), usually in the presence of dementia, which results in the caregiver responding in a similar manner.2,4 Furthermore, the elderly may also try to resist care which could put the caregiver in a difficult situation because if they do not force care, any accidents can be attributed to negligence. On the other hand, giving care against the individual’s wishes may be seen as abuse.4,5
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-	===Physical Impairment===
-	Those who are limited in their physical functioning are at a higher risk of elder abuse mainly because they need more contact with their care providers on a daily basis, providing more opportunities for elder abuse to transpire. This occurs particularly if the provider is overworked from the higher demands that physical impairments bring.4
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-	===Cognitive Impairment===
-	Studies have shown mixed results on cognitive impairment as a risk factor for elder abuse.234 Most researchers found that it was not the cognitive impairment but the pattern of cognitive deterioration which is correlated with elder abuse.23 It is possible that cognitive impairment could become a risk factor when combined with behavioural factors or physical impairment.4 Finally, cognitive disorders may create a communication barrier between the older individual and the caregiver, leading to unsuitable interactions.24
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-	==The Physician's Role==
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-	Physicians are in the best position to identify and report elder abuse. However, instances of mistreatment are often not caught or reported due to numerous reasons. First, physicians may adapt an ageist bias in which the elderly are valued less. They may also be unwilling to become involved with the authorities. Furthermore, the elderly may not report abuse as they may fear a negative reaction from the abuser, who may insist on being present during the visit. Placement in long term care facilities may also be a factor as it is the physicians’ or health care providers’ job to make sure the patient is safe. However, the elderly are more prone to injurious accidents, adverse drug reactions and cognitive disorders, and the emergence of these may result in blaming the health care providers with abuse or neglect.
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-	===Neglectful Treatment===
-	Health care providers may undertreat the older individual due to their ageist perspective, resulting in the patient being deprived of the necessary treatment despite the fact that it could improve their condition. On the other hand, overtreatment can also occur, where the physician gives the older adult a form of therapy not yet tested in the elderly, which has no chance of improving the condition and may actually be harmful.
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-	Unsuitable treatment may be a result of the physician’s uneasiness with the situation, lack of geriatric knowledge, and low reimbursement rate per visit.5
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-	==Notes and References==
-	<references/>

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Revision as of 13:44, 30 October 2011

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Risk Factors