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	=What is Elder Abuse?=		=What is Elder Abuse?=
-	Elder abuse is becoming an increasing field of research as the 'baby boomers' reach old age. As the population of elderly people increases so does the incidence of abuse. Elder abuse is a difficult term to define and can be broken up into sub sections such as: Physical Abuse, Sexual Abuse, Financial Abuse and Neglect.	+	Elder abuse is becoming an increasing field of research as the 'baby boomers' reach old age. As the population of elderly people increases so does the incidence of abuse. Elder abuse is a difficult term to define and can be broken up into sub sections including physical abuse, sexual abuse, financial abuse and neglect.
	<videoflash>OP0sZB9jRlA&feature=related|300|300|right|</videoflash>		<videoflash>OP0sZB9jRlA&feature=related|300|300|right|</videoflash>
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	* Force-feeding		* Force-feeding
	* Physical punishment<ref name="Brozowski" />		* Physical punishment<ref name="Brozowski" />
-	Family members are most commonly the abusers in physical elder abuse with adult children being the highest perpetrators (32.6%), followed by other family members (21.5%) and spouses (11.3%). <ref name="Friedman"> Taking care of an aging family member can often leave people feeling frustrated and overwhelmed. This is known as the stressed caregiver hypothesis, which states that the likelihood of physical abuse occurring increases if the caregiver perceives the relationship as lacking satisfaction or being tedious. <ref>Gordon, R. M., & Brill, D. (2001). The abuse and neglect of the elderly. International Journal of Law and Psychiatry, 24(2-3), 183-183-197.</ref> Women experience physical abuse more often than men and are also less likely to report it <ref name="Brozowski" />. Physical abuse becomes such an issue for both men and women as they age because their ability to fight off attacks decreases as they experience physical and mental declines.	+	Family members are most commonly the abusers in physical elder abuse with adult children being the highest perpetrators (32.6%), followed by other family members (21.5%) and spouses (11.3%). <ref name="Friedman"> Taking care of an aging family member can often leave people feeling frustrated and overwhelmed. This phenomenon is known as the stressed caregiver hypothesis, which states that the likelihood of physical abuse occurring increases if the caregiver perceives the relationship as lacking satisfaction or being tedious. <ref>Gordon, R. M., & Brill, D. (2001). The abuse and neglect of the elderly. International Journal of Law and Psychiatry, 24(2-3), 183-183-197.</ref> Women experience physical abuse more often than men and are also less likely to report it <ref name="Brozowski" />. Physical abuse becomes such an issue for both men and women as they age because their ability to fight off attacks decreases as they experience physical and mental declines.
	==Sexual Abuse==		==Sexual Abuse==
Line 71:		Line 71:
	* Sexual assault		* Sexual assault
	* Sexually explicit photographing with a person not capable of giving consent<ref name="Brozowski" />		* Sexually explicit photographing with a person not capable of giving consent<ref name="Brozowski" />
-	Sexual abuse occurs 3 times more often to women than men.<ref>Lobell, T. (2006). Predictors of reported elder sexual abuse: Analyses of Wisconsin's adult protective services report data. The Florida State University, 1 – 171.</ref> This is due to the fact that aging increases a woman’s vulnerability to sexual abuse because they experience a decrease in status after losing jobs, friends, partners and social support. <ref name="Brozowski" /> They are also more likely to conceal the violence since they feel ashamed and vulnerable in their living conditions. <ref name="Brozowski" /> A majority of these abusers tend to be spouses who display some form of mental illness, alcoholism, or financial dependence on he victim. <ref name="Brozowski" /> Also people who commit these sex offences and are not spouses tend to exhibit antisocial behaviour and psychopathology. <ref name="Brozowski" /> Furthermore, there are cases in which adult children are the abusers and these children tend to be unmarried, unemployed, financially supported by the parent and often display mental illness or substance abuse.<ref name="Ramsey">Ramsey-Klawsnik, H. (2003). Elder sexual abuse within the family. Journal of Elder Abuse & Neglect, 15(1), 43-58.</ref> There are different forms of physical and psychological consequences that accompany sexual elder abuse including anxiety attacks, disrupted sleep patterns, weight loss, nausea, depression, stress, anger and problems with personal relationships.<ref name="Ramsey" />	+	Sexual abuse occurs 3 times more often to women than men.<ref>Lobell, T. (2006). Predictors of reported elder sexual abuse: Analyses of Wisconsin's adult protective services report data. The Florida State University, 1 – 171.</ref> Woman’s vulnerability to sexual abuse increases over men's because they experience a decrease in status after losing jobs, friends, partners and social support which leaves them less protected. <ref name="Brozowski" /> They are also more likely to conceal the violence since they feel ashamed and threatened in their living conditions. <ref name="Brozowski" /> A majority of these abusers tend to be spouses who display some form of mental illness, alcoholism, or financial dependence on he victim. <ref name="Brozowski" /> Also people who commit these sex offenses and are not spouses tend to exhibit antisocial behaviour and psychopathology. <ref name="Brozowski" /> Furthermore, there are cases in which adult children are the abusers and these children tend to be unmarried, unemployed, financially supported by the parent and often display mental illness or substance abuse.<ref name="Ramsey">Ramsey-Klawsnik, H. (2003). Elder sexual abuse within the family. Journal of Elder Abuse & Neglect, 15(1), 43-58.</ref> There are different forms of physical and psychological consequences that accompany sexual elder abuse including anxiety attacks, disrupted sleep patterns, weight loss, nausea, depression, stress, anger and problems with personal relationships.<ref name="Ramsey" />
	==Financial Abuse==		==Financial Abuse==
-	Violent crimes may be decreasing in North America but the incidence of [http://www.elder-abuse-information.com/abuse/abuse_financial.htm financial abuse] involving the elderly are on a steady incline <ref name="Malks">Malks, B., Buckmaster, J., & Cunningham, L. (2003). Combating elder financial abuse: A multidisciplinary approach to a growing problem. Journal of Elder Abuse & Neglect, 15(3), 55 – 70. </ref> This phenomenon is due to the increase in elderly population as well as the increase in wealth amongst the elderly.<ref name="Malks" /> People are beginning to see the opportunity tin taking advantage of the elderly for financial gain. Victims tend to be females with some sort of mental impairment and 75% of them fall between the ages of 70 and 89.<ref name="Malks" /> These people are prime targets because they have little to no ability to fight off attacks and their mental impairments make it easy for them to be cheated. Elders are also unlikely to report financial abuse because they humiliated, ashamed and fear retaliation from the perpetrator.<ref name="Malks" /> Furthermore, since family members or in-home caregivers conduct 60 – 90% of financial abuse, the victim feels helpless and will not report it.<ref name="Malks" />	+	Violent crimes may be decreasing in North America but the incidence of [http://www.elder-abuse-information.com/abuse/abuse_financial.htm financial abuse] involving the elderly are on a steady incline <ref name="Malks">Malks, B., Buckmaster, J., & Cunningham, L. (2003). Combating elder financial abuse: A multidisciplinary approach to a growing problem. Journal of Elder Abuse & Neglect, 15(3), 55 – 70. </ref> This phenomenon is due to the increase in elderly population as well as the increase in wealth amongst the elderly.<ref name="Malks" /> People are beginning to see the opportunity tin taking advantage of the elderly for financial gain. Victims tend to be females with some sort of mental impairment and 75% of them fall between the ages of 70 and 89.<ref name="Malks" /> These people are prime targets because they have little to no ability to fight off attacks and their mental impairments make it easy for them to be cheated. Elders are also unlikely to report financial abuse because they humiliated, ashamed and fear their abuser.<ref name="Malks" /> Furthermore, since family members or in-home caregivers conduct 60 – 90% of financial abuse, the victim feels helpless and will not report it.<ref name="Malks" />
	==Neglect==		==Neglect==
-	[http://www.preventelderabuse.org/elderabuse/neglect.html Neglect] is the most common form of elder abuse representing 50 – 70% of reported cases.<ref name="Dyer">Dyer, C. B., Toronjo, C., Cunningham, M., Festa, N. A., Pavlik, V. N., Hyman, D. J., et al. (2005). The key elements of elder neglect: A survey of adult protective service workers. Journal of Elder Abuse & Neglect, 17(4), 1-1-10.</ref> Neglect is often described as the failure to fulfill a person’s duties to an elder to supply them with basic life necessities.<ref name="Dyer" /> Neglect can include denial of food, water, shelter, clothing, personal comfort, medicine or personal hygiene.<ref name="Dyer" />Neglect can be both voluntary and involuntary on the part of the caregivers. Meaning that the caregiver can either intentionally withhold basic necessities or carelessly forget meet hose basic needs. Adult children tend to be the abusers in neglect situations.<ref name="Brozowski" /> This abuse often occurs when the abusers was not prepared to take on the responsibility of the elder and is reluctant to do so.	+	[http://www.preventelderabuse.org/elderabuse/neglect.html Neglect] is the most common form of elder abuse representing 50 – 70% of reported cases.<ref name="Dyer">Dyer, C. B., Toronjo, C., Cunningham, M., Festa, N. A., Pavlik, V. N., Hyman, D. J., et al. (2005). The key elements of elder neglect: A survey of adult protective service workers. Journal of Elder Abuse & Neglect, 17(4), 1-1-10.</ref> Neglect is often described as the failure to fulfill a person’s obligation to an elder to supply them with basic life necessities.<ref name="Dyer" /> Neglect can include:
-	Another form of neglect is self-neglect. Self-neglect can be defined as the inability or reluctance to take care of ones basic needs.<ref name="Dyer" /> This form of neglect is specifically focused on the elder’s ability to take care of themselves. When they reach the point of self-neglect they often need to be placed in the care of a family member or a care center.	+	*Denial of food
		+	*Denial of water
		+	*Inadequate shelter
		+	*Failure to supply clothing
		+	*Low levels of personal comfort
		+	*Insufficient medication administration
		+	*Low levels of personal hygiene.<ref name="Dyer" />
		+	Neglect can be both voluntary and involuntary on the part of the caregivers. Meaning that the caregiver can either intentionally withhold basic necessities or carelessly forget to meet those basic needs. Adult children tend to be the abusers in neglect situations.<ref name="Brozowski" /> This abuse often occurs when the abusers was not prepared to take on the responsibility of the elder and is reluctant to do so.
		+	Another form of neglect is self-neglect. Self-neglect can be defined as the inability or reluctance to take care of ones basic needs.<ref name="Dyer" /> This form of neglect is specifically focused on the elder’s ability to take care of themselves. When they reach the point of self-neglect they often need to be placed in the care of a family member or a care facility.
	==Notes and References==		==Notes and References==
	<references/>		<references/>

---

Revision as of 08:31, 31 October 2011

Contents 1 Risk Factors and Prevention of Elder Abuse 1.1 Risk Factors 1.1.1 Behavioural Problems 1.1.2 Physical Impairment 1.1.3 Cognitive Impairment 1.1.4 Environmental Risk Factors 1.2 Prevention of Elder Abuse 1.2.1 Primary Prevention 1.2.2 Secondary Prevention 1.2.3 Tertiary Prevention 1.3 Notes and References 2 What is Elder Abuse? 2.1 Physical Abuse 2.2 Sexual Abuse 2.3 Financial Abuse 2.4 Neglect 2.5 Notes and References

Risk Factors and Prevention of Elder Abuse

Risk Factors

Through becoming aware of risk factors, loved ones as well as elders themselves will be more equipped with the knowledge they need to ensure that they do not become victims of abuse.

Behavioural Problems

Behavioural Problemsare described as the resistance of care either verbally or physically by an elder individual^[1]. Behavioural problems are also one of the main risk factors for all types of elder abuse. If an elder is displaying difficult behaviours or is acting abusively towards their caregiver, their caregiver is more likely to abuse the elder in return ^[1]. Caregivers in facilities are also physically assaulted by patients on a regular basis. These behaviours, paired with the lack of knowledge given to caregivers on how to handle conflict with a patient, may lead to an instance of abuse ^[2].

Physical Impairment

Two specific forms of physical impairments are incontinence as well as failure to maintain personal hygiene^[1]. This puts an elder at risk for abuse because caregivers come into contact with them more often so there is an increased opportunity for abuse to occur. The demand for attention and care due to these impairments may lead to neglect or abuse especially in a facility where staff is low, or overworked^[1]. Physical impairments may lead to verbal abuse through the belittling of the elder by their caregiver due to their inability to care for themselves.

Cognitive Impairment

Cognitive impairments are things such as problems with memory, thinking, and communication^[1]. However, cognitive impairment on its own is not found to be a significant risk factor for abuse towards the elderly^[1]. This may be because individuals with cognitive disabilities may have trouble communicating their experiences of abuse to others^[1]. However, Mental deficits such as disoriented or aggressive behaviours are found to be significant risk factors because they cause the most stress on the caregiver. ^[3]

Environmental Risk Factors

Any type of factor that reduces the amount of support available to the caregiver, as well as any factor that leads to a stressful home environment, leads to the increased risk of abuse^[3]. One example is the likelihood of care workers in long-term care facilities to abuse elder adults when they are overworked and overstressed ^[1].If a caregiver in a long-term care facility does not have many coworkers, they are less likely to find support in their time of need^[3].

A family member who is also caring for dependent children, as well as working a full-time job and caring for their dependent elder, may be more likely to perform abuse ^[3].

Other environmental factors include things such as poverty, homelessness, unsafe housing, lack of resources, and social isolation ^[3].

Prevention of Elder Abuse

Elder abuse is included in both public health and medical boundaries, as well as social work and criminal justice realms. This means that professional preventionand intervention can be set in place to help reduce the risk of elder abuse ^[4]

Primary Prevention

Primary prevention is concerned with health promoton, and specific protection^[3]. Health promotion includes public education about normal aging, support for elders and caregivers, as well as community programs to help elders in their own home ^[3][5]. Caregivers in facilities are likely to abuse due to misunderstanding as well as a lack of skills or knowledge. Training caregivers and providing them with important knowledge about how to work with an elder will help reduce the risk of abuse^[2].

Another form of prevention that may be set in place is screening by hospitals upon the discharge of elderly patients. The hospital staff evaluates families for their likelihood of abuse, and if it is necessary, the elder will be placed in a nursing home instead ^[3].

Secondary Prevention

This form of prevention is mainly concerned with detecting and stopping abuse as soon as possible ^[3]. One way to detect elder abuse, is through an assessment tool that can be used by caregivers which allows them to evaluate the home as well as the family where elder abuse is suspected ^[3][5]. In addition, careful monitoring of the family as well as the elder is important, including the monitoring of medical records. This is to look for indicators of abuse, such as burns, cuts, bruises, and lacerations that are not documented in their medical history, as well as a change in the psychological well being of the elder ^[3].

Tertiary Prevention

Tertiary prevention is concerned with the rehabilitation of an abused individual as well as the abuser, and the family of the abused ^[3]. This form of help for the family and elder is done through providing a live-in caregiver, placing the elder in a nursing home, as well as in-home support. In extreme cases, where the home cannot be rehabilitated, the elder will be placed into a home and an adult protective service agency may be involved ^[3].

Caregivers may be helped and rehabilitated through education, awareness, and training towards how to care for an elder individual. This will provide the caregiver with the skills needed to resolve conflict and treat the patient or loved one correctly^{[2] [5]}. In addition, interventions for the caregiver and abused are aimed towards promoting awareness, which in turn will increase the reporting of elder abuse^[4].

Mickey Rooney speaks about his experience with elder abuse. One of the many ways to spread awareness is through speaking about it publicly.

--Jb08zl 16:26, 23 October 2011 (EDT) --Jb08zl 21:50, 24 October 2011 (EDT) --Jb08zl 13:59, 25 October 2011 (EDT) --Jb08zl 14:55, 30 October 2011 (EDT)

Notes and References

1. ↑ ^{1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7} Biroscak, B.J., Conner, T., Fang, Y., Page, C., Post, C.,Prokhorov, A. (2010). Elder Abuse in Long-Term Care: Types, Patterns, and Risk Factors. Research On Aging, 32, 323-348. doi:10.1177/0164027509357705
2. ↑ ^{2.0 2.1 2.2} Dana DeHart PhD, Jennifer Webb MA & Carol Cornman RNPA (2009): Prevention of Elder Mistreatment in Nursing Homes: Competencies for Direct-Care Staff, Journal of Elder Abuse & Neglect, 21:4, 360-378
3. ↑ ^{3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12} Hackbarth, D.P., Andresen, P., Konestabo, B. (1989). Maltreatment of the elderly in the home: A framework for prevention and intervention. Journal Of Home Health Care Practice, 2(1),43-56.
4. ↑ ^{4.0 4.1} Kim L. Alt MD, Annie L. Nguyen MPH & Linda N. Meurer MDMPH (2011): The Effectiveness of Educational Programs to Improve Recognition and Reporting of Elder Abuse and Neglect: A Systematic Review of the Literature, Journal of Elder Abuse & Neglect, 23:3, 213-233
5. ↑ ^{5.0 5.1 5.2} Jenny Ploeg RNPhD, Jana Fear MLIS, Brian Hutchison MD, Harriet MacMillan MD & Gale Bolan RNBScN (2009): A Systematic Review of Interventions for Elder Abuse, Journal of Elder Abuse & Neglect, 21:3, 187-210

What is Elder Abuse?

Elder abuse is becoming an increasing field of research as the 'baby boomers' reach old age. As the population of elderly people increases so does the incidence of abuse. Elder abuse is a difficult term to define and can be broken up into sub sections including physical abuse, sexual abuse, financial abuse and neglect.

Physical Abuse

It is estimated that between 500,000 and 2.5 million case of physical abuse to elders occur each year ^[6] Physical elder abuse can be defined as any use of physical force that may result in impairment, pain or bodily harm ^[7]. Physical Abuse can include:

• Beating
• Hitting
• Shaking
• Kicking
• Slapping
• Burning
• Inappropriate use of drugs
• Inappropriate use of physical restraints
• Force-feeding
• Physical punishment^[7]

Family members are most commonly the abusers in physical elder abuse with adult children being the highest perpetrators (32.6%), followed by other family members (21.5%) and spouses (11.3%). ^[6] Women experience physical abuse more often than men and are also less likely to report it ^[7]. Physical abuse becomes such an issue for both men and women as they age because their ability to fight off attacks decreases as they experience physical and mental declines.

Sexual Abuse

Elder sexual abuse is defined as any non-consenting sexual contact upon an elderly person.^[7] This includes:

• Unwanted touching
• Sexual assault
• Sexually explicit photographing with a person not capable of giving consent^[7]

Sexual abuse occurs 3 times more often to women than men.^[8] Woman’s vulnerability to sexual abuse increases over men's because they experience a decrease in status after losing jobs, friends, partners and social support which leaves them less protected. ^[7] They are also more likely to conceal the violence since they feel ashamed and threatened in their living conditions. ^[7] A majority of these abusers tend to be spouses who display some form of mental illness, alcoholism, or financial dependence on he victim. ^[7] Also people who commit these sex offenses and are not spouses tend to exhibit antisocial behaviour and psychopathology. ^[7] Furthermore, there are cases in which adult children are the abusers and these children tend to be unmarried, unemployed, financially supported by the parent and often display mental illness or substance abuse.^[9] There are different forms of physical and psychological consequences that accompany sexual elder abuse including anxiety attacks, disrupted sleep patterns, weight loss, nausea, depression, stress, anger and problems with personal relationships.^[9]

Financial Abuse

Violent crimes may be decreasing in North America but the incidence of financial abuse involving the elderly are on a steady incline ^[10] This phenomenon is due to the increase in elderly population as well as the increase in wealth amongst the elderly.^[10] People are beginning to see the opportunity tin taking advantage of the elderly for financial gain. Victims tend to be females with some sort of mental impairment and 75% of them fall between the ages of 70 and 89.^[10] These people are prime targets because they have little to no ability to fight off attacks and their mental impairments make it easy for them to be cheated. Elders are also unlikely to report financial abuse because they humiliated, ashamed and fear their abuser.^[10] Furthermore, since family members or in-home caregivers conduct 60 – 90% of financial abuse, the victim feels helpless and will not report it.^[10]

Neglect

Neglect is the most common form of elder abuse representing 50 – 70% of reported cases.^[11] Neglect is often described as the failure to fulfill a person’s obligation to an elder to supply them with basic life necessities.^[11] Neglect can include:

• Denial of food
• Denial of water
• Inadequate shelter
• Failure to supply clothing
• Low levels of personal comfort
• Insufficient medication administration
• Low levels of personal hygiene.^[11]

Neglect can be both voluntary and involuntary on the part of the caregivers. Meaning that the caregiver can either intentionally withhold basic necessities or carelessly forget to meet those basic needs. Adult children tend to be the abusers in neglect situations.^[7] This abuse often occurs when the abusers was not prepared to take on the responsibility of the elder and is reluctant to do so. Another form of neglect is self-neglect. Self-neglect can be defined as the inability or reluctance to take care of ones basic needs.^[11] This form of neglect is specifically focused on the elder’s ability to take care of themselves. When they reach the point of self-neglect they often need to be placed in the care of a family member or a care facility.

Notes and References

1. ↑ ^{1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7} Biroscak, B.J., Conner, T., Fang, Y., Page, C., Post, C.,Prokhorov, A. (2010). Elder Abuse in Long-Term Care: Types, Patterns, and Risk Factors. Research On Aging, 32, 323-348. doi:10.1177/0164027509357705
2. ↑ ^{2.0 2.1 2.2} Dana DeHart PhD, Jennifer Webb MA & Carol Cornman RNPA (2009): Prevention of Elder Mistreatment in Nursing Homes: Competencies for Direct-Care Staff, Journal of Elder Abuse & Neglect, 21:4, 360-378
3. ↑ ^{3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12} Hackbarth, D.P., Andresen, P., Konestabo, B. (1989). Maltreatment of the elderly in the home: A framework for prevention and intervention. Journal Of Home Health Care Practice, 2(1),43-56.
4. ↑ ^{4.0 4.1} Kim L. Alt MD, Annie L. Nguyen MPH & Linda N. Meurer MDMPH (2011): The Effectiveness of Educational Programs to Improve Recognition and Reporting of Elder Abuse and Neglect: A Systematic Review of the Literature, Journal of Elder Abuse & Neglect, 23:3, 213-233
5. ↑ ^{5.0 5.1 5.2} Jenny Ploeg RNPhD, Jana Fear MLIS, Brian Hutchison MD, Harriet MacMillan MD & Gale Bolan RNBScN (2009): A Systematic Review of Interventions for Elder Abuse, Journal of Elder Abuse & Neglect, 21:3, 187-210
6. ↑ ^{6.0 6.1} Friedman L. S., Availa, S., Tanouye, K., & Kimberly, J. (2011). A case-control study of severe physical abuse of older adults. Journal of the American Geriatrics Society, 59(3), 417 – 434.
7. ↑ ^{7.0 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9} Brozowski, K. & Hall, D. R. (2010). Aging and risk: Physical and sexual abuse of elders in Canada. Journal of Interpersonal Violence, 25(7), 1183 – 1199.
8. ↑ Lobell, T. (2006). Predictors of reported elder sexual abuse: Analyses of Wisconsin's adult protective services report data. The Florida State University, 1 – 171.
9. ↑ ^{9.0 9.1} Ramsey-Klawsnik, H. (2003). Elder sexual abuse within the family. Journal of Elder Abuse & Neglect, 15(1), 43-58.
10. ↑ ^{10.0 10.1 10.2 10.3 10.4} Malks, B., Buckmaster, J., & Cunningham, L. (2003). Combating elder financial abuse: A multidisciplinary approach to a growing problem. Journal of Elder Abuse & Neglect, 15(3), 55 – 70.
11. ↑ ^{11.0 11.1 11.2 11.3} Dyer, C. B., Toronjo, C., Cunningham, M., Festa, N. A., Pavlik, V. N., Hyman, D. J., et al. (2005). The key elements of elder neglect: A survey of adult protective service workers. Journal of Elder Abuse & Neglect, 17(4), 1-1-10.