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--[[User:Lb07eh|Lb07eh]] 07:25, 1 November 2011 (EDT)LB --[[User:Lb07eh|Lb07eh]] 07:25, 1 November 2011 (EDT)LB
-=== '''Who is at risk''' === +=== Who is at risk ===
Elders who are more vulnerable to being victims of physical abuse are those who are currently living with a caregiver. <ref name="Elder"/> Elders who are at risk of being victimized physically also tend to share some other common characteristics with each other as well <ref name="Analysis"> Lee, M. (2009) A Path Analysis on Elder Abuse by Family Caregivers: Applying the ABCX Model. Journal of family violence, 24. </ref>. First, many victims live in a shared living situation with their caregiver who is abusing them. Elders who do not live with their caregiver are at much lower risk of victimization. Secondly, studies demonstrate that elderly people are more likely to be victims of physical abuse if they are suffering from dementia. This is likely attributed to the stress this disease can cause on the caregiver <ref name="Analysis"/>. Social isolation is a third variable that appears to be present in families in which elder abuse occurs. <ref name="Analysis"/> Many elders socially isolate themselves from the outside world for many reasons, including fear of being injured <ref name="Analysis"/>. This social isolation actually increases familial stress which can give rise to an abusive environment. Contrarily, It is also entirely possible that the abusers may isolate the elderly person so that no one is able to find out about the abuse <ref name="Analysis"/>. There are many other situations and characteristics which are theorized to contribute to elder abuse as well. Elders who live with a family member who misuses drugs or alcohol are also at a greater risk of being abused <ref name="Analysis"/>. It is also important to note that most caregivers who abuse an elderly person tend to also be heavily dependent on this elder person. --[[User:Lb07eh|Lb07eh]] 07:25, 1 November 2011 (EDT)LB Elders who are more vulnerable to being victims of physical abuse are those who are currently living with a caregiver. <ref name="Elder"/> Elders who are at risk of being victimized physically also tend to share some other common characteristics with each other as well <ref name="Analysis"> Lee, M. (2009) A Path Analysis on Elder Abuse by Family Caregivers: Applying the ABCX Model. Journal of family violence, 24. </ref>. First, many victims live in a shared living situation with their caregiver who is abusing them. Elders who do not live with their caregiver are at much lower risk of victimization. Secondly, studies demonstrate that elderly people are more likely to be victims of physical abuse if they are suffering from dementia. This is likely attributed to the stress this disease can cause on the caregiver <ref name="Analysis"/>. Social isolation is a third variable that appears to be present in families in which elder abuse occurs. <ref name="Analysis"/> Many elders socially isolate themselves from the outside world for many reasons, including fear of being injured <ref name="Analysis"/>. This social isolation actually increases familial stress which can give rise to an abusive environment. Contrarily, It is also entirely possible that the abusers may isolate the elderly person so that no one is able to find out about the abuse <ref name="Analysis"/>. There are many other situations and characteristics which are theorized to contribute to elder abuse as well. Elders who live with a family member who misuses drugs or alcohol are also at a greater risk of being abused <ref name="Analysis"/>. It is also important to note that most caregivers who abuse an elderly person tend to also be heavily dependent on this elder person. --[[User:Lb07eh|Lb07eh]] 07:25, 1 November 2011 (EDT)LB
This video demonstrates an elder who is being abused by their caregiver. It is implied that the elder lives with their caregiver. <videoflash>5cauXgZhROM</videoflash> This video demonstrates an elder who is being abused by their caregiver. It is implied that the elder lives with their caregiver. <videoflash>5cauXgZhROM</videoflash>
-=== '''Prevalence''' === +=== Prevalence ===
Canadian and American instances of physical abuse on elders differ quite a bit. A study on recent international physical elder abuse states that it is likely that 4.3% of elderly adults are physically abused in some way. <ref name="Prevalence"/> As mentioned previously, these rates are said to be higher if the victim lives with the caregiver who is abusing them. <ref name="Bruising"/> In a Canadian based study, <ref name="Prevalence"/> data was collected from 2,008 elderly persons regarding physical abuse. Results indicated that of these 2,008, 80 elderly persons reported being abused in some way. Interestingly, physical abuse by the caregiver is reported more often by the caregiver than from the elderly person who is being abused. It is also noteworthy that a second Canadian study found somewhat inconsistent results, and published that 1.6% of elderly people were physically abuse or mistreated in some way. This study also found that approximately 31% of the abuse cases were reported to the police. <ref name="Analysis"/> Although these studies provide important information to society, it is clear an abundance of the abuse goes unreported. <ref name="Nurse"> Fraser, A. (2010). Preventing abuse of older people. Journal of nursing management, 17 (6). </ref> Canadian and American instances of physical abuse on elders differ quite a bit. A study on recent international physical elder abuse states that it is likely that 4.3% of elderly adults are physically abused in some way. <ref name="Prevalence"/> As mentioned previously, these rates are said to be higher if the victim lives with the caregiver who is abusing them. <ref name="Bruising"/> In a Canadian based study, <ref name="Prevalence"/> data was collected from 2,008 elderly persons regarding physical abuse. Results indicated that of these 2,008, 80 elderly persons reported being abused in some way. Interestingly, physical abuse by the caregiver is reported more often by the caregiver than from the elderly person who is being abused. It is also noteworthy that a second Canadian study found somewhat inconsistent results, and published that 1.6% of elderly people were physically abuse or mistreated in some way. This study also found that approximately 31% of the abuse cases were reported to the police. <ref name="Analysis"/> Although these studies provide important information to society, it is clear an abundance of the abuse goes unreported. <ref name="Nurse"> Fraser, A. (2010). Preventing abuse of older people. Journal of nursing management, 17 (6). </ref>
--[[User:Lb07eh|Lb07eh]] 07:25, 1 November 2011 (EDT)LB --[[User:Lb07eh|Lb07eh]] 07:25, 1 November 2011 (EDT)LB
-=== '''Prevention''' ===+=== Prevention ===
The two most important aspects in ending physical abuse are recognition and reporting.<ref name="Suspect"> Franch J., Juvina, D., Olmo, J., Pousa, S., Pujol, X., Villa, A. (2009). Prevalence and Risk Factors of Suspected Elder Abuse Subtypes in People Aged 75 and Older. The American geriatrics society, 57. </ref> There are many systems in place that aim to do these two things, as well as prevent physical abuse from occurring at all. If abuse is taking place, one of the first lines of defence is recognition. Due to the fact that many elderly people have to visit a general practitioner (GP) more frequently than younger adults, the GP is someone who should be skilled in recognizing the signs of abuse. <ref name="Bruising"> Austin, R., Corona, M., Gibbs, Liao, S., L., Mosqueda, L., Schneider, D., Wigleworth A. Bruising as a Marker of Physical Elder Abuse. Journal of geriatrics, 57 (7). </ref>. One way that GP’s may do this is by looking at bruising on the elderly person. Bruising can be a sign that physical abuse is occurring. GP’s can differentiate between normal age related, or poor health related bruising by checking to see the size of the bruises. Bruises resulting from abuse have been documented as large, and are typically found on the face, on the torso, or on the arms <ref name="Bruising"/>. The two most important aspects in ending physical abuse are recognition and reporting.<ref name="Suspect"> Franch J., Juvina, D., Olmo, J., Pousa, S., Pujol, X., Villa, A. (2009). Prevalence and Risk Factors of Suspected Elder Abuse Subtypes in People Aged 75 and Older. The American geriatrics society, 57. </ref> There are many systems in place that aim to do these two things, as well as prevent physical abuse from occurring at all. If abuse is taking place, one of the first lines of defence is recognition. Due to the fact that many elderly people have to visit a general practitioner (GP) more frequently than younger adults, the GP is someone who should be skilled in recognizing the signs of abuse. <ref name="Bruising"> Austin, R., Corona, M., Gibbs, Liao, S., L., Mosqueda, L., Schneider, D., Wigleworth A. Bruising as a Marker of Physical Elder Abuse. Journal of geriatrics, 57 (7). </ref>. One way that GP’s may do this is by looking at bruising on the elderly person. Bruising can be a sign that physical abuse is occurring. GP’s can differentiate between normal age related, or poor health related bruising by checking to see the size of the bruises. Bruises resulting from abuse have been documented as large, and are typically found on the face, on the torso, or on the arms <ref name="Bruising"/>.
A second important way to both prevent as well as recognize signs of abuse is by training all health care professionals to identify elderly who may be at a high risk <ref name="Bruising"/>. These high risk cases were discussed previously in the “who is at risk” section. Lastly, having social support programs available to both the elderly person and their caregiver can also help alleviate the stress that may foster an abusive environment. <ref name="Suspect"/> A second important way to both prevent as well as recognize signs of abuse is by training all health care professionals to identify elderly who may be at a high risk <ref name="Bruising"/>. These high risk cases were discussed previously in the “who is at risk” section. Lastly, having social support programs available to both the elderly person and their caregiver can also help alleviate the stress that may foster an abusive environment. <ref name="Suspect"/>

Revision as of 22:17, 27 November 2011

Contents

Group # 12

  • 1. Angela Gilmour
  • 2. Victoria Cowan
  • 3. Lauren Bauer

The three types of elder abuse

Over the last decade, elder abuse has become an increasing problem which has earned a lot of attention from society internationally. [1] There are three main methods of abuse in which vulnerable elders can become victims of, and each of these types have varying prevalence rates. These three types of abuse include physical abuse, psychological abuse, and through the neglect of the elders' basic needs.

Physical elder abuse

A common form of elder abuse is Physical abuse. Physical elder abuse tends to receive the most attention from the media, which may be due to the fact that physical abuse tends to be the most commonly reported type of abuse [1]. This can be attributed to the fact that it is easier for people to notice signs of physical abuse than it is the other forms of abuse [1]. Physical abuse can be identified as intentional actions that cause bodily harm, or risk of bodily harm to an elder [1]. The perpetrator tends to be someone who is currently in a caregiver role to the elderly person [1]. In many studies physical abuse includes hitting, restraining, or deliberately injuring in some other way [2] This increasing issue can be seen both internationally and Canada wide [2]. --Lb07eh 07:25, 1 November 2011 (EDT)LB

Who is at risk

Elders who are more vulnerable to being victims of physical abuse are those who are currently living with a caregiver. [1] Elders who are at risk of being victimized physically also tend to share some other common characteristics with each other as well [3]. First, many victims live in a shared living situation with their caregiver who is abusing them. Elders who do not live with their caregiver are at much lower risk of victimization. Secondly, studies demonstrate that elderly people are more likely to be victims of physical abuse if they are suffering from dementia. This is likely attributed to the stress this disease can cause on the caregiver [3]. Social isolation is a third variable that appears to be present in families in which elder abuse occurs. [3] Many elders socially isolate themselves from the outside world for many reasons, including fear of being injured [3]. This social isolation actually increases familial stress which can give rise to an abusive environment. Contrarily, It is also entirely possible that the abusers may isolate the elderly person so that no one is able to find out about the abuse [3]. There are many other situations and characteristics which are theorized to contribute to elder abuse as well. Elders who live with a family member who misuses drugs or alcohol are also at a greater risk of being abused [3]. It is also important to note that most caregivers who abuse an elderly person tend to also be heavily dependent on this elder person. --Lb07eh 07:25, 1 November 2011 (EDT)LB

This video demonstrates an elder who is being abused by their caregiver. It is implied that the elder lives with their caregiver.

Prevalence

Canadian and American instances of physical abuse on elders differ quite a bit. A study on recent international physical elder abuse states that it is likely that 4.3% of elderly adults are physically abused in some way. [2] As mentioned previously, these rates are said to be higher if the victim lives with the caregiver who is abusing them. [4] In a Canadian based study, [2] data was collected from 2,008 elderly persons regarding physical abuse. Results indicated that of these 2,008, 80 elderly persons reported being abused in some way. Interestingly, physical abuse by the caregiver is reported more often by the caregiver than from the elderly person who is being abused. It is also noteworthy that a second Canadian study found somewhat inconsistent results, and published that 1.6% of elderly people were physically abuse or mistreated in some way. This study also found that approximately 31% of the abuse cases were reported to the police. [3] Although these studies provide important information to society, it is clear an abundance of the abuse goes unreported. [5] --Lb07eh 07:25, 1 November 2011 (EDT)LB

Prevention

The two most important aspects in ending physical abuse are recognition and reporting.[6] There are many systems in place that aim to do these two things, as well as prevent physical abuse from occurring at all. If abuse is taking place, one of the first lines of defence is recognition. Due to the fact that many elderly people have to visit a general practitioner (GP) more frequently than younger adults, the GP is someone who should be skilled in recognizing the signs of abuse. [4]. One way that GP’s may do this is by looking at bruising on the elderly person. Bruising can be a sign that physical abuse is occurring. GP’s can differentiate between normal age related, or poor health related bruising by checking to see the size of the bruises. Bruises resulting from abuse have been documented as large, and are typically found on the face, on the torso, or on the arms [4]. A second important way to both prevent as well as recognize signs of abuse is by training all health care professionals to identify elderly who may be at a high risk [4]. These high risk cases were discussed previously in the “who is at risk” section. Lastly, having social support programs available to both the elderly person and their caregiver can also help alleviate the stress that may foster an abusive environment. [6] --Lb07eh 07:25, 1 November 2011 (EDT)LB


Psychological Elder Abuse

Psychological elder abuse (also know as emotional elder abuse) is an act done on purpose that causes emotional or psychological harm or distress to and elderly person[7]. Specific behaviours that have been studied are name calling, being criticized, and being possessed or controlled by some one else [8]. Unnecessary stress is caused when elderly people are psychologically abused, these victims are often treated like children, and are sometimes isolated from their friends and family, who would be a source of comfort for the victim, or as the abuser sees it, an outlet to discuss the abuse. Victims are also often limited in their daily activities and the abuser has total control over what they are allowed to do, they mainly control the victim by fear, threats and insults.[9] --Vc09rk 13:16, 31 October 2011 (EDT)

Who is at Risk

Being verbally abused is the most common form of psychological abuse, however abuse types are often co-occurring among the elderly. In women, psychological abuse is the most common type of abuse and although it is the most common, psychological abuse is often accompanied by physical or sexual abuse [8]. Women are more likely to be psychologically abused than men [8]Elderly women who experience psychological abuse are often dismissive about the abuse, as they are thankful that physical and sexual abuse is not occurring, or it has ended [8]. Once psychological abuse occurs, it is more likely to occur again, more than half of elderly women who have been abused psychologically have been repeatedly abused[8]. In a survey of nearly one thousand women age 55 or older, nearly half of the women said that they had suffered from at least one form of abuse since becoming elderly [8]. These women were less likely to be as healthy as their elderly counterparts who were not abused.Psychological abuse can also affect health, negative health effects include (but are not limited to) chronic stress, depression, anxiety, and cardiac problems [8]. Another study showed that in the United States, African-American women are almost twice as likely to be abused psychologically than non African American women, the rates are 24.4 percent versus 13.2 percent, which suggests that racial differences are in play and this information should be researched further by health professionals and psychologists alike[10]. Psychological or emotional abuse is more common than physical abuse, but only slightly[8].

Decreasing and Helping Psychological Abuse Victims

To help decrease psychological abuse, social services workers, registered nurses or anyone working with elderly people need to be properly trained in the detection of abuse. Detecting psychological abuse can be difficult as there is not any physical evidence [8]. Cross training health professionals with people experienced in domestic violence could be effective in abuse detection[8] . In order to decrease psychological abuse it is important to understand the patterns and risk factors involved [11]. Psychological abuse rates are highest in adults that have cognitive functioning problems [11] To reduce psychological abuse in the elderly population, it is important that the caregivers take a break from watching their loved ones, in a nursing or retirement home different nurses and social workers take turns taking care of the elderly patients however at home, the onus often lies with one person. By taking time away from the caregiving role, the caregiver is able to relax and recharge, ensuring that there is not an outburst brought on from stress of taking care of the elderly person [9]. When dealing directly with an elder abuse victim it is important to be subtle when trying to help them, elderly people will likely be embarrassed that this is happening, and they may try to draw away from people if they push to hard [12]. Subtle attempts to find out who the abuser is would be more effective and help give the victim confidence to talk to a social worker or domestic violence professional.

Signs of Psychological Elder Abuse

Psychological abuse is harder to spot than physical abuse because there are not any actual marks on the person, which is one of the most reliable signs of spotting abuse. One way to determine if an elderly person is being psychologically abused is by witnessing the act. A person may be verbally abusing an elderly person and not be aware that other people are listening or may not care. Witnessing the abuse is not very likely, so it is important to look for more inconspicuous signs, such as fear of other people and the inability to make decisions alone. If the abuse is occurring at a nursing home or retirement home, the elder victim may disconnect themselves from their family because their abuser told them to do so [12].


Elder Neglect as Abuse

The phenomenon of abuse towards elders is an unfortunate crime in many countries, and yet some aspects of this problem are still unknown. Although research in this area is beginning to emerge more prominently, more research is needed to identify the main causes in each setting and appropriate actions that can be taken to prevent elder neglect in this ever-changing society.

Elder abuse has been defined by many as a “single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person." [13] Although many different types of elder abuse exist, elder neglect as a form of abuse is a forthcoming problem, and is not very well recognized by the public. Elder neglect has been defined by many as any “failure to rotate or flip a person to prevent bed sores; failure to provide a person with food, water, shelter, hygiene, medicine, comfort, or personal safety; and ignoring requests for help”.[11]

Active and passive neglect

Research on neglect has shown that there are two different types of neglect seen in many cases. Active neglect is the first form and is distinguished by the purposeful harm or punishment of an individual through refusal or failure to provide the necessary requirements to meet the needs of the elderly individual.[14] [15] [16] This punishment and refusal is seen through the abandonment and/or denial of any life necessities such as food, shelter, medication and health services.[14] [15] [16] The second form of neglect has been identified as passive neglect where there is a lack of attention to the elder, which in turn results in a failure to fulfill the needs of the elder.[17] [15][14] This form of neglect might stem from the inability to provide adequate care or from pure ignorance, resulting in the elder not receiving the necessities to survive.[17] [15][14]


Click on the #1 for the link for CTV Toronto's new report on elder neglect. [1]

Prevalence

Both active or passive neglect of elders is a serious problem in many developed countries. In 1996 the National Center on Elder Abuse at the American Public Human Services Association estimated that in domestic settings there were approximately 689,000 older Americans who were abused and/or neglected.[11] Hudson (1986)[17] and Wolf and Pillemer (1989) [14] further support this statement by showing that anywhere between 1 and 10 percent of elders have been abused either by family members or in institutions, and some estimates for elder neglect exceed those for abuse. Furthermore, Lowenstein (2010)[18] has shown that neglect can range anywhere from 3 to 18 percent depending on the country. However, caution should be taken in light of the fact that the actual incidence of neglect of elders may be much higher due to the number of unidentified and unreported cases of neglect around the world, termed the “iceberg theory”, where we see only a small portion of neglect cases. [18] Schiamberg and Gans (2000)[19] have further suggested that adult children and spouses are the most frequent abusers in family settings, mainly for the fact that they are most frequently in contact with the older adult, resulting in a greater number of opportunities for abuse and neglect.

Who is at risk?

The act of neglect seems to be more prominent in certain older adults compared to others. [11] There have been three health problems that have been identified as risk factors for elder neglect in long term and familial care settings.[11] These risk factors include cognitive problems, physical impairments as well as behavioral problems.[11] In one particular study, 16% of individuals identified times when neglect had occurred, and these cases of neglect were more likely to reoccur when the risk factors were involved, with behavioral problems being the highest risk factor for elder neglect.[11]

Why is this important?

Changing demographics push the issue of elder abuse and neglect to be an exceedingly important topic for future research. Decreasing birth rates and the increased life expectancy have resulted in a population trend where projections for the years 2030 suggest that the older adults will surpass 20% of the population. Moreover, the growth of those 75 and older will be even more dramatic.[20] With the new norm of average life expectancy for men and women ranging anywhere from 71 to 78, along with future aging trends will result in a larger number of children being placed with the burden and/or responsibility of care, where the cases of neglect may increase further [20][18] These cases of neglect may increase because Schiamberg and Gans (2000)[19] and Lowenstein (2010)[18] have shown that the family members are the most frequent abusers of elders.

Prevention and Intervention

Elder neglect is a subject that is difficult to research because most elders who are neglected do not want to cause more problems for themselves and the abuser.[19] This occurs because of fear of more abuse, dependence on the abuser and the love they have for the abuser if it is a family member.[19] Furthermore, neglect is much harder to spot than any other form of abuse because neglect has so many different forms. Preventative measures that may be taken include collection of data of those over a certain age, establishing whether neglect occurs through follow-up visits, as well as training not only long term care workers, but also training the family members that will be taking on the full-time support of an elder.[11]

Notes and References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Lachs, M., Pillemer, K. (2004). Elder abuse. The division of geriatric medicine and gerontology, 364.
  2. ↑ 2.0 2.1 2.2 2.3 Acierno, R., Amstadter, A., Hernandez, M., Kilpatrick, D., Muzzy, W., Resnick, H., Keneth, S. (2010). Prevalence and Correlates of Emotional, Physical, Sexual, and Financial Abuse and Potential Neglect in the United States: The National Elder Mistreatment Study. Journal of Public Health, 100(2).
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 Lee, M. (2009) A Path Analysis on Elder Abuse by Family Caregivers: Applying the ABCX Model. Journal of family violence, 24.
  4. ↑ 4.0 4.1 4.2 4.3 Austin, R., Corona, M., Gibbs, Liao, S., L., Mosqueda, L., Schneider, D., Wigleworth A. Bruising as a Marker of Physical Elder Abuse. Journal of geriatrics, 57 (7).
  5. ↑ Fraser, A. (2010). Preventing abuse of older people. Journal of nursing management, 17 (6).
  6. ↑ 6.0 6.1 Franch J., Juvina, D., Olmo, J., Pousa, S., Pujol, X., Villa, A. (2009). Prevalence and Risk Factors of Suspected Elder Abuse Subtypes in People Aged 75 and Older. The American geriatrics society, 57.
  7. ↑ Zeranski,L., and Halgin,R. (2011) Ethical issues in elder abuse reporting: A professional psychologist’s guide. Professional Psychology: Research and Practice 42(4) 294-300. Retrieved from : http://search.proquest.com.proxy.library.brocku.ca/ psycarticles/docview/864787121/132AC4DBDF517B9FB5D/1?accountid=9744.
  8. ↑ 8.0 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 Fisher,B., Zink,T., Regan,S., (2010) Abuse Against Older Women: Prevalence and Health Effects. Journal of Interpersonal Violence 26 (254) DOI: 10.1177/0886260510362877
  9. ↑ 9.0 9.1 American Psychological Association, 2011. Elder Abuse and Neglect, In Search of Solutions. Retrieved from : http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx
  10. ↑ Beach.S., Schulz,R.,Castle,N., and Rosen,J. (2010) Financial Exploitations and Psychological Mistreatment Among Older Adults: Differences Between African Americans and Non-African Americans in a Population-Based Survey. Gerontologist 50(6) 744-746. DOI:10.1093/geront/gnq053
  11. ↑ 11.0 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 Post,L., Page,C., Connor,T., Prokhorov,A., Fang,Y., Biroscak,B., (2010) Elder Abuse in Long-Term Care: Types, Patterns, and Risk Factors. Research on Aging 32 (323) DOI: 10.1177/0164027509357705
  12. ↑ 12.0 12.1 Myers, Wyatt (2010, July 14) Spotting the Signs of Emotional Abuse. Retrieved from: http://www.everydayhealth.com/emotional-health/spotting-the-signs-of-emotional- abuse.aspx
  13. ↑ Wolf, R., L., Daichman, & G. Bennett. (2002). “Abuse of the Elderly.” Pp. 123-46 in World Report on Violence and Health, edited by E. G. Krug, L. L. Dahlberg, J. A. Mercy, A. B. Zwi, and R. Lozano. Geneva, Switzerland: World Health Organization.
  14. ↑ 14.0 14.1 14.2 14.3 14.4 Wolf, R. S., & Pillemer, K. A. (1989). Helping elderly victims: The reality of elder abuse. New York: Columbia University Press.
  15. ↑ 15.0 15.1 15.2 15.3 Pillemer, K. A., & Finkelhor, D. (1988). The prevalence of elder abuse: A random sample. The Gerontologist, 28 (1), 51–57.
  16. ↑ 16.0 16.1 Lachs, M. S., & Pillemer, K. (1995). Abuse and neglect of elderly persons. New England Journal of Medicine, 332 (7), 437–443.
  17. ↑ 17.0 17.1 17.2 Hudson, M. F. (1986). Elder mistreatment: Current research. In K. A. Pillemer & R. S. Wolf (Eds.), Elder abuse: Conflict in the family (pp. 125–165). Dover, MA: Auburn House Publishing Company.
  18. ↑ 18.0 18.1 18.2 18.3 Lowenstein, A. (2010). Caregiver and elder abuse and neglect: Developing a new conceptual perspective. Aging International, 35, 215-227.
  19. ↑ 19.0 19.1 19.2 19.3 Schiamberg, L., B., & Gans, D. (2000). Elder abuse by adult children: An applied ecological framework for understanding contextual risk factors and the intergenerational character of quality of life. International journal of Aging and Human Development, 50 (4), 329-359.
  20. ↑ 20.0 20.1 Zarit, S. H., & Reid, J. D. (1994). Family caregiving and the older family. In C. B. Fisher & R. M. Lerner (Eds.), Applied developmental psychology (pp. 237 264). New York: McGraw-Hill.
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