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 +=Abuse and Mistreatment of Elderly Adults by Family Members=
 +
 +The abuse and mistreatment of elderly adults is now being recognized as a growing social and medical problem.<ref>Lachs, M. S., & Pillemer, K. (2004). Elder abuse. Lancet, 364, 1263-1272.</ref> The prevalence of elder abuse is expected to continue increasing in the future. The number of people 60 years of age and older is predicted to grow to 1.2 billion globally, which is more than double the number in 1995.<ref name="WHO">Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B., & Lozano, R. (2002). World report on violence and health. Retrieved from World Health Organization website: http://whqlibdoc.who.int/hq/2002/9241545615.pdf</ref>
 +
 +
 +[[Image:bar.jpg]]
 +
 +
 +Elder mistreatment has been defined by the World Health Organization 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”, p. 126<ref name="WHO" /> Often, the perpetrators of abuse are the ones that elderly individuals know the best and perhaps trust the most, members of their immediate family. In a study of over 3000 older people (aged 57-85), spouses or romantic partners were reported as responsible for 26.2% of verbal and 19.2% of physical abuse and children were reported to be responsible for 14.5% of verbal and 24.8% of physical abuse.<ref>Laumann, E. O., Leitsch, S. A., Waite, L. J. (2008). Elder mistreatment in the United States: Prevalence estimates from a nationally representative study. Journal of Gerontology, 63B(4), S248-S254.</ref> An even more alarming statistic was found in a study of forty-one cases of elder physical abuse, resulting in severe traumatic injury. 85% of those responsible for the abuse were family members or intimate partners.<ref>Friedman, Lee S., Avila, S., Tanouye, K., & Joseph, K. (2011). A case-control study of severe physical abuse of older adults. Journal of the American Geriatrics Society, 59, 417-422.</ref> Elder abuse by family caregivers is quite evidently an area for concern. It is important to ask ourselves: Why is it happening? What can be done to prevent future abuse of this growing population?
 +
 +
 +==WHO IS MOST AT RISK TO BE A VICTIM?==
 +
 +===Risk Factor: Low Social Support===
 +
 +Having low social support is a risk factor for almost every type of abuse for older individuals<ref name="ACIERNO">Acierno, R., Hernandez, M. A., Amstadter, A. B., Resnick, H. S., Steve, K., Muzzy, W., & Kilpatrick, D. G. (2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The national elder mistreatment study. American Journal of Public Health, 100(2), 292-297.</ref> Low social support refers to the extent to which an elderly person believes they are cared for, respected and valued by others. Acierno and his colleagues (2010)<ref name="ACIERNO" /> believe that there is a reciprocal relationship between mistreatment and social support – not only does low social support put certain elders at higher risk for abuse, but mistreatment may cause victims to perceive less social support. Amstadter and colleagues (2011)<ref name="AMSTADTER">Amstadter, A. B., Zajac, K., Strachan, M., Hernandez, M. A., Kilpatrick, D. G., & Acierno, R. (2011). Prevalence and correlates of elder mistreatment in South Carolina: The South Carolina elder mistreatment study. Journal of Interpersonal Violence, 26(15), 2947-2972.</ref> suggested that victims of abuse may feel too ashamed to share their experiences of mistreatment with others, avoid or withdraw from contact with others due to a lack of trust, or fear retaliation from the abuser if they disclose information about mistreatment to others.
 +
 +====Interventions====
 +
 +*Funding for programs that allow elders with positive opportunities to interact with neighbours and family members<ref name="AMSTADTER" />
 +*Affordable and accessible public transportation<ref name="AMSTADTER" />
 +*Information about community resources available to them when they are in need<ref name="AMSTADTER" />
 +
 +==Notes and References==
 +<references/>
 +
 +
=Elder Financial Abuse= =Elder Financial Abuse=

Revision as of 05:14, 3 November 2011

Contents

Abuse and Mistreatment of Elderly Adults by Family Members

The abuse and mistreatment of elderly adults is now being recognized as a growing social and medical problem.[1] The prevalence of elder abuse is expected to continue increasing in the future. The number of people 60 years of age and older is predicted to grow to 1.2 billion globally, which is more than double the number in 1995.[2]


Image:bar.jpg


Elder mistreatment has been defined by the World Health Organization 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”, p. 126[2] Often, the perpetrators of abuse are the ones that elderly individuals know the best and perhaps trust the most, members of their immediate family. In a study of over 3000 older people (aged 57-85), spouses or romantic partners were reported as responsible for 26.2% of verbal and 19.2% of physical abuse and children were reported to be responsible for 14.5% of verbal and 24.8% of physical abuse.[3] An even more alarming statistic was found in a study of forty-one cases of elder physical abuse, resulting in severe traumatic injury. 85% of those responsible for the abuse were family members or intimate partners.[4] Elder abuse by family caregivers is quite evidently an area for concern. It is important to ask ourselves: Why is it happening? What can be done to prevent future abuse of this growing population?


WHO IS MOST AT RISK TO BE A VICTIM?

Risk Factor: Low Social Support

Having low social support is a risk factor for almost every type of abuse for older individuals[5] Low social support refers to the extent to which an elderly person believes they are cared for, respected and valued by others. Acierno and his colleagues (2010)[5] believe that there is a reciprocal relationship between mistreatment and social support – not only does low social support put certain elders at higher risk for abuse, but mistreatment may cause victims to perceive less social support. Amstadter and colleagues (2011)[6] suggested that victims of abuse may feel too ashamed to share their experiences of mistreatment with others, avoid or withdraw from contact with others due to a lack of trust, or fear retaliation from the abuser if they disclose information about mistreatment to others.

Interventions

  • Funding for programs that allow elders with positive opportunities to interact with neighbours and family members[6]
  • Affordable and accessible public transportation[6]
  • Information about community resources available to them when they are in need[6]

Notes and References

  1. Lachs, M. S., & Pillemer, K. (2004). Elder abuse. Lancet, 364, 1263-1272.
  2. 2.0 2.1 Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B., & Lozano, R. (2002). World report on violence and health. Retrieved from World Health Organization website: http://whqlibdoc.who.int/hq/2002/9241545615.pdf
  3. Laumann, E. O., Leitsch, S. A., Waite, L. J. (2008). Elder mistreatment in the United States: Prevalence estimates from a nationally representative study. Journal of Gerontology, 63B(4), S248-S254.
  4. Friedman, Lee S., Avila, S., Tanouye, K., & Joseph, K. (2011). A case-control study of severe physical abuse of older adults. Journal of the American Geriatrics Society, 59, 417-422.
  5. 5.0 5.1 Acierno, R., Hernandez, M. A., Amstadter, A. B., Resnick, H. S., Steve, K., Muzzy, W., & Kilpatrick, D. G. (2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The national elder mistreatment study. American Journal of Public Health, 100(2), 292-297.
  6. 6.0 6.1 6.2 6.3 Amstadter, A. B., Zajac, K., Strachan, M., Hernandez, M. A., Kilpatrick, D. G., & Acierno, R. (2011). Prevalence and correlates of elder mistreatment in South Carolina: The South Carolina elder mistreatment study. Journal of Interpersonal Violence, 26(15), 2947-2972.


Elder Financial Abuse

What is Elder Financial Abuse?

-Elder financial abuse is the financial exploitation of the elderly generation. Financial exploitation being defined as any way in which people try and trick, connive, or scheme to attain an older persons savings. [7] This is a huge problem in our society not often talked about as it hides in the shadows with the shameful people who are taking advantage of the older folks. Another reason financial abuse is not talked about more often is the fact that the victims are usually suspect to blurred memories and mental impairments such as Alzheimer’s.[8] A study released last summer showed that the elderly generation, that continues to grow as the baby boomers age, was swindled and duped out of 3 billion dollars last year. The frightening part about this statistic is that as mentioned before this is only the tip of the iceberg as most financial abuse cases go unreported. [9] Furthermore this abuse is destined to increase so long as average age increases, technology improves and communication lines become simple to cross. [10]


Image:elderabu.jpg


Types/Examples of Financial Abuse

Power Of Attorney Abuse

One of the fastest growing types of elderly financial abuse is power of attorney abuse, or POA abuse. People doing this often have the senior in their care declared as incompetent in order to diminish the senior’s ability to make financial decisions for themselves. POA abuse can happen in all scales from small amounts being taken from a chequings account to whole multi-million dollar estates being snatched. [11]


Most POA documents give the person in power the ability to end any criminal investigation or prosecution by simply telling the investigators they felt as though they were doing the right thing and did not realize they were mismanaging the persons money. Unfortunately the current power of attorney law is basically based on the honor system in a society with so little honorable people around.[12]

Other Potential Financial Abuse Schemes:

-Annuities: Can be a well paying investment, but only if buyer knows exactly what they are getting into and has a trust worthy investor.

-Telephone Fraud: People often call house-to-house selling fake products or services. Most people get frustrated and hang up immediately but Women over 60 living alone are lonely and easy targets of financial abusers.

-Mortgage Help: People or fake firms that promise aid to gullible homeowners in financial trouble take fees for services that are never preformed.

-Free Lunch Seminars: Events that are pitched as information only can lead to high pressure follow ups in which mentally impaired may not be able to withstand.[13]


Financial Abuse Statistics

The statistics in regards to elderly financial abuse are truly jaw dropping, here are some examples:

-2010 studies found 1 in 5 elderly person over 65 had been ripped off.[14]

-One third of people over the age of 71 have at least mild cognitive impairments making them more susceptible to investment swindles and other financial abuse.[15]

-It is suspected that only 1 in 25 elder financial abuse cases are reported. [16]

- The aging baby boomer generation controls more then 13 trillion in assets.[17]

- The peak age for financial decision making seems to be 53.3 years old.[18]

-Today over half a million Canadians are living with Alzheimer’s or a related mental impairment, within ten years this number will double.[19]



How It Can Be Prevented

There are multiple simple ways in which seniors can protect themselves from POA financial abuse. For one they can include a statement in the POA document stating that the POA must continue to use the same financial advisor the senior has been using. If it so happens this advisor is incapable to continue, there should be another predetermined advisor that the senior feels comfortable with, such as a lawyer or accountant, to choose another advisor. Though, the financial advisor would need the POA’s approval for any proposed transactions[20]. This makes it safer as it is a joint decision as opposed to one persons rule.

Four Suggested Strategies for Detecting and Preventing Elder Financial Abuse:

1-Education and Outreach: We must work towards raising awareness in the following groups of people, persons 65 and older, care providers, family members, and the general public.

2-Screening and Early Detection: Universal screening can detect indicators of financial abuse at beginning stages.

3-Legal Interventions: When assets have been misused legal assistance may be required.

4-Multidisciplinary Teams: Partnerships within professionals in which expertise is used to protect elders.[21] Elderly abuse within nursing homes

is becoming a serious problem globally because physical abuse, mental abuse, financial abuse

and neglect can all occur within the same nursing care facility. This has inspired researchers

to study the characteristics that make staff vulnerable to committing maltreatment, and the

characteristics of elderly patients that are vulnerable to being abused. The majority of research

has found three common factors that influence whether a nurse or staff member will engage in abusive

behaviour. The three common factors include; staff to patient ratio, the amount of training and

education received and burnout effect.


Patient to Staff Ratio

Much research has shown that facilities with a large number of patients and low number of staff tended

to be at risk for abuse, it is believed that this happens because the lack of staff can lead to poor

management and decision making. [22] Using questionnaires there was found a strong link

between the number of staff and the number of cases of abuse and neglect. [23]

It's important for older adults and the families of older adults to be aware of this risk.


Training Level

The amount of training and education regarding how to treat older adults in nursing care plays a strong

factor in abuse. It is important for nurses and staff members to have the proper amount of education

and training to make the right decisions. Buzgova & Ivanova (2011) performed research on 454

employees from 12 nursing homes using interviews and questionnaires, results showed that employees

at risk for being abusers tended to be employed for more than 5 years without proper training. Further

researcher should be conducted on how through education on treating older adults with ethical

principles could reduce the risk in once high risk staff. [24]


Burnout Effect

Burnout effect is when a person becomes so stressed that they can no longer function at a normal level.

They start to feel numb and apathetic. This can cause serious damage when nursing staff become affected

by burnout. Nurses with burnout effect are at risk for abusing patients because they will no longer feel

empathy or a high sense of responsibility for their well being. Hasson & Arnetz (2006) was interested in

the factors related to work satisfaction, through comparing nurses working in home-based elderly care and

nurses working in nursing home care. They used a questionnaire which measured their beliefs of competence

and how much stress and satisfaction they felt at work. [25] They found that nurses working in home-based

elderly care felt less competent, however, they tended to feel less stress and more satisfaction with their

work environment than nurses working in nursing home care. [26] Nurses from both care organizations felt

exhaustion from work though. Hasson & Arnetz (2006) argue that their findings show an importance

for interventions to be set up that would help nurses deal with work-related exhaustion. In Buzgova &

Ivanova (2011) correlative study they found more cases of abuse when nurses had more than 5 years

experience without proper training and also suffered from burnout effect. Natan, Lowenstein & Eisikovits

(2010) measured burn out effect in nurses using a Maslach Burnout Inventory, it was found that as they

had predicted there was a strong relationship found between burnout and elder abuse. This relationship

was statistically stronger than educational level and attitudes about elders and abuse. [27] Older adult

patients also have characteristics that put themselves at risk for being abused.


Traits of the Abused

Research has found that older adults with certain personality traits, mental disorders or behavioural

problems are vulnerable to abuse. Malmedal, Ingebrigtsen & Saveman (2009) found that elders tended

to be more vulnerable to abuse when they were very dependent on nursing staff. [28] This might be due

to the fact that when a nurse has to focus all of his or her attention on a patient they can experience

frustration and burnout effect more often. Buzgova & Ivanova (2011) measured survey responses from

patients and nursing staff and found that there was a link between personality and mental state of the

patient and the likelihood of them being abused. Older adults that have an aggressive or depressive

temperament and those suffering from mental problems such as dementia are vulnerable to being abused. [29]



--Kb09ou 16:07, 29 October 2011 (EDT)

Notes and References

  1. Lachs, M. S., & Pillemer, K. (2004). Elder abuse. Lancet, 364, 1263-1272.
  2. 2.0 2.1 Krug, E. G., Dahlberg, L. L., Mercy, J. A., Zwi, A. B., & Lozano, R. (2002). World report on violence and health. Retrieved from World Health Organization website: http://whqlibdoc.who.int/hq/2002/9241545615.pdf
  3. Laumann, E. O., Leitsch, S. A., Waite, L. J. (2008). Elder mistreatment in the United States: Prevalence estimates from a nationally representative study. Journal of Gerontology, 63B(4), S248-S254.
  4. Friedman, Lee S., Avila, S., Tanouye, K., & Joseph, K. (2011). A case-control study of severe physical abuse of older adults. Journal of the American Geriatrics Society, 59, 417-422.
  5. 5.0 5.1 Acierno, R., Hernandez, M. A., Amstadter, A. B., Resnick, H. S., Steve, K., Muzzy, W., & Kilpatrick, D. G. (2010). Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The national elder mistreatment study. American Journal of Public Health, 100(2), 292-297.
  6. 6.0 6.1 6.2 6.3 Amstadter, A. B., Zajac, K., Strachan, M., Hernandez, M. A., Kilpatrick, D. G., & Acierno, R. (2011). Prevalence and correlates of elder mistreatment in South Carolina: The South Carolina elder mistreatment study. Journal of Interpersonal Violence, 26(15), 2947-2972.
  7. "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
  8. Garre-Olmo, J, X Planas-Pujol, S López-Pousa, and J Vilalta-Franch. "Prevalence and Risk Factors of Suspected Elder Abuse Subtypes in People Aged 75 and Older.." Journal of the American Geriatrics Society 57.5 (2009): 815-822.
  9. "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
  10. Black, J. "The not-so-golden years: Power of attorney, elder abuse, and why our laws are failing a vulnerable population.." St. John's Law Review 82.1 (2005): 289-314.
  11. Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
  12. Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
  13. "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
  14. "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
  15. "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
  16. Reeves, S, and J Wysong. "Stratigies to Address Financial Abuse." Journal of Elder Abuse & Neglect 22.3/4 (2010): 328-334
  17. Kemp, B, and L Mosqueda. "Elder Financial Abuse: An Evaluation Framework and Supporting Evidence." Journal of the American Geriatrics Society 53.7 (2005): 1123-1127.
  18. "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
  19. Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
  20. Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
  21. Reeves, S, and J Wysong. "Stratigies to Address Financial Abuse." Journal of Elder Abuse & Neglect 22.3/4 (2010): 328-334<ref></ref>

    Professional Abuse of Elders

    In countries like UK, Canada and Sweden there is an increasing rate of older

    adults needing full time care in nursing facilities. <ref>Hasson, H. H., & Arnetz, J. E. (2006). Nursing staff competence, work

    strain, stress and satisfaction in elderly. Journal of Clinical Nursing, (17), 468-481.</li> <li id="_note-18">[[#_ref-18|↑]] Natan, M. B., & Lowenstein, A. (2010). Study of factors that

    affect abuse. Nursing Management, 17(8), 20-24.</li> <li id="_note-19">[[#_ref-19|↑]] Natan, M. B., &

    Lowenstein, A. (2010). Study of factors that affect abuse. Nursing Management, 17(8), 20-24.</li> <li id="_note-20">[[#_ref-20|↑]] Buzgova, R., & Ivanova, K. (2011).

    Violation of ethical principles. Nursing Ethics, 18(1), 64-78.</li> <li id="_note-21">[[#_ref-21|↑]] Hasson, H. H., & Arnetz, J. E. (2006). Nursing

    staff competence, work strain, stress and satisfaction in elderly. Journal of Clinical Nursing, (17), 468-481.</li> <li id="_note-22">[[#_ref-22|↑]] Hasson, H. H., & Arnetz, J. E. (2006). Nursing staff competence, work strain, stress and satisfaction in

    elderly. Journal of Clinical Nursing, 17), 468-481.</li> <li id="_note-23">[[#_ref-23|↑]] Natan, M. B., Lowenstein, A., &

    Eisikovits, Z. (2010). Psycho-social factors affecting elders’. International Nursing Review, 57, 113-

    120</li> <li id="_note-24">[[#_ref-24|↑]] Malmedal, W.,

    Ingebrigtsen, O., & Saveman, B. (2009). Inadequate care in Norwegian nursing homes – as reported.

    Scandinavian Journal of Caring Sciences, 23, 231-242</li> <li id="_note-25">[[#_ref-25|↑]] Buzgova, R., & Ivanova, K. (2011). Violation of ethical principles. Nursing Ethics, 18(1), 64-78</li></ol></ref>

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