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| - | ==WHO IS MOST AT RISK | + | ==WHO IS MOST AT RISK FOR BECOMING A VICTIM?== |
| ===Risk Factor: Low Social Support=== | ===Risk Factor: Low Social Support=== | ||
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| *Affordable and accessible public transportation<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" /> | *Information about community resources available to them when they are in need<ref name="AMSTADTER" /> | ||
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| + | ==WHO IS MOST AT RISK FOR BECOMING ABUSIVE== | ||
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| + | ===Risk Factor: Anxiety and Depression=== | ||
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| + | Family caregivers of elders with dementia who were more psychologically distressed (or had higher levels of anxiety and/or depression) were more likely to act in an abusive manner towards the elderly person they were caring for<ref name="COOPER">Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R., & Livingston, G. (2010). The determinants of family carers' abusive behaviour to people with dementia: Results of the CARD study. Journal of Affective Disorders, 121, 136-142.</ref> Psychological distress was explained by poor methods of coping with stress, such as blaming oneself, denial and substance use and by physical and psychological burden felt by the caregiver<ref name="COOPER" /> | ||
| + | |||
| + | When it was a spouse providing care for an elderly individual with dementia, the couple’s relationship before the illness was related depression experienced by the caregiving spouse.<ref name="WILLIAMSON">Williamson, G. M., & Shaffer, D. R. (2001). Relationship quality and potentially harmful behaviors by spousal caregivers: How we were then, how we are now. Psychology and Aging, 16(2), 217-226.</ref> More specifically, if couples were more vs. less responsive to each other’s needs before the onset of illness, caregivers reported being less depressed and engaged in less abusive behaviour. These caregivers were more likely to view the role they were playing in the relationship as rewarding, and were less likely to experience burden in caregiving.<ref name="WILLIAMSON" /> | ||
| + | |||
| + | ====Interventions==== | ||
| + | |||
| + | *Physicians providing information, referrals to clinicians or support groups and monitoring caregiver health and wellbeing to ensure elder wellbeing<ref name="BEACH">Beach, S. R., Schulz, R., Williamson, G. M., Miller, S., Weiner, M., & Lance, C. E. Risk factors for potentially harmful informal caregiver behaviour. Journal of the American Geriatrics Society, 53(2), 255-261.</ref> | ||
| + | *Target caregivers who had less responsive relationships with spouse prior to spouses illness, provide therapies that will make them feel good about themselves which may in turn allow for more closeness in relationship with spouse<ref name="WILLIAMSON" /> | ||
| + | |||
| + | |||
| + | <videoflash>JFIXxhyUWng&feature=related</videoflash> | ||
| + | |||
| + | |||
| + | ==OTHER RISK FACTORS== | ||
| + | |||
| + | The above risk factors appeared to be the most prevalent and well-supported in present research. Other risk factors that have been found include: care recipients being very dependent on their caregiver<ref name="BEACH" /> , older caregivers<ref name="BEACH" /> and previous traumatic or abusive experience.<ref name="ACIERNO" /> | ||
| + | |||
| + | |||
| + | ==OTHER INTERVENTIONS== | ||
| + | |||
| + | In a study by Selwood and her colleagues (2009)<ref>Selwood, A., Cooper, C., Owens, C., Blanchard, M., & Livingston, G. (2009). What would help me stop abusing? The family carer’s perspective. International Psychogeriatrics, 21(2), 309-313.</ref>, caregivers were asked what types of interventions they would find most helpful to them in caring for an elder with dementia. Caregivers suggested that medication to help the elder with memory loss, written information on memory loss and advice, and information and advice from professionals about memory loss would be the most helpful to them. | ||
| + | |||
| + | =====Useful Links===== | ||
| + | http://www.who.int/violence_injury_prevention/violence/world_report/factsheets/en/elderabusefacts.pdf | ||
| ==Notes and References== | ==Notes and References== | ||
Revision as of 05:39, 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]
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 FOR BECOMING 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]
WHO IS MOST AT RISK FOR BECOMING ABUSIVE
Risk Factor: Anxiety and Depression
Family caregivers of elders with dementia who were more psychologically distressed (or had higher levels of anxiety and/or depression) were more likely to act in an abusive manner towards the elderly person they were caring for[7] Psychological distress was explained by poor methods of coping with stress, such as blaming oneself, denial and substance use and by physical and psychological burden felt by the caregiver[7]
When it was a spouse providing care for an elderly individual with dementia, the couple’s relationship before the illness was related depression experienced by the caregiving spouse.[8] More specifically, if couples were more vs. less responsive to each other’s needs before the onset of illness, caregivers reported being less depressed and engaged in less abusive behaviour. These caregivers were more likely to view the role they were playing in the relationship as rewarding, and were less likely to experience burden in caregiving.[8]
Interventions
- Physicians providing information, referrals to clinicians or support groups and monitoring caregiver health and wellbeing to ensure elder wellbeing[9]
- Target caregivers who had less responsive relationships with spouse prior to spouses illness, provide therapies that will make them feel good about themselves which may in turn allow for more closeness in relationship with spouse[8]
OTHER RISK FACTORS
The above risk factors appeared to be the most prevalent and well-supported in present research. Other risk factors that have been found include: care recipients being very dependent on their caregiver[9] , older caregivers[9] and previous traumatic or abusive experience.[5]
OTHER INTERVENTIONS
In a study by Selwood and her colleagues (2009)[10], caregivers were asked what types of interventions they would find most helpful to them in caring for an elder with dementia. Caregivers suggested that medication to help the elder with memory loss, written information on memory loss and advice, and information and advice from professionals about memory loss would be the most helpful to them.
Useful Links
Notes and References
- ↑ Lachs, M. S., & Pillemer, K. (2004). Elder abuse. Lancet, 364, 1263-1272.
- ↑ 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
- ↑ 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.
- ↑ 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.
- ↑ 5.0 5.1 5.2 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.
- ↑ 6.0 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.
- ↑ 7.0 7.1 Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R., & Livingston, G. (2010). The determinants of family carers' abusive behaviour to people with dementia: Results of the CARD study. Journal of Affective Disorders, 121, 136-142.
- ↑ 8.0 8.1 8.2 Williamson, G. M., & Shaffer, D. R. (2001). Relationship quality and potentially harmful behaviors by spousal caregivers: How we were then, how we are now. Psychology and Aging, 16(2), 217-226.
- ↑ 9.0 9.1 9.2 Beach, S. R., Schulz, R., Williamson, G. M., Miller, S., Weiner, M., & Lance, C. E. Risk factors for potentially harmful informal caregiver behaviour. Journal of the American Geriatrics Society, 53(2), 255-261.
- ↑ Selwood, A., Cooper, C., Owens, C., Blanchard, M., & Livingston, G. (2009). What would help me stop abusing? The family carer’s perspective. International Psychogeriatrics, 21(2), 309-313.
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. [11] 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.[12] 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. [13] Furthermore this abuse is destined to increase so long as average age increases, technology improves and communication lines become simple to cross. [14]
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. [15]
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.[16]
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.[17]
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.[18]
-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.[19]
-It is suspected that only 1 in 25 elder financial abuse cases are reported. [20]
- The aging baby boomer generation controls more then 13 trillion in assets.[21]
- The peak age for financial decision making seems to be 53.3 years old.[22]
-Today over half a million Canadians are living with Alzheimer’s or a related mental impairment, within ten years this number will double.[23]
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[24]. 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.[25] 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. [26] Using questionnaires there was found a strong link
between the number of staff and the number of cases of abuse and neglect. [27]
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. [28]
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. [29] 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. [30] 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. [31] 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. [32] 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. [33]
 Elderly Abuse Statistics |
 Burnout Effect |
--Kb09ou 16:07, 29 October 2011 (EDT)
Notes and References
- ↑ Lachs, M. S., & Pillemer, K. (2004). Elder abuse. Lancet, 364, 1263-1272.
- ↑ 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
- ↑ 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.
- ↑ 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.
- ↑ 5.0 5.1 5.2 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.
- ↑ 6.0 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.
- ↑ 7.0 7.1 Cooper, C., Selwood, A., Blanchard, M., Walker, Z., Blizard, R., & Livingston, G. (2010). The determinants of family carers' abusive behaviour to people with dementia: Results of the CARD study. Journal of Affective Disorders, 121, 136-142.
- ↑ 8.0 8.1 8.2 Williamson, G. M., & Shaffer, D. R. (2001). Relationship quality and potentially harmful behaviors by spousal caregivers: How we were then, how we are now. Psychology and Aging, 16(2), 217-226.
- ↑ 9.0 9.1 9.2 Beach, S. R., Schulz, R., Williamson, G. M., Miller, S., Weiner, M., & Lance, C. E. Risk factors for potentially harmful informal caregiver behaviour. Journal of the American Geriatrics Society, 53(2), 255-261.
- ↑ Selwood, A., Cooper, C., Owens, C., Blanchard, M., & Livingston, G. (2009). What would help me stop abusing? The family carer’s perspective. International Psychogeriatrics, 21(2), 309-313.
- ↑ "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
- ↑ 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.
- ↑ "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
- ↑ 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.
- ↑ Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
- ↑ Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
- ↑ "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
- ↑ "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
- ↑ "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
- ↑ Reeves, S, and J Wysong. "Stratigies to Address Financial Abuse." Journal of Elder Abuse & Neglect 22.3/4 (2010): 328-334
- ↑ 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.
- ↑ "The crime of the 21st century." Kiplinger's Personal Finance Nov. 2011: 11.
- ↑ Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
- ↑ Gotlieb, R.. "Stealing from mom and dad." Macleans 124.27 (2011): 27-28
- ↑ 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-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|↑]] Natan, M. B., &
Lowenstein, A. (2010). Study of factors that affect abuse. Nursing Management, 17(8), 20-24.</li> <li id="_note-21">[[#_ref-21|↑]] Buzgova, R., & Ivanova, K. (2011).
Violation of ethical principles. Nursing Ethics, 18(1), 64-78.</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|↑]] 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-24">[[#_ref-24|↑]] Natan, M. B., Lowenstein, A., &
Eisikovits, Z. (2010). Psycho-social factors affecting elders’. International Nursing Review, 57, 113-
120</li> <li id="_note-25">[[#_ref-25|↑]] 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-26">[[#_ref-26|↑]] Buzgova, R., & Ivanova, K. (2011). Violation of ethical principles. Nursing Ethics, 18(1), 64-78</li></ol></ref>
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