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CSAP Substance Abuse Resource Guide: Violence Against The Elderly



2000 CSAP 21 pages 210 to a Box This resource guide examines incidence and risk factors for elder abuse, as well as substance abuse and violence among the elderly. The Federal Government estimates that 1.5 million to 2 million elders suffer from abuse each year, while other studies estimate close to 2.5 million. With the aging of the U.S. population, the number will likely increase.






Nelba Chavez, Ph.D.
Administrator
Substance Abuse and Mental Health Services Administration

Ruth Sanchez-Way, Ph.D.
Acting Director, Center for Substance Abuse Prevention
Substance Abuse and Mental Health Services Administration

Table of Contents:

•Books
•Booklets, Brochures, and Fact Sheets
•Magazines and Newsletters
•Videos, Posters, and Other Items
•Studies, Articles, and Reports
•Organizations and Internet Sites

15744


The listing of materials of programs in this resource guide does not constitute or imply endorsement by the Center for Substance Abuse Prevention, the Public Health Service, the Substance Abuse and Mental Health Services Administration, or the Department of Health and Human Services. The materials have been reviewed for accuracy, appropriateness, and conformance with public health principals.

This Substance Abuse Resource Guide was compiled from a variety of publications and data bases and represents the most current inforamtion to date. It is not an all-inclusive listing of materials on this topic. This guide will be updated regularly, and your comments or suggestions are welcome. To suggest information or materails that might be included in future editions, please write to SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), P.O. Box 2345, Rockville, MD 20847-2345.

Produced by SAMHSA's National Clearinghouse for Alcohol and Drug Information, Denise C. Jones, editor.

For further information on alcohol, tobacco, and illicit drugs, call 800-729-6686, 301-468-2600, or TDD 800-487-4889. Or visit us on our World Wide Web Site at http://ncadi.samhsa.gov.


Books


Substance Abuse in the Elderly

Found in Sourcebook on Substance Abuse: Etiology, Epidemiology, Assessment, and Treatment, edited by P.J. Ott, R.E. Tarter, et al., this chapter discusses substance abuse in the elderly. Topics include substance abuse in older individuals; changes in the aging body’s response to drugs (pharmacokinetic age changes, pharmacodynamic age changes, adverse drug reactions); substances of abuse; illicit drugs; tobacco; pre-scribed psychoactive medications; over-the-counter drugs; alcohol (problem drinking, etiology, and the age of onset); screening for alcohol-related disorders; interventions; modalities (detoxification, chemotherapy, counseling, family therapies, group treatment, self-help groups, behavioral-cognitive therapies, adjunctive services); elder-specific treatment; dual diagnosis; stress as etiology; and outcome studies.

Organization: 
Editor: 
Author: Gomberg, E.S.L.
Publication: 
Publisher: 
Year: 1999
Length: 472 pages
Topic: Abuse of the elderly
Target Audience: Elderly persons and general public
Availability: Allyn & Bacon, 160 Gould Street, Needham, MA 02494; 800-666-9433 or bookstores
Format: Book (hardcover)
Cost: $76
Internet Address: 


Domestic Abuse: Public Policy/Criminal Justice Approaches Towards Child, Spousal, and Elderly Abuse

This book features theoretical and analytical discussions about the occurrence of domestic violence, particularly against children and the elderly.

Organization: 
Editor: 
Author: Kakar, S.
Publication: 
Publisher: 
Year: 1997
Length: 490 pages
Topic: Domestic violence
Target Audience: General public and the elderly
Availability: Bookstores
Format: Book (paperback)
Cost: $69
Internet Address: 


Confronting Maltreatment of Elders by Their Family

This chapter in Strengthening Aging Families: Diversity in Practice and Policy, edited by G.C. Smith, S.S. Tobin, et al., defines elder abuse and maltreatment, describes possible causes of the problem, and suggests various methods of intervention, including supportive services.

Organization: 
Editor: 
Author:  Kosberg, J.I.; Garcia, J.L.
Publication: 
Publisher: 
Year: 1995
Length: 290 pages
Topic: Elder abuse
Target Audience: General public and the elderly
Availability: Sage Publications, Inc., 2455 Teller Road, Thousand Oaks, CA 91320; 800-499-0721 or bookstores
Format: Book
Cost: $25.50
Internet Address: 


Elder Abuse: International and Cross-Cultural Perspectives

This book discusses elder abuse in countries ranging from Australia to Finland, from South Africa to Hong Kong, from Ireland to Israel. It addresses the consequences of aging, dynamics of elder abuse, family care of the elderly, formal and informal mechanisms for preventing elder abuse, and methods of publicizing possibilities of abuse. Each chapter’s authors explore the definition of elder abuse in their country; the ex-tent of the problem; causes of the problem (as related to values and practices); societal attitudes about the existence of the problem; and private and public efforts to detect and prevent the problem and to intervene where it has occurred. The book is of interest to individuals who work in social work, nursing, and psychology settings and to those in the fields of sociology, anthropology, and gerontology.

Organization: 
Editor: Kosberg, J.; Garcia, J.L.
Author: 
Publication: 
Publisher: 
Year: 1995
Length: 200 pages
Topic:  International perspectives on elder abuse
Target Audience: General public and the elderly General public and the elderly
Availability: Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580; 800-HAWORTH or bookstores
Format: Book (hardcover)
Cost: $49.95
Internet Address: 


Booklets, Brochures, and Fact Sheets


Crimes Against Persons Age 65 or Older, 1992-97

This report supersedes the report, “Elderly Crime Victims: National Crime Victimization Survey.” This more recent document provides data from the National Crime Victimization Survey and the Uniform Crime Reports to summarize levels and rates of violent and property crimes (reported and unreported) against persons age 65 or older. Crime rates for the elderly are compared with those of other age groups. These crimes are murder, rape, robbery, assault, larceny, household burglary, property theft, and motor vehicle theft. The report also discusses 1992-97 trends, comparing the eld-erly with other age groups, and presents data on offender weapon use, self-protective measures by victims, victim injury and treatment, stranger versus nonstranger crime, place and time of occurrence, and victim and offender demographics, including gender, race, ethnicity, and household income.

Organization:  Bureau of Justice Statistics
Editor: 
Author: 
Publication: 
Publisher: 
Year: 2000
Length: 41 pages
Topic: Crimes against the elderly
Target Audience: Elderly persons and the general public
Availability: Department of Justice, Office of Justice Pro-grams, Bureau of Justice Statistics, Report NCJ#176352, National Criminal Justice Research Service, P.O. Box 6000, Rockville, MD 20849-6000; 800-851-3420
Format: Booklet
Cost: Free
Internet Address: http://www.ojp.usdoj.gov/bjs/cvict_v.htm


The National Elder Abuse Incidence Study: Final Report

This report brings a severely underreported problem to light. It estimates that at least one-half million older persons in domestic settings were abused or neglected, or experienced self-neglect during 1996, and that for every reported incident of elder abuse, neglect, or self-neglect, approximately five go unreported.

Organization:  The National Center on Elder Abuse
Editor: 
Author: 
Publication: 
Publisher: 
Year: 1998
Length: 80 pages
Topic: Abuse of the elderly
Target Audience: Elderly persons and general public
Availability: Document No. NAIC-48, National Aging In-formation Center, Administration on Aging, 330 Independence Avenue, SW., Room 4656, Washington, DC 20201; 202-619-7501
Format: Booklet
Cost: Free
Internet Address: 


Elderly Crime Victims: National Crime Victimization Survey

The survey uses data from the National Crime Victimization Survey to summarize levels and rates of violent and nonviolent crimes against persons ages 65 years or older. These crimes are rape, robbery, assault, larceny, household burglary, household larceny, and motor vehicle theft. It also includes 1973-1992 trends and data on use of weapons by offenders; self-protective measures by victims; victim injury and treatment; stranger versus non-stranger crime; place of occurrence; and victims’ income, marital status, and residence in urban, rural, or suburban area. Crime rates for the elderly are compared with those of other age groups by race and sex.

Organization:  Bureau of Justice Statistics
Editor: 
Author: 
Publication: 
Publisher: 
Year: 1994
Length: 4 pages
Topic: Crimes against the elderly
Target Audience: Elderly person and general public
Availability: Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, Report NCJ#147186, National Criminal Justice Research Service, P.O. Box 6000, Rockville, MD 20849-6000; 800-851-3420
Format: Booklet
Cost: Free
Internet Address: http://www.ojp.usdoj.gov/bjs/abstract/ecv.htm


Elder Abuse—Help Put an End to It

This booklet describes types of abuse, patterns of elder abuse and how they develop, and resources to stop or prevent this problem. (Also available in Spanish.)

Organization:  Channing L. Bete Co., Inc.
Editor: 
Author: 
Publication: 
Publisher: 
Year: Not listed
Length: 8 pages
Topic: Elder abuse
Target Audience: General public
Availability: Channing L. Bete Co., Inc., 200 State Road, South Deerfield, MA 01373-0200; 800-628-7733
Format: Brochure
Cost: $1.05 each for a quantity of 1-99; $ .70 each for quantity of 100-499
Internet Address: 


Magazines and Newsletters


Prevention Pipeline

The CSAP/NCADI award-winning bi-monthly magazine features an array of articles, statistics, abstracts, descriptions of new materials in the NCADI catalog, updates on new research in the substance abuse field, funding resources, public service ads, and reprinted materials. Subscribers are encouraged to “lift” articles and artwork for their own newsletters.

Organization: 
Editor: 
Author: 
Publication: 
Publisher: Center for Substance Abuse Prevention (CSAP)
Year: Published bimonthly
Length: 60 pages
Topic: Alcohol and substance abuse
Target Audience: Substance abuse prevention professionals, educators, parents, teens, and adults
Availability: SAMHSA’s National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345; 800-729-6686
Format: Magazine
Cost: Annual subscriptions are $28 for domestic orders, $32 for international orders
Internet Address: http://www.health.org


Videos, Posters, and Other Items


I’d Rather Be Home

This film documents the case of Norman, an older man repeatedly abused by one of his adult sons, over a period of 7 years. After one severe beating, Norman ends up in a nursing home, has a mild stroke, and is placed under State guardianship. This film addresses the cycle of abuse and neglect through interviews with Norman, his wife, police officers, and a doctor.

Organization:  Terra Nova Films
Editor: 
Author: 
Publication: 
Publisher: 
Year: 1997
Length: 30 minutes
Topic: Elder abuse
Target Audience: General public
Availability: National Media Owl Award Video Collection, University of North Texas Media Library, P.O. Box 305190, Denton, TX 76203-5190; 940-565-2484
Format: Videotape
Cost: Rental only for three business days—$10 + $5 shipping and handling (Texas residents only); $23 + $5.75 shipping and handling (all other U.S. States)
Internet Address: 


Reporting Elder Abuse: You Can Make A Difference

This video series includes a dramatization to inform fire fighters, mental health professionals, physicians, law enforcement personnel, and emergency room staff of their obligation to report senior abuse to the proper authorities. The general video covers the complexity and severity of elder abuse, the detection of potential abuse, the necessity of reporting it, and outlines the service available through protective service intervention. The videos highlight the warning signs of elder abuse and ways to respond to those signs for each of the aforementioned professions. This video series was produced under the Massachusetts Executive Office of Elder Affairs as a training tool.

Organization:  Massachusetts Executive Office of Elder Affairs
Editor: 
Author: 
Publication: 
Publisher: 
Year: 1993
Length: 30 minutes
Topic: Abuse of the elderly
Target Audience:  Senior service agency staff
Availability: National Media Owl Award Video Collection, University of North Texas Media Library, P.O. Box 305190, Denton, TX 76203-5190
Format: Videotape series of five
Cost: Rental for three business days—$10 + $5 shipping and handling (Texas residents only); $23 + $5.75 shipping and handling (all other U.S. States)
Internet Address: 


Elder Abuse and Neglect in the Family

This is a series of three videos focusing on abuse of the elderly. The first tape features an overview of the problem; it looks at definitions, causes and manifestations of abuse and neglect through conversations with actual victims, medical staff, and elder abuse professionals. In tape two, social workers discuss intervention strategies involving: conducting an assessment, developing a service plan, coordinating community services, using the legal system, and building trusting relationships. The third tape features a caseworker, lawyers, and other elder abuse professionals examining the civil rights of individuals to live their own lives without intervention from the State. Issues of competency, reluctant victims, and quality of life are discussed.

Organization:  Intersection Associations for Project Idea
Editor: 
Author: 
Publication: 
Publisher: 
Year: 1986
Length: 71 minutes
Topic: Elder abuse
Target Audience: General public, elderly persons, medical and legal professionals, and social workers
Availability: National Media Owl Award Video Collection, University of North Texas Media Library, P.O. Box 305190, Denton, TX 76203-5190; 940-565-2484
Format: Videotape series of three
Cost: Rental for three business days—$10 + $5 shipping and handling (Texas residents only); $23 + $5.75 shipping and handling (all other U.S. States)
Internet Address: 


Studies, Articles, and Reports


Aged and Dangerous: Old-Age Forensic Psychiatry

The article discusses the small minority of elderly men and women who commit violent crimes, as well as the role of old-age forensic psychiatry in dealing with these crimes. It discusses the epidemiology of crimes committed by the elderly and describes the stages of the criminal justice system, including arrest, court appearances, prison, and hospitalization. Offenses committed include sex offenses, shoplifting, and homicide. The article describes diagnosis of dementia, schizophrenia, depression, personality disorder, and alcohol abuse.

Organization: 
Editor: 
Author: Yorston, G.
Publication: British Journal of Psychiatry, 174(1): 193–195,
Publisher: 
Year: 1999
Length: 
Topic: 
Target Audience: 
Availability: 
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Internet Address: 


Elder Mistreatment

Elder mistreatment is a widespread problem in our society that is often underrecognized by physicians. As a result of growing public outcry over the past 20 years, all States now have abuse laws that are specific to older adults; most States have mandated reporting by all health care professionals. The term “mistreatment” includes physical abuse and neglect, psychological abuse, financial exploitation, and violation of rights. Poor health, physical or cognitive impairment, alcohol abuse, and a history of domestic violence are some of the risk factors for elder mistreatment. Diagnosis of elder mistreatment depends on acquiring a detailed history from the patient and the caregiver. It also involves performing a comprehensive physical examination. Only through awareness, a healthy suspicion, and the performing of certain procedures are physicians able to detect elder mistreatment. Once it is suspected, elder mistreatment should be reported to adult protective services.

Organization: 
Editor: 
Author: Swagerty D.L., Jr.; Takahashi, P.Y.; and Evans, J.M.
Publication: American Family Physician, 59(10): 2804-2808
Publisher: 
Year: 1999
Length: 
Topic: 
Target Audience: 
Availability: 
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Internet Address: 


The Mortality of Elder Mistreatment

Although elder mistreatment is suspected to be life-threatening in some instances, little is known about the survival of elderly persons who have been mistreated. This study estimates the independent contribution of reported elder abuse and neglect to all-cause mortality. It observed a cohort of community-dwelling older adults, using a prospective cohort study with at least 9 years of follow-up (the New Haven Established Population for Epidemiologic Studies in the Elderly cohort, which included 2,812 community-dwelling adults who were older than 65 in 1982, a subset of whom were referred to protective services for the elderly). The study looked at all-cause mortality among (1) elderly persons for whom protective services were used for corroborated elder mistreatment (elder abuse, neglect, or exploitation), or (2) elderly persons for whom protective services were used for self-neglect. In the first 9 years after cohort inception, 176 cohort members were seen by elderly protective services for verified allegations; 10 (5.7 percent) of these were for abuse, 30 (17.0 percent) for neglect, 8 (4.5 percent for exploitation, and 128 (72.7 percent) for self-neglect. At the end of a 13-year follow-up period from cohort inception, cohort members seen for elder mistreatment at any time during the follow-up had poorer survival (9 per-cent) than either those seen for self-neglect (17 percent) or other non-investigated cohort members (40 per-cent). In a pooled logistic regression that adjusted for demographic characteristics, chronic diseases, functional status, social networks, cognitive status, and depressive symptomatology, the risk of death remained elevated for cohort members experiencing either elder mistreatment or self-neglect when compared with other members of the cohort. Reported and corroborated elder mistreatment and self-neglect are associated with shorter survival after adjusting for other factors associated with increased mortality in older adults.

Organization: 
Editor: 
Author: Lachs, M.S.; Williams, C.S.; O’Brien, S.; Pillemer, K.A.; and Charlson, M.E.
Publication: Journal of the American Medical Associa-tion, 280(5): 428-432
Publisher: 
Year: 1998
Length: 
Topic: 
Target Audience: 
Availability: 
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Internet Address: 


Under the Rug: Substance Abuse and the Mature Woman

Under the Rug provides an analysis of alcohol and substance abuse among women over age 59 who are an exception to the axiom that an individual who has reached age 21 without smoking, using drugs, or abusing alcohol is virtually certain to never do so. The National Center on Ad-diction and Substance Abuse at Co-lumbia University estimates that of the 25.6 million women over age 59 in the United States, 17 percent are addicted to nicotine, 7 percent abuse al-cohol, and 11 percent abuse psychoac-tive drugs.

Organization: 
Editor: 
Author:  National Center on Addiction and Sub-stance Abuse at Columbia University 1998, 178 pages
Publication: National Center On Addiction and Substance Abuse, Columbia University
Publisher: 
Year: 1998
Length: 178 pages
Topic: 
Target Audience: 
Availability: National Center On Addiction and Substance Abuse, Columbia University, 633 Third Avenue, 19th floor, New York, NY 10017-6706; 212-841-5200
Format: 
Cost: 
Internet Address: 


Elder Abuse: A Review

Elder abuse exists in many forms: physical, emotional, financial, and sexual, neglect, and self-neglect. As many as 2.5 million older people are abused each year, and the number of cases will likely increase as this population grows. Elder abuse receives less attention than other forms of domestic violence, and fewer than 10 percent of cases are reported. Although all States have legislation addressing elder abuse, financial support for evaluation and protective services is lacking. Most States have mandatory reporting; however, it may infringe on the autonomy of competent geriatric individuals. Physicians infrequently report elder abuse because they are not familiar with reporting laws, fear offending patients, are concerned with time limitations, or believe they do not have appropriate evaluation skills. Victims often have low self-esteem, blame themselves for the abuse, and do not want to admit their vulnerabilities or betray their families. The “caregiver stress hypothesis,” which suggests that abuse stems from caregiver stress and resentment resulting from chronic care of dependent geriatric patients, is a misconception. Abuse is actually more correlated with the emotional and financial dependence of the caregivers on the geriatric victims. Relatives or other members of their immediate household most commonly abuse older patients. Older men and women have similar per capita abuse rates. Assessment and management should be supportive without assigning blame and should focus on both the patient and the caregiver. Patients in immediate danger should be hospitalized or placed in emergency shelters. Suspected abuse should be reported directly to the appropriate State agency, which can provide a thorough long-term assessment.

Organization: 
Editor: 
Author: Kleinschmidt, K.C.
Publication: Annals of Emergency Medicine, 30(4): 463–472
Publisher: 
Year: 1997
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Elder Abuse and Neglect: Causes and Consequences

This article provides an overview of the more often cited theoretical models to explain elder mistreatment, reviews the research literature on risk factors and consequences, and presents some general thoughts on service delivery. The risk factors for elder abuse and neglect are caregiver stress and the victim dependency, psychopathology, and the abuser dependency. The consequences for victims include depression, learned helplessness and alienation, posttraumatic stress disorder, guilt, and denial. For abusers, the consequences include depression and a web of interdependency. If elder abuse is thought to be mainly a result of caregiver stress, helping the caregiver is the treatment of choice: bringing into the home skilled nursing, personal care, meals-on-wheels, and chore services. For situations where it is advisable to remove the victim from the home temporarily, emergency shelters can be used. The strong association between dependency of the abuser and physical abuse has suggested a series of services to encourage independence through housing and financial assistance, job training, and substance abuse counseling.

Organization: 
Editor: 
Author: Wolf, R.S.
Publication: Journal of Geriatric Psychiatry, 30(1): 153–174
Publisher: 
Year: 1997
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Elder Mistreatment: National Survey of Emergency Physicians

To determine the perceived magnitude of elder mistreatment, physician awareness of applicable State laws and the barriers to reporting suspected cases, the authors surveyed a random sample of 3,000 members of the American College of Emergency Physicians in the United States. Survey questions included characteristics of the practice, number and type of suspected cases of elder mistreatment seen in the Emergency Department, number of cases actually reported, and reasons for not reporting abuse. Physicians were also asked about the availability of elder-mistreatment protocols and their familiarity with local laws and reporting requirements. Completed surveys totaled 705, for a response rate of 24 percent. Most physicians (52 percent) described elder mistreatment as prevalent but less so than spouse or child abuse. The respondents had evaluated a mean of 4 +/- 8 (range, 0 to 93) suspected cases of elder mistreatment in the preceding 12 months; approximately 50 percent were reported. Only 31 percent of emergency physicians reported having a written protocol for the reporting of elder mistreatment, and physicians were generally not familiar with applicable State laws. Twenty-five percent were able to recall educational content pertaining to elder mistreatment during their emergency medicine residencies. Most physicians were not certain or did not believe that clear-cut medical definitions of elder abuse or neglect exist (74 percent); that emergency physicians can accurately identify cases of mistreatment (58 percent); or that their States had sufficient resources to meet the needs of victims (92 percent). These results suggest that practicing emergency physicians are not confident in identifying or reporting geriatric victims of abuse or neglect. This lack of confidence may reflect inadequacies of training, research, and continuing education with regard to mistreatment of older people.

Organization: 
Editor: 
Author: Jones, J.S.; Veenstra, T.R.; Seamon, J.P.; and Krohmer, J.
Publication: Annals of Emergency Medicine, 30(4): 473–479
Publisher: 
Year: 1997
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The Association of Elder Abuse and Substance Abuse in the Illinois Elder Abuse Sys-tem

This article explores the role of substance abuse in 552 cases of substantiated elder abuse in Illinois. When the abuser was identified as having a substance abuse (SA) problem, the type of elder abuse substantiated was more likely to involve either physical or emotional abuse than neglect or financial exploitation. Abusers with SA problems were more likely to be men and children of their victims, and less likely to be caregivers. Abuser SA was associated with victim SA. Cases involving abusers with SA problems were more likely to be evaluated by case workers as having a high potential risk for future abuse. Elder abuser case workers should be trained to identify both victim and abuser and appropriate intervention strategies.

Organization: 
Editor: 
Author: Hwalek, M.A.; Neale, A.V.; Goodrich, C.S.; and Quinn, K.
Publication: Gerontologist, 36(5): 694–700
Publisher: 
Year: 1996
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Violence and Women’s Mental Health

The article discusses the epidemiology, etiology, consequences, management, and prognosis of physical violence including homicide, battering, rape, and elder abuse. Statistics are presented regarding prevalence of specific kinds of violence against women. The etiology is complex, involving societal factors, transgenerational cycles of violence, and, often, substance abuse. Medical, behavioral, and psychological consequences may follow violent acts against women. Assessment of the effects must include the nature and severity of the act, the woman’s past history and coping abilities, and her current life circumstances and supports. Psychiatric care should include emergency management and the longer-term psychotherapeutic relationship. Psychotherapeutic interventions that seem most helpful include having empathy, validating the experience of helplessness, and helping the victim regain a sense of empowerment and trust.

Organization: 
Editor: 
Author: Stewart, D.E.; Robinson, G.E.
Publication: Harvard Review of Psychiatry, 4(1): 54–57
Publisher: 
Year: 1996
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Abuse of Patients with Dementia by Carers—Out of Sight But Not Out of Mind

This study discusses factors influencing the abuse of elderly people with dementia by their carers and the limitations of existing research (1974-1994). The term “abuse” implies criticism of the carer. Definitions of abuse are too vague for research purposes. Further, prevalence studies use different criteria for abuse, though studies from different countries generally show a rate of less than 5 percent. Elderly dementia patients living with a carer are at significantly higher risk of abuse than the general population over age 65. Carers who admit to abuse are more likely than non-abusers to have a history of mental illness and alcohol abuse. There is an association between physical abuse and high psychological and physical demands placed on family carers of dementia patients. Intervention should focus on both carers and patients. The study also discusses implications for research.

Organization: 
Editor: 
Author: Cooney, C.; Howard, R.
Publication: International Journal of Geriatric Psychia-try, 10(9): 735–741
Publisher: 
Year: 1995
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Characteristics of Violent Elderly in the Emergency Department

This study examined the incidence of violent acts committed by violent elderly patients over a 5-year period and their characteristics. Twenty-one violent eld-erly persons—ages 60 and older—were compared with 190 non-elderly violent subjects whose mean age was 41. Data were collected from all dangerous behavior incident reports, which included descriptions of verbal or physical aggression, use of weapon, injury to others, and out-come of the incident. Demographic information, psychiatric and medical diagnoses, and frequency of medical center use were obtained. Results show that 81 percent of the elderly subjects had a psychiatric diagnosis, generally alcohol dependence or a psychotic disorder. They had more medical illness than non-elderly subjects, but both groups were frequent users of medical services. There were no differences between the two groups in perpetrators’ characteristics, nature of the violent episodes, or outcomes. Elderly subjects were likely to have both medical and psychiatric illness, and they used medical services frequently.

Organization: 
Editor: 
Author: Ganzini, L.; Edwards, P.; Surkan, P.J.; and Drummond, D.J.
Publication: International Journal of Geriatric Psychia-try, 10(11): 945–950
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Year: 1995
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Cross-Cultural Perspectives on Elder Abuse As a Family Dilemma

The article presents a perspective on elder abuse by reviewing relevant literature from various cultures. Comparative studies of cases by type of elder abuse disclose distinct profiles of abuse, neglect, and financial exploitation. Physical and psychological abuse were more closely associated with the problems of perpetrators than of the victims. Victim-perpetrator dependency, perpetration psychopathology, and caregiver stress emerge as major risk factors for elder abuse, with substance abuse and social isolation as serious contributing elements. The article comments on the lack of national policies in many countries that have reported elder abuse, such as Norway, Sweden, and Finland, and the lack of relevant studies from Africa. The multiple dimensions and variations of elder abuse have forced researchers to give up the search for one unifying theoretical model, and to start describing the parameters of their studies in terms of different variables.

Organization: 
Editor: 
Author: Sijuwade, P.O.
Publication: Social Behavior and Personality, 23(3): 247–251
Publisher: 
Year: 1995
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Elder Abuse and Neglect: How to Recognize Warning Signs and Intervene

Elder mistreatment, whether abuse or neglect, can be classified as physical, psychological, or financial/material. Several types of mistreatment may occur simultaneously, and abuse occurs across all socioeconomic, racial, and religious lines. Risk factors for elder abuse include a history of mental illness or substance abuse, a family history of violence, isolation of the victim, and recent stressful events in the life of the victim or abuser. This study suggests that, for the physician, the patient workup includes a careful history and physical exam, covering cognitive evaluation, living arrangements, financial status, social supports, and emotional stressors, and, if possible, the interaction between the patient and family member or caregiver. Helpful resources include the State Office of Protective Services and the American Medical Association’s recently published guidelines.

Organization: 
Editor: 
Author: Paris, B.E.; Meier, D.E.; Goldstein, T.; Weiss, M.; and Fein, E.D.
Publication: 
Publisher: Geriatrics, 50(4): 47–51
Year: 1995
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Risk Factors for Abuse and Neglect Among Older Adults

In the context of four theoretical perspectives (the social exchange theory, situational interactionism, symbolic interactionism, and a feminist model), this study examines the risk factors of abuse and neglect among 605 adults ages 55 and older. The quality of the relationship with the spouse was found to be an important factor in elder abuse and neglect. Age, coping ability, early adulthood abuse, and the client’s alcohol abuse had a significant effect on the type of abuse. The study suggests that the risk factors associated with the situational and feminist models are best in terms of physical abuse; the symbolic interaction model explains the most variance in chronic verbal abuse.

Organization: 
Editor: 
Author: Pittaway, E.D.; Westhues, A.; and Peressini, T.
Publication: Canadian Journal on Aging, 14 (2, Suppl 2): 20–44
Publisher: 
Year: 1995
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Silent Suffering: A Case Study of Elder Abuse and Neglect

Using the case study of a male age 62 whose causes of death had been listed as malnutrition, dehydration, and end-stage senile dementia, this study discusses the reporting and evaluation of elder abuse and neglect (EAN). Investigation revealed that the caregiver of the facility where the subject lived for 2 months before his death had been guilty of abuse. Types of EAN include physical or psychological abuse and neglect, financial/material abuse or exploitation, and violation of rights. Abusive caregivers often have difficulties with the law, hospitalizations for psychiatric illnesses, and substance abuse. They also show poor social and communication skills, emotional reserve, and coping skills. Health care professionals often fail to report cases of EAN. Such failure occurs more commonly in cases of unintentional neglect. A full and competent evaluation depends upon the availability, education, and expertise of an evaluator.

Organization: 
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Author: Conlin, M.M.
Publication: Journal of the American Geriatrics Soci-ety, 43(11): 1303–1308
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Year: 1995
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Alcoholism and Elder Abuse

This study focuses on the relationship between alcohol use and abuse and violence against the elderly. Twenty-three abusers of elderly parents and 39 non-abusers were administered structured interviews within their homes. Abusers were more likely to be male (56.5 percent), unmarried (78.3 percent), and younger (mean age 48) than non-abusers. Abusers were also twice as likely to drink heavily than non-abusers. Abusers specifically linked the consumption of alcohol to interactions with the elder parent. Fifty percent of the abusers had been told by someone that they had a drinking problem. The study discusses policy and practice implications.

Organization: 
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Author: Anetzberger, G.J.; Korbin, J.E.; and Austin, C.
Publication: Journal of Interpersonal Violence, 9(2): 184–193
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Year: 1994
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A Prospective Community-Based Pilot Study of Risk Factors for the Investigation of Elder Mistreatment

This study identifies risk factors for the investigation of elder abuse, neglect, self-neglect, exploitation, and abandonment in a population-based observational cohort of 2,812 community-living elders (over age 65). Sixty-eight members of the cohort received investigation. In multiple logistic regression, the following features at cohort entry were significantly associated with ombudsman investigation: requiring assistance with feeding, being a minority elder, being over age 75 at cohort inception, and having a poor social network.

Organization: 
Editor: 
Author: Lachs, M.S.; Berkman, L.F.; Fulmer, Terry, T.; and Horwitz, R.I.
Publication: Journal of the American Geriatrics Soci-ety, 42(2): 169–173
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Year: 1994
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Racial/Ethnic Variations in Informal Caregiving

This study documents and discusses variations in informal caregiving among members of racial ethnic minority groups in American society. Family members are the main providers of informal care for older persons, furnishing approximately 80 percent of in-home care for persons ages 75 or older and suffering chronic disabilities. Specifically, the article summarizes the literature regarding attitudes, norms, practices, expectations, and stereotypes in informal caregiving among blacks, Hispanics, American Indians, Asians, and Pacific Islanders. Al-though informal caregiving is the predominant mode of care provided for most older persons, demographic and cultural changes in all groups in the United States should lead to a greater balance between informal and formal care.

Organization: 
Editor: 
Author: Mangum, W.P.; Garcia, J.L.; Kosberg, J.I.; and Mullins, L.C.
Publication: Educational Gerontology, 20(7): 715–731
Publisher: 
Year: 1994
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Organizations and Internet Sites


 

Action on Smoking and Health

http://www.ash.org/




Admistration on Aging

http://www.aoa.dhhs.gov

202-619-7501

800-677-1116

330 Independence Avenue, SW
Washington, DC 20201




American Association for Retired Persons (AARP)

http://www.aarp.org

800-424-3410

800-515-2299 To Join (M-F 8-8 EST)

601 E Street
Washington, DC 20049

member@aarp.org




American Medical Association

http://www.ama-assn.org

312-464-5000

800-621-8335 Spanish available (M-F 8-4:30 CST)

515 North State Street
Chicago, IL 60610




American Psychiatric Association

http://www.psych.org

202-682-6000

888-357-7924

1400 K Street NW
Washington, DC 20005




American Psychological Association (APA)

http://www.apa.org/

202-336-5500

750 First Street, NE
Washington, DC 20002




Bureau of Alcohol, Tobacco, and Firearms

http://www.atf.treas.gov/

202-927-8500

650 Massachusetts Avenue, NW.
Room 8290
Washington, DC 20226

atfmail@atfhq.atf.treas.gov




Bureau of Justice Statistics (BJS)

http://www.ojp.usdoj.gov/bjs

202-307-0765 Washington, DC

800-732-3277

810 Seventh Street, NW.
Washington, DC 20531

askbjs@ojp.usdoj.gov




Bureau of Primary Health Care

http://bphc.hrsa.gov/

301-594-4490

4350 East-West Highway
3rd Floor
Bethesda, MD 20814




Caregiver Network-Social Issues

http://www.caregiver.on.ca/

410-323-1090

561 Avenue Road
Suite 206
Toronto, Ontario, M4V 2J8




Center for Mental Health Services

http://www.mentalhealth.samhsa.gov

301-443-9006 TDD

800-789-2647 Spanish available (M-F 8:30-5 EST)

PO Box 42490
Washington, DC 20015




Center for Study and Prevention of Violence

http://www.colorado.edu/cspv/

303-492-8465

Institute of Behavioral Science
University of Colorado at Boulder, Campus Box 442
Boulder, CO 80309




Center for Substance Abuse Prevention (CSAP)

http://www.samhsa.gov/centers/csap/csap.html

301-443-0365

800-729-6686 SAMHSA's National Clearinghouse for Alcohol and Drug Information

5600 Fishers Lane
Rockwall II Building, Suite 800
Rockville, MD 20857

info@samhsa.gov




Center on Addiction and Substance Abuse (CASA)

http://www.casacolumbia.org/

212-841-5200

212-956-8020 Fax

633 Third Avenue
19th Floor
New York, NY 10017




Centers for Disease Control and Prevention (CDC)

http://www.cdc.gov

202-512-1800 General Public (annual subscription of single copies)

800-843-6356 Government Employees (free copies from CDC)

1600 Clifton Road
Atlanta, GA 30333



Resources for Parents

http://www.cdc.gov/tobacco/tips_4_youth/prentlnk.htm


Health Topics A-Z

http://www.cdc.gov/health/diseases.htm


National Center for Injury Prevention and Control (NCIPC)

http://www.cdc.gov/ncipc/

770-488-1506  

National Center for Injury Prevention and Control (NCIPC)
Mailstop K65
4770 Buford Highway, NE
Atlanta, GA 30341



Centers for Disease Control and Prevention (CDC)

http://www.cdc.gov

202-512-1800 General Public (annual subscription of single copies)

800-843-6356 Government Employees (free copies from CDC)

1600 Clifton Road
Atlanta, GA 30333



Resources for Parents

http://www.cdc.gov/tobacco/tips_4_youth/prentlnk.htm


Health Topics A-Z

http://www.cdc.gov/health/diseases.htm


National Center for Injury Prevention and Control (NCIPC)

http://www.cdc.gov/ncipc/

770-488-1506  

National Center for Injury Prevention and Control (NCIPC)
Mailstop K65
4770 Buford Highway, NE
Atlanta, GA 30341



Centers for Disease Control and Prevention (CDC)

http://www.cdc.gov

202-512-1800 General Public (annual subscription of single copies)

800-843-6356 Government Employees (free copies from CDC)

1600 Clifton Road
Atlanta, GA 30333



Resources for Parents

http://www.cdc.gov/tobacco/tips_4_youth/prentlnk.htm


Health Topics A-Z

http://www.cdc.gov/health/diseases.htm


National Center for Injury Prevention and Control (NCIPC)

http://www.cdc.gov/ncipc/

770-488-1506  

National Center for Injury Prevention and Control (NCIPC)
Mailstop K65
4770 Buford Highway, NE
Atlanta, GA 30341



CSAP's PreventionPlatform

http://www.preventiondss.org/




Department of Justice

http://www.usdoj.gov/

950 Pennsylvania Avenue, NW
Washington, DC 20530



Bureau of Statistics

http://www.ojp.usdoj.gov

202-307-0765  

Bureau of Statistics
810 Seventh Street, NW
Washington, DC 20531



Federal Bureau of Investigation (FBI)

http://www.fbi.gov

202-737-3759

935 Pennsylvania Avenue, NW
Washington, DC 20535




Minnesota Higher Education Center Against Violence and Abuse

http://www.mincava.umn.edu/

612-624-0721

105 Peters Hall
1404 Gortner Avenue
St. Paul, MN 55108

http://www.mincava.umn.edu/mail/




National Aging Information Center

http://www.aoa.dhhs.gov/naic/




National Center for Women and Aging

http://heller.brandeis.edu/national/ind.html

781-736-3866

800-929-1995

Heller Graduate School
MS 035 - Brandeis University
Waltham, MA 02454




National Clearinghouse for Alcohol and Drug Information

http://www.health.org/links

800-487-4889 TDD

800-729-6686

PO Box 2345
Rockville, MD 20847

info@health.org



For Kids Only

http://www.health.org/kidsarea/



National Council on Alcoholism and Drug Dependence, Inc. (NCADD)

http://www.ncadd.org/

212-269-7797 National Office

20 Exchange Place
Suite 2902
New York, NY 10005

national@ncadd.org




National Incident-Based Reporting System (NIBRS)

http://www.search.org/nibrs/




National Institute of Mental Health (NIMH)

http://www.nimh.nih.gov/




National Institute on Alcohol Abuse and Alcoholism

http://www.niaaa.nih.gov/

301-443-3860 Scientific Information Branch

301-443-4703 Grants Office - Management and posting

301-496-4000 NIH Employee Locator/Personnel

6000 Executive Boulevard
Willco Building
Bethesda, MD 20892




National Institute on Drug Abuse

http://www.drugabuse.gov/

301-443-1124 Publication Information Branch

301-443-6245 Press Office

6001 Executive Boulevard
Room 5213
Bethesda, MD 20892

Information@lists.nida.nih.gov




National Institutes of Health

http://www.nih.gov/

301-496-4143 Publications

9000 Rockville Pike
Bethesda, MD 20892



National Institute of Child Health and Human Development

http://www.nichd.nih.gov/

800-370-2943  

National Institute of Child Health and Human Development
31 Center Drive
Bldg. 31, Room 2A32, MSC 2425
Bethseda, MD 20892



National Library of Medicine (NLM)

http://www.nlm.nih.gov/

301-594-5983

888-346-3656

8600 Rockville Pike
Bethesda, MD 20894

custserv@nlm.nih.gov




National Medical Association

http://www.nmanet.org

202-347-1895

1012 Tenth St. NW
Washington, DC 20001




National Organization for Victim Assistance

http://www.try-nova.org

202-232-6682

1730 Park Road NW
Washington, DC 20010

Nova@try-nova.org




National Women's Health Information Center

http://www.4women.org/

800-994-9662 Spanish available (M-F 9-6 EST)

888-220-5546 TDD

8550 Arlington Boulevard
Suite 300
Fairfax, VA 22031




Office of Behavioral and Social Sciences

http://obssr.od.nih.gov

1 Center Drive
Buliding 1, Room 326
Bethesda, MD 20892




Office of Minority Health Resource Center

http://www.omhrc.gov/

301-230-7199 TDD

800-444-6472 Spanish available (M-F 9-4 EST)

PO Box 37337
Washington, DC 20013




Office of National Drug Control Policy (ONDCP)

http://www.whitehousedrugpolicy.gov/

202-395-6700 (M-F 8:30-5:30 EST)

ondcp@ncjrs.org




Pacific Center for Violence Prevention

http://www.health.org/links/




Partnership for a Drug-Free America

http://www.drugfreeamerica.org

212-922-1560 (M-F 8:30-5:30 EST)

212-973-3502 Press inquires

405 Lexington Avenue
Suite 1601
New York, NY 10174




Partnerships Against Violence NETwork

http://www.pavnet.org/




Physicians for Social Responsibility

http://www.psr.org

202-667-4260

1875 Connecticut Ave, NW
Suite 1012
Washington, DC 20009




PubMed

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi




Rutgers University Center of Alcohol Studies

http://www.rci.rutgers.edu/~cas2

732-445-2190

607 Allision Road
Piscataway, NJ 08854




Seniors-site Homepage

http://www.seniors-site.com



Nursing Home Abuses

http://www.seniors-site.com/nursingm/abuses.html



Seniors-site Homepage

http://www.seniors-site.com



Nursing Home Abuses

http://www.seniors-site.com/nursingm/abuses.html



Sourcebook of Criminal Justice Statistics

http://www.albany.edu/sourcebook/




Substance Abuse and Mental Health Services Administration

http://www.samhsa.gov/

301-443-0746 SAMHSA News

301-443-6315

301-443-8956 Public Affairs Office

5600 Fishers Lane
Rockville, MD 20857




The Uniform Crime Report

http://fisher.lib.virginia.edu/crime/




Violence Policy Center

http://www.vpc.org

1140 19th Street, NW
Suite 600
Washington, DC 20036




 
Research  |   Initiatives  |   Funding  |   State/Local Info (RADAR Network)  |   Home
  
Substance Abuse Mental Health Services Administration
Center for Mental Health Services   Center For Substance Abuse Prevention   Center for Substance Abuse Treatment
(800) 729-6686 or webmaster
National Clearinghouse for Alcohol and Drug Information