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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.
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.
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Topic: Abuse of the elderly
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Target Audience: Elderly persons and general public
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Availability: Allyn & Bacon, 160 Gould Street, Needham, MA 02494; 800-666-9433 or bookstores
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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.
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Target Audience: General public and the elderly
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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.
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Author: Kosberg, J.I.; Garcia, J.L.
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Target Audience: General public and the elderly
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Availability: Sage Publications, Inc., 2455 Teller Road, Thousand Oaks, CA 91320; 800-499-0721 or bookstores
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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.
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Editor: Kosberg, J.; Garcia, J.L.
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Topic: International perspectives on elder abuse
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Target Audience: General public and the elderly
General public and the elderly
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Availability: Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580; 800-HAWORTH or bookstores
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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
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Topic: Crimes against the elderly
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Target Audience: Elderly persons and the general public
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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
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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
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Topic: Abuse of the elderly
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Target Audience: Elderly persons and general public
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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
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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
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Topic: Crimes against the elderly
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Target Audience: Elderly person and general public
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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
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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.
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Target Audience: General public
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Availability: Channing L. Bete Co., Inc., 200 State Road, South Deerfield, MA 01373-0200; 800-628-7733
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Cost: $1.05 each for a quantity of 1-99; $ .70 each for quantity of 100-499
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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.
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Publisher: Center for Substance Abuse Prevention (CSAP)
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Year: Published bimonthly
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Topic: Alcohol and substance abuse
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Target Audience: Substance abuse prevention professionals, educators, parents, teens, and adults
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Availability: SAMHSA’s National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345; 800-729-6686
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Cost: Annual subscriptions are $28 for domestic orders, $32 for international orders
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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
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Target Audience: General public
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Availability: National Media Owl Award Video Collection, University of North Texas Media Library, P.O. Box 305190, Denton, TX 76203-5190; 940-565-2484
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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)
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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
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Topic: Abuse of the elderly
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Target Audience: Senior service agency staff
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Availability: National Media Owl Award Video Collection, University of North Texas Media Library, P.O. Box 305190, Denton, TX 76203-5190
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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)
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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
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Target Audience: General public, elderly persons, medical and legal professionals, and social workers
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Availability: National Media Owl Award Video Collection, University of North Texas Media Library, P.O. Box 305190, Denton, TX 76203-5190; 940-565-2484
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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)
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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.
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Publication: British Journal of Psychiatry, 174(1): 193–195,
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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.
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Author: Swagerty D.L., Jr.; Takahashi, P.Y.; and Evans, J.M.
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Publication: American Family Physician, 59(10): 2804-2808
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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.
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Author: Lachs, M.S.; Williams, C.S.; O’Brien, S.; Pillemer, K.A.; and Charlson, M.E.
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Publication: Journal of the American Medical Associa-tion, 280(5): 428-432
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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.
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Author:
National Center on Addiction and Sub-stance Abuse at Columbia University
1998, 178 pages
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Publication: National Center On Addiction and Substance Abuse, Columbia University
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Availability: National Center On Addiction and Substance Abuse, Columbia University, 633 Third Avenue, 19th floor, New York, NY 10017-6706; 212-841-5200
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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.
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Author: Kleinschmidt, K.C.
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Publication: Annals of Emergency Medicine, 30(4): 463–472
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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.
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Publication: Journal of Geriatric Psychiatry, 30(1): 153–174
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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.
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Author: Jones, J.S.; Veenstra, T.R.; Seamon, J.P.; and Krohmer, J.
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Publication: Annals of Emergency Medicine, 30(4): 473–479
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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.
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Author: Hwalek, M.A.; Neale, A.V.; Goodrich, C.S.; and Quinn, K.
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Publication: Gerontologist, 36(5): 694–700
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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.
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Author: Stewart, D.E.; Robinson, G.E.
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Publication: Harvard Review of Psychiatry, 4(1): 54–57
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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.
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Author: Cooney, C.; Howard, R.
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Publication: International Journal of Geriatric Psychia-try, 10(9): 735–741
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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.
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Author: Ganzini, L.; Edwards, P.; Surkan, P.J.; and Drummond, D.J.
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Publication: International Journal of Geriatric Psychia-try, 10(11): 945–950
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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.
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Publication: Social Behavior and Personality, 23(3): 247–251
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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.
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Author: Paris, B.E.; Meier, D.E.; Goldstein, T.; Weiss, M.; and Fein, E.D.
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Publisher: Geriatrics, 50(4): 47–51
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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.
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Author: Pittaway, E.D.; Westhues, A.; and Peressini, T.
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Publication: Canadian Journal on Aging, 14 (2, Suppl 2): 20–44
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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.
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Publication: Journal of the American Geriatrics Soci-ety, 43(11): 1303–1308
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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.
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Author: Anetzberger, G.J.; Korbin, J.E.; and Austin, C.
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Publication: Journal of Interpersonal Violence, 9(2): 184–193
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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.
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Author: Lachs, M.S.; Berkman, L.F.; Fulmer, Terry, T.; and Horwitz, R.I.
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Publication: Journal of the American Geriatrics Soci-ety, 42(2): 169–173
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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.
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Author: Mangum, W.P.; Garcia, J.L.; Kosberg, J.I.; and Mullins, L.C.
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Publication: Educational Gerontology, 20(7): 715–731
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