Effects of Elder Abuse

Abstract

The significance of this report is to draw attention to the severity of elder abuse. Elder abuse is becoming a recognized, and prevalent problem amongst many older adults and its effects are detrimental to the health and well-being of the seniors. Recognition of abuse is vital with the growing numbers of seniors and being able to recognize the vulnerability factors of elder abuse can change the under-reporting of elder abuse to Adult Protective Services. What is known about elder abuse is that there are several categories: physical abuse, fiduciary abuse (financial abuse), verbal abuse, and neglect. The data collected is not accurate because of the underreporting of the elder abuse and the inability to account for all the seniors not just in facilities but those who’s guardians care for them. The goal of this literature review is to explain the importance of conducting more research to protect this population from exploitation.
Keywords: Abuse, Neglect, Under-reporting, Physical abuse, Verbal Abuse, financial abuse.

The Effects of Elder Abuse

In this literature review, I will explain the present knowledge of elder abuse and its risk factors as well as impacts on the health of older adults. I will also discuss the research methods and designs used by authors and which I found most useful in addressing elder abuse. Then a brief description of the main ideas and the benefits of further research on the elder abuse issue.

Present State of Knowledge in Elder Abuse

Elder abuse is defined as: “(a) intentional actions that cause harm or create a serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship, or (b) failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.”(Pillemer, Burnes, Riffin,& Lachs, 2015, p.195). Elder abuse is categorized into physical abuse, psychological, material exploitation, and neglect. Based on the article, physical abuse in the United States is the least common category at 1.4%. Phycological abuse is 1.5%, but please consider that for phycological abuse to be reported the mistreatment has to be seen as severe. Financial abuse was recorded at 4.5%, and neglect at 1.1% (Pillemer, et al., 2015, p.196). The percent appears low but take into consideration that those percentages are from 325 million population in the US.

Factors that contributed to the elder abuse research are emotional dependence/disability, poor physical health, cognitive impairment/dementia, poor mental health, or low income (Pillemer et al., 2015, p.198). The more factors an older adult had, the more at risk they were for elder abuse. Factors that contribute to elder abuse perpetrators/ caregivers are mental illness, substance misuse, abuser dependency (Pillemer et al., 2015, p. 198). Depression and anxiety are characteristics of the most frequent abusers; caregivers with depression/anxiety are linked to physical/emotional abuse while caregivers with substance abuse problems have been linked to verbal and financial abuse (Pillemer et al., 2015, p. 198). The relationship between the dependent and the caregiver could determine abuse.
Understand that elder mistreatment can be discovered not just at home but in hospitalized settings. “Evidence suggests that elder abuse is associated with emergency room visits and hospitalization” (Dong, 2014, p.156). Signs of elder abuse at home can be connected with depression, anxiety, and isolation; the most obvious signs would be bruising (Dong, 2014, p.256). The signs may become difficult to recognize if the elder lives at home, which then places the responsibility on health care providers in hospital settings to “screen for elder abuse and detect vulnerabilities during a routine physician office visit… and suggest predisposing issues that will eventually impair the patient’s ability to live independently” (Dong, 2014, pg. 156 ). Being able to recognize the signs of elder abuse can be the difference between an elder having devastating health consequences and receiving the aid that they need to escape an abusive dependent relationship.

Elder abuse on an individual can cause depression, anxiety, and posttraumatic disorder detailed within the article, Elder Abuse and Psychological Well-Being: A Systematic Review and Implications for Research and Policy by XinQi Dong, RuiJia Chen, E-Shien Chang, and Melissa Simon. The article mentions that the individual may begin to isolate themselves (or be isolated), stop doing their ADL’s, and resign from social activates. While, in the article Elder Abuse and Mortality: The Role of Psychological and Social Wellbeing by X.Q. Dong a M.A. Simon c T.T. Beck a C. Farran b J.J. McCann a, b C.F. Mendes de Leon a E. Laumann d D.A. Evans details “that there were 22.03 deaths/100 person-years for those with confirmed elder abuse” (Dong et al. 2010). Those deaths accounted for the 100 people they studied who were suffering from depression as a result of the elder abuse. Twenty-two older adults died as a result of elder abuse; those numbers demand that attention be drawn to the issue of elder abuse.

Research Designs Used to Study Elder Abuse

In the article, Elder Abuse and Psychological WellBeing: A Systematic Review and Implications for Research and Policy by Dong, X., Chen, R., Chang, E., & Simon, M. (2013). The research method was searching the medical and social sciences databases to create a “systematic review of the association between psychological distress and elder abuse and the effect of interventions and to provide directions for future research” (Dong et al., 2013, p.133). While, in the article Elder Abuse: Research, Practice, and Health Policy by Xinqi Dong does a meta-analysis of multiple articles that he references to prove that there needs to be more Nationally representative longitudinal research is needed to define the incident, risk/protective factors better, and consequences of elder abuse in diverse racial/ethnic populations. Systematic education and training are critically needed across all relevant fields.” (Dong, 2013,p. 161). Bridget Penhale’s article, Responding and Intervening in Elder Abuse and Neglect. Ageing International (2010) was also a meta-analysis of multiple articles brought together to find various interventions and theories to the causation of elder abuse.

In, Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies by Karl Pillemer, David Burnes, Catherine Riffin, and Mark S. Lachs, the authors used “a scoping review of key issues in the field from an international perspective” by “drawing primarily on population-based studies” (Pillemer et. al, 2015, p. 194). By using a scoping review based on population studies, I found this article much more useful for its statistics and evidential reliability. The article, A case-control study of severe physical abuse of older adults by Leeman Friedman, Susan Avila, Kathy Tanouye, and Kimberly Joseph used a case study in a trauma unit in Chicago involving forty-one randomly selected participants. This article was particularly useful in that it was able to conclusively confirm elder abuse (which since it is not a significant or medically studied issue makes it very difficult to prove and survey from hospitalized settings).

Main Ideas Revealed in Literature Review.

Main ideas revealed in the literature review where that: elder abuse is more common when the elder is dependent, that neglect was the most common form of abuse, and that older adults that are victims of abuse can suffer depression, weight loss, anxiety, and post-traumatic stress disorder. There are vulnerability factors that put a senior at risk for abuse, and there are risk factors that put caregivers in situations to abuse such as mental illnesses, economic struggles, or burnout. Elder abuse varies, and it is not a single action but rather a series of events that can be prevented, and if the abuse occurs, it can be resolved with proactive preventions, legislation, and advocacy.

How Further Research Would Benefit the Advocacy for Elder Abuse

If research could get an accurate account of the number of older adults becoming victims of elder abuse, we could force the government to recognize it as a prevalent issue and draw awareness. Bridget Penhale (2010) states, “It is clear that there is a need to improve awareness and recognition of abuse and neglect, in terms of the general public, professionals and the older population.” (p.249). If we make elder abuse a national problem not a familial problem, we can get the proper aid and training to recognize, treat, and prevent elder abuse. “We also need to undertake research on effectiveness and impact, not just of interventions but also the impact of abuse and neglect, and of processes and interventions on individuals.” (Penhale, 2010, p.249). Once elder abuse has been taught to healthcare professionals, social workers, and family supporters, there needs to be a measure of how successful it was and use that knowledge to remodify and individualize plans of care.

“There is a need for larger studies and comprehensive interventions that assess the long-term health and social and economic impact of physical abuse; evaluate protective services and effectiveness of placement in alternative living facilities in reducing risk of abuse; develop simple screening tools to assist medical professionals in identifying and reporting cases of abuse; and elucidate the relationship between abuse and specific individual characteristics, health conditions, personal habits, and medical outcomes.” (Friedman et al., 2011, p. 421). Researchers need to conduct a study that is all-inclusive in the consequences of elder abuse, then and only then can we find a way to propose significant interventions that can hopefully reduce elder abuse.

Cite this page