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World Elder Abuse Awareness Day: A reading list on elder mistreatment and neglect

The abuse and mistreatment of older adults is a devastating and widespread social problem that spans all social classes, races, genders, religions and nations. An estimated four to six percent of the more than 725 million older adults worldwide have experienced some form of mistreatment, often at the hands of the very people entrusted with their care. In the United States, experts estimate that as many as 10% of adults ages 65+ have experienced mistreatment. Elder mistreatment comes in many forms, including neglect, financial exploitation, and emotional, physical, and sexual abuse.

This abuse and neglect of older adults violates the cultural expectation that society’s elders should be respected. Mistreatment has far-reaching implications for the physical, mental and financial well-being of older adults, and is particularly harmful to those who are already socially isolated. Recognizing the magnitude and severity of this problem, in 2011 the United Nations General Assembly, in its resolution 66/127, designated 15 June as World Elder Abuse Awareness Day. It represents the one day each year when the entire world is called on to recognize and voice its opposition to the abuse and suffering inflicted on older adults. In recognition of World Elder Abuse Day and in solidarity with older adults who have experienced mistreatment, we have created a reading list of recent articles from Gerontological Society of America journals that reveal the sources, consequences, and possible interventions to address elder abuse worldwide.

Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies by Karl Pillemer, David Burnes, Catherine Riffin, and Mark S. Lachs in The Gerontologist.

This article provide an overview of the global context of elder abuse, with a focus on prevention. The authors identify the characteristics of the victim, abuser, relationship between the two, local community, and broader social context that are sources of risk and resilience. The study identifies five promising strategies for prevention: multidisciplinary team approaches (particularly in countries where the service system is sufficiently developed to require coordination); helplines for potential victims; financial management for elders at risk of financial exploitation; caregiver support interventions; and emergency shelter for victims.

Perceived Quality of Life following Elder Mistreatment in Rural India by Srinivasan Chokkanathan and Aravindhan Natarajan in Journal of Gerontology: Social Sciences.

Drawing on theories of resilience, the authors investigate factors that protect against declines in quality of life among older adults experiencing mistreatment in rural Tamil Nadu, India. Results show that being single, hailing from a low income family, high levels of relationship strain, and experiencing more than one type of mistreatment were associated with decreased quality of life. High levels of mastery and social support were associated with better quality of life following mistreatment. Resources that protect one’s well-being are effective only for those experiencing relatively low levels of mistreatment, shedding light on the need for resources to help the most severely abused.

Elder Mistreatment Among Chinese American Families: Do Acculturation and Traditionalism Matter?  by XiangGao, Fei Sun, and David R. Hodge in  Journal of Gerontology: Social Sciences.

This study used survey and focus group data to understand abuse and neglect among the under-researched population of Chinese-American older adults. The main goal was to understand whether acculturation (adopting and integrating US cultures and practices) versus traditionalism (maintaining Chinese beliefs and practices) were linked to older adults’ experiences of abuse. They found that acculturation was linked with higher levels of abuse, although traditionalism was not protective. The authors conclude that prevention efforts should focus on building “bi-cultural” identities among both older adults and their adult children.

Varying Appraisals of Elder Mistreatment among Victims: Findings from a Population-Based Study by David Burnes, Mark S. Lachs, Denise Burnette, and Karl Pillemer in  Journal of Gerontology: Social Sciences.

Most studies of elder mistreatment use service provider data or victim reports of whether they were abused, with little attention to victims’ subjective assessments of the experience. This study examined victims’ appraisals of perceived seriousness of emotional abuse, physical abuse, and neglect.  Emotional abuse was appraised less seriously among victims who were both functionally impaired and dependent upon the perpetrator, lived with the perpetrator, and of older age. Emotional abuse was perceived with greater seriousness among victims enduring more frequent or varied abuse and when the perpetrator was less closely related. These findings may help social service workers to identify populations at greatest risk of severe mistreatment.

Using Latent Class Analysis to Identify Profiles of Elder Abuse Perpetrators by Marguerite DeLiema et al. in Journal of Gerontology: Social Sciences.

Efforts to stem elder abuse require an understanding of perpetrators, as well as victims. This study uses latent class analysis to identify distinctive profiles of elder abuse perpetrators. Using both victim and caseworker data provided by Adult Protective Service (APS), the researchers identified four profiles of abusers: Caregiver, Temperamental, Dependent Caregiver, and Dangerous. Dangerous abusers evidenced the highest levels of aggression, financial dependency, substance abuse, and irresponsibility. Caregivers are lowest in harmful characteristics and highest in providing emotional and instrumental support to victims. The authors recommend tailored interventions to reduce problem behaviors and enhance strengths specific to each abuser profile.

A Systematic Review of Sexual Assaults in Nursing Homes by Daisy Smith, Lyndal Bugeja, Nicola Cunningham, and Joseph E. Ibrahim in The Gerontologist.

Over the past decade, reports of sexual abuse in nursing home have captured extensive media attention. This study explores published studies on the topic, and found that sexual assault is the least reported type of assault in nursing homes. Victims of sexual assault were likely to be women with cognitive or physical impairments. Perpetrators were likely to be male residents, although staff members were occasionally the perpetrators too. The results highlight the need for better staff training in detecting, examining, and managing sexual assaults in nursing homes.

Featured image credit: old hands by Jack Thacker. Public domain via Unsplash.

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