DETECTION OF ELDER ABUSE BY FAMILY PHYSICIANS IN MONGOLIA: AN EXPLORATORY STUDY

Abstract Elder abuse (EA) is a significant global social problem that jeopardizes the health and wellbeing of older adults around the world. Health providers can play a pivotal role in detection of EA and accessing resources and interventions. In Mongolia, where elder abuse is not widely recognized, family physicians (FPs) are particularly critical, providing frequent contact and home visits free of charge to community-dwelling older adults. However, little is known about FP knowledge and engagement with potential victims of EA. We interviewed 12 FPs from Ulaanbaatar participated via Skype about their knowledge of and responses to EA, using Grounded Theory data collection and analysis. All respondents reported encountering at least one case of EA in practice, and described the creative strategies they used to engage older patients, detect abuse, and prevent further harm. We present significant implications for guidelines for identification and prevention of EA in primary health care.

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Elder abuse and health outcomes among community-dwelling older adults in India: results of a national survey in 2017-2018

Journal of Elder Abuse & Neglect ◽

10.1080/08946566.2021.1970683 ◽

2021 ◽

pp. 1-15

Author(s):

Supa Pengpid ◽

Karl Peltzer

Keyword(s):

Older Adults ◽

Health Outcomes ◽

National Survey ◽

Elder Abuse ◽

Community Dwelling ◽

Community Dwelling Older Adults

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LO13: Characteristics of emergency department visits by community-dwelling older adults who screened positive for elder abuse during home care assessments

CJEM ◽

10.1017/cem.2019.56 ◽

2019 ◽

Vol 21 (S1) ◽

pp. S11 ◽

Cited By ~ 1

Author(s):

E. Mercier ◽

A. Jones ◽

A. Brousseau ◽

J. Hirdes ◽

F. Mowbray ◽

...

Keyword(s):

Older Adults ◽

Home Care ◽

Reporting System ◽

Elder Abuse ◽

Frailty Index ◽

Population Based ◽

Community Dwelling ◽

Care Assessment ◽

Ed Visits ◽

Community Dwelling Older Adults

Introduction: Elder abuse is infrequently detected in the emergency department (ED) and less than 2% are reported to proper law authorities by ED physicians. This study aims to examine the characteristics of community-dwelling older adults who screened positive for elder abuse during home care assessments and the epidemiology of ED visits by these patients relative to other home care patients. Methods: This study utilized a population-based retrospective cohort study of home care patients in Canada between April 1, 2007 and March 31, 2015. Standardized, comprehensive home care assessments were extracted from the Home Care Reporting System. A positive screen for elder abuse was defined as at least one these criteria: fearful of a caregiver; unusually poor hygiene; unexplained injuries; or neglected, abused, or mistreated. Home care assessments were linked to the National Ambulatory Care Reporting System in the regions and time periods in which population-based estimates could be obtained to identify all ED visits within 6 months of the home care assessment. Results: A total of 30,413 from the 2,401,492 patients (1.3%) screened positive for elder abuse during a home care assessment. They were more likely to be male (40.5% versus 35.3%, p < 0.001), to have a cognitive impairment (82.9% versus 65.3%, p < 0.001), a higher frailty index (0.27 versus 0.22, p < 0.001) and to exhibit more depressive symptoms (depression rating scale 1 or more: 68.7% versus 42.7%, p < 0.001). Patient who screened positive for elder abuse were less likely to be independent in activities of daily living (41.9% versus 52.7%, p < 0.001) and reported having fallen more frequently (44.2% versus 35.5%, p < 0.001). Caregiver expressing distress was associated with elder abuse (35.3% versus 18.3%, p < 0.001) but not a higher number of hours caring for the patient. Victims of elder abuse were more likely to attend the ED for low acuity conditions (Canadian triage and acuity scale (CTAS) 4 or 5). Diagnosis at discharge from ED were similar with the exception of acute intoxication that was more frequent in patients who are victims of abuse. Conclusion: Elder abuse is infrequently detected during home care assessments in community-dwelling older adults. Higher frailty index, cognitive impairment, depressive symptoms were associated with elder abuse during homecare assessments. Patients who are victims of elder abuse are attending EDs more frequently for low acuity conditions but ED diagnosis at discharge, except for acute intoxication, are similar.

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Levels of depressive symptoms may modify the relationship between the WHOQOL-BREF and its determining factors in community-dwelling older adults

International Psychogeriatrics ◽

10.1017/s1041610215002276 ◽

2015 ◽

Vol 28 (4) ◽

pp. 591-601 ◽

Cited By ~ 10

Author(s):

Yu-Chen Chang ◽

Wen-Chen Ouyang ◽

Mei-Chun Lu ◽

Jung-Der Wang ◽

Susan C. Hu

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Depressive Symptoms ◽

Early Recognition ◽

Depression Scale ◽

Community Dwelling ◽

World Health ◽

Community Dwelling Older Adults ◽

Different Levels

ABSTRACTBackground:Depression is closely associated with quality of life (QOL) in older adults. Being elderly and exhibiting mild depressive symptoms may not lead to a depression diagnosis, but these attributes are clinically important. However, the extent to which these factors influence QOL and its determinants in older adults remains unclear.Methods:Questionnaires were administered to people aged 65 years or older at community senior centers in Taiwan to collect socio-demographic information and to assess results from the brief version of the World Health Organization's Quality of Life instrument (WHOQOL-BREF), Modified Barthel Index (MBI), 15-item Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Levels of depressive symptoms were classified as no depressive symptoms (NDS), lower level of depressive symptoms (LLDS), and higher level of depressive symptoms (HLDS), corresponding to GDS = 0, 1≦GDS≦5, and GDS>5, respectively. Multiple linear regression analyses were conducted to assess associations between the WHOQOL-BREF and its covariates for different levels of depressive symptoms.Results:A total of 454 older adults participated. The GDS and MBI scores significantly affected the WHOQOL-BREF physical and psychological domain scores in the LLDS group. Gender influenced the WHOQOL-BREF scores in the NDS group, and increased age demonstrated protective effects on the three domains in the HLDS group. Moreover, the association between the WHOQOL-BREF and its covariates varied for different levels of depressive symptoms.Conclusions:Treatment for depressive symptoms is of high priority, and early recognition of and appropriate intervention for mild depressive symptoms may improve community-dwelling older adults’ QOLs.

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The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey

BMJ Open ◽

10.1136/bmjopen-2017-017025 ◽

2017 ◽

Vol 7 (8) ◽

pp. e017025 ◽

Cited By ~ 6

Author(s):

Rajini Sooryanarayana ◽

Wan Yuen Choo ◽

Noran N Hairi ◽

Karuthan Chinna ◽

Farizah Hairi ◽

...

Keyword(s):

Older Adults ◽

Elder Abuse ◽

Depressive Symptomatology ◽

Community Dwelling ◽

Local Context ◽

Secondary Outcome ◽

Prior History ◽

Elder Mistreatment ◽

Physical Neglect ◽

Community Dwelling Older Adults

BackgroundAs Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia.DesignCross-sectional study, analysing baseline findings of a cohort of older adults.SettingKuala Pilah district, Negeri Sembilan state, Malaysia.ObjectivesTo determine the prevalence of elder abuse among community dwelling older adults and its associated factors.ParticipantsA total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census.Primary and secondary outcome measuresElder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined.ResultsThe prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse.ConclusionElder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse.

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Do factors across the World Health Organisation's International Classification of Functioning, Disability and Health framework relate to caregiver availability for community-dwelling older adults in Ghana?

PLoS ONE ◽

10.1371/journal.pone.0233541 ◽

2020 ◽

Vol 15 (5) ◽

pp. e0233541 ◽

Cited By ~ 3

Author(s):

Kofi Awuviry-Newton ◽

Kylie Wales ◽

Meredith Tavener ◽

Julie Byles

Keyword(s):

Older Adults ◽

Community Dwelling ◽

International Classification ◽

World Health ◽

International Classification Of Functioning ◽

Disability And Health ◽

The World ◽

Community Dwelling Older Adults

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Association Between Frailty and Elder Abuse in Community-Dwelling Older Adults in Mexico City

Journal of the American Geriatrics Society ◽

10.1111/jgs.15489 ◽

2018 ◽

Vol 66 (9) ◽

pp. 1773-1778 ◽

Cited By ~ 5

Author(s):

Sara Torres-Castro ◽

Claudia Szlejf ◽

Lorena Parra-Rodríguez ◽

Oscar Rosas-Carrasco

Keyword(s):

Older Adults ◽

Mexico City ◽

Elder Abuse ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Immersive Virtual Reality for the Management of Pain in Community-Dwelling Older Adults

OTJR Occupation Participation and Health ◽

10.1177/1539449218817291 ◽

2018 ◽

Vol 39 (2) ◽

pp. 90-96 ◽

Cited By ~ 2

Author(s):

Sara Benham ◽

Minhee Kang ◽

Namrata Grampurohit

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Virtual Reality ◽

Community Dwelling ◽

World Health ◽

Immersive Virtual Reality ◽

Quality Of Life Scale ◽

Patient Reported ◽

Community Dwelling Older Adults

Immersive virtual reality (VR) can provide a high level of engagement and distraction analgesia to address pain. However, community-based applications of this technology for older adults have not been studied. The objective of this study was to examine the applicability and effectiveness of an immersive VR intervention for pain, depression, and quality of life (QOL) in older adults. This pretest–posttest, mixed-methods design included senior center members ( n = 12) with pain that interfered with daily functioning. The outcomes included the Numeric Pain Rating Scale, Patient-Reported Outcomes Measurement Information System (PROMIS®) depression scale, World Health Organization Quality of Life Scale Brief Version (WHO QOL-BREF), and open-ended questions. The VR intervention (15- to 45-min sessions, 12 sessions over 6 weeks) was well accepted with no dropouts. There was a significant decrease in pain ( p = .002, d = −1.54) with no effect on depression and QOL. There were no adverse effects, and positive perceptions of VR were reported. The 6-week immersive VR intervention was applicable and effective in reducing pain intensity for community-dwelling older adults.

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Risk Factors Influencing Probability and Severity of Elder Abuse in Community-dwelling Older Adults: Applying Zero-inflated Negative Binomial Modeling of Abuse Count Data

Journal of Korean Academy of Nursing ◽

10.4040/jkan.2012.42.6.819 ◽

2012 ◽

Vol 42 (6) ◽

pp. 819 ◽

Cited By ~ 10

Author(s):

Mi Heui Jang ◽

Chang Gi Park

Keyword(s):

Risk Factors ◽

Older Adults ◽

Count Data ◽

Negative Binomial ◽

Elder Abuse ◽

Community Dwelling ◽

Factors Influencing ◽

Binomial Modeling ◽

Community Dwelling Older Adults

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Malnutrition and obesity in community-dwelling older adults: concomitant conditions? (PEN-3S study)

Proceedings of The Nutrition Society ◽

10.1017/s002966512000556x ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Teresa Madeira ◽

Catarina Peixoto-Plácido ◽

Nuno Sousa-Santos ◽

Nuno Mendonça ◽

Osvaldo Santos ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Community Dwelling ◽

Screening Tools ◽

World Health ◽

Anthropometric Measures ◽

Community Dwelling Older Adults

AbstractBoth malnutrition (which here refers to undernutrition) and obesity are prevalent in older adults, but they are frequently seen as mutually exclusive. In fact, a low body mass index (BMI) is one of the aetiological diagnostic criteria for malnutrition. On the contrary, the concomitant presence of malnutrition and obesity has been less studied. The aim of this study was to characterise the nutritional status of community-dwelling older adults (≥ 65 years old) living in Portugal. The study included a nationally representative sample of randomly selected community-dwelling older adults. Trained nutritionists collected data through face-to-face structured interviews regarding sociodemographic characteristics, nutritional status and anthropometric measures (namely, weight and height), among other variables of the PEN-3S study. Nutritional status was assessed by the 18-item Mini Nutritional Assessment (full MNA®), in which a lower score indicates worse nutritional status. The World Health Organisation's (WHO) BMI cut-offs for adults were followed (obesity: BMI ≥ 30Kg/m2). MNA and BMI categories estimates (95% CI) were obtained using Complex Samples analysis (SPSS® 24.0). Non-difference between sexes was analysed with Chi-square tests. Complete information was available for 1110 community-dwelling participants (mean age: 75.9 ± 8.1 years; 48.9% women; 71.4% attended school for < 5 years). According to the MNA, 0.5% (95%CI: 0.2–1.7) were classified as malnourished and 16.0% (12.9–19.7) were at risk of malnutrition. Following WHO's BMI criteria, 0.6% (0.2–1.5) had a BMI ≤ 18.5Kg/m2, 41.9% (37.9–46.0) had a BMI between 25–30Kg/m2, and 36.7% (32.8–40.9) presented a BMI ≥ 30Kg/m2. The prevalence of risk of malnutrition was significantly higher for women (20.1%, 95%CI: 15.4–25.9) than men (10.4%, 7.6–14.1; p < 0.001). The prevalence of obesity was also significantly higher for women (42.2%, 35.9–48.7 versus 29.3%, 24.8–34.2; p = 0.007). Moreover, 13.9% (9.2–20.4) were simultaneously at risk of malnutrition and had a BMI ≥ 30Kg/m2, while no one in this BMI category was classified as malnourished. Although appropriate BMI cut-offs for older adults are still uncertain, these results highlight that a high BMI does not exclude the risk of malnutrition, particularly in women. Therefore, health professionals should routinely screen for malnutrition using multi-component, validated screening tools, irrespective of the BMI. In fact, malnutrition is preventable if detected on time and effective interventions exist. The concomitant presence of malnutrition and obesity may pose additional challenges to the treatment.

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