scholarly journals POLICY SERIES: ELDER ABUSE AND THE OPIOID EPIDEMIC IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S762-S762
Author(s):  
Brian W Lindberg ◽  
Robert Blancato
Keyword(s):  
Older Adults ◽  
Prescription Drugs ◽  
Elder Abuse ◽  
Multiple Chronic Conditions ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Rural America ◽  
Related Substance ◽  
National Crisis ◽  
Related Substances

Abstract Misuse of opioids is a national crisis affecting the social and economic welfare of communities throughout the U.S. and is particularly rampant in rural America. Older adults are far too frequently excluded from consideration of those who are affected by the opioid epidemic. While rural older adults may not suffer the highest per capita rate of opioid overdose deaths, they are deeply affected by the problem. In their youth and middle adulthood, many older adults used their bodies for labor. At older ages, they experience multiple chronic conditions and high rates of chronic pain for which opioids and related prescription and non-prescription drugs are often the treatment of choice. Also and far too frequently, older people become easy targets for abuse by persons needing resources to feed their addiction. This symposium focuses on elder abuse associated with opioid and related substance misuse. Zanjani’s presentation provides the context of rurality and drugs and alcohol as a precursor to elder abuse. The second paper by Teaster and colleagues examines trends in APS cases of elder abuse in which the perpetrator is a substance user and identifies perpetrator and victim characteristics predictive of different types of substantiated abuse. Using APS case notes, Roberto and colleagues characterize cases of elder abuse in rural Kentucky in which the perpetrator used opioids and related substances. Robert Blancato and Brian Lindberg will discuss presenters’ collective findings by weaving together concepts of rurality, addiction, and elder abuse and recommending strategies for prevention, intervention, and policy.

Causes and Implications of the Opioid Crisis in Rural America

2020 ◽  
pp. 46-74
Author(s):  
Bita Ashouri Rivas ◽  
Anthony L. Rivas
Keyword(s):  
Rural Communities ◽  
War On Poverty ◽  
Rural America ◽  
Community Members ◽  
Historical Trends ◽  
National Crisis ◽  
Opioid Crisis ◽  
Related Substances ◽  
Level Of Use ◽  
Urban Rural

The purpose of this chapter is to outline the history and development of the opioid crisis; to identify impacts to rural America; to elaborate on the implications to individuals, families, and communities; and to identify resources for these communities. The level of use, misuse, and impact of opioids on communities has caught national attention and has been labeled a national crisis. The opioid epidemic has hit rural communities especially hard with community members citing opioid abuse as the biggest problem in their communities. To better understand the current epidemic, it is important to understand historical trends in relation to opioids and opioid related substances; the War on Poverty; the recession of 2007; job loss; and the shifting of urban/rural divide politically, financially, and economically. The flooding of opioids into these communities impacted every system, with layered consequences.

scholarly journals ELDER ABUSE AMID THE OPIOID EPIDEMIC: APS CASES IN RURAL AMERICA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S763-S763
Author(s):  
Pamela B Teaster ◽  
Karen A Roberto ◽  
Jyoti Savla
Keyword(s):  
Older Adults ◽  
Elder Abuse ◽  
Standard Errors ◽  
Opioid Misuse ◽  
Rural America ◽  
Opioid Use ◽  
Care Needs ◽  
Community Based ◽  
Community Based Services ◽  
Physical Care

Abstract Older adults are hidden victims of the opioid crises, suffering abuse at the hands of those who seek resources to support their addiction. Using APS data from 2015-2017 provided by the Kentucky Department for Community-Based Services, we used a logistic regression model with robust standard errors to examine whether substantiated cases of elder abuse were associated with opioid misuse by perpetrators. Overall, 9% of the 462 substantiated cases over the three-year period involved perpetrators were substance users. The percentage of these cases rose from 5% in 2015 to 13% in 2016 before dropping to 7% of elder abuse cases in 2017. Opioid use was most prevalent among perpetrators of financial abuse of older adults with cognitive and/or physical care needs. The current study offers a first look at empirical linkages between opioid misuse and elder abuse and revealed consistencies across cases that call for further investigation.

scholarly journals In the Eye of the COVID-19 Storm: An Ethical Analysis on Aging, End of Life, and Recovery

2021 ◽  
Vol 9 (5) ◽  
Author(s):  
Al Giwa
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Elder Abuse ◽  
Adult Population ◽  
Severe Disease ◽  
Multiple Chronic Conditions ◽  
Geriatric Population ◽  
Term Care ◽  
Medical Response ◽  
Older Adult Population

Early into the COVID pandemic, epidemiologists and infectious disease experts warned that older adults were among those most vulnerable to the disease, as multiple studies from China, Italy, Washington State, and New York City showed that age greater than 65 significantly increased the risk of severe disease and/or death from the novel 2019 coronavirus. Centers for Disease Control data through June 2020 show that nearly 81% of deaths due to COVID-19 are of people 65 years of age and older. These breakdowns indicate that, primarily, persons with advanced age and most, often, those with multiple chronic conditions are those who have died. The effects of the virus led to public health measures aimed at reducing exposures of older people and other vulnerable populations. The disease was amplified in rehabilitation centers, skilled nursing facilities, assisted living centers, group homes, and other long-term care facilities serving a primarily geriatric population. Even as parts of the country are opening up, the death toll is still climbing and affecting the older adult population disproportionately. Duty to care, autonomy and self-determination, non-judgmental regard, justice, and futility are all significant ethical principles and constructs that have arisen in the intense and real-time application of healthcare as we continue to face the present global pandemic. We use an ethical lens to examine the medical response of the SARS-CoV-2 pandemic on the older adult population and explore if society is doing enough to protect older adults, or rather, engaging in and furthering collective and systematic elder abuse.

scholarly journals ELDER ABUSE AND THE OPIOID CRISIS: PERPETRATORS WHO ARE SUBSTANCE USERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S763-S763
Author(s):  
Karen A Roberto ◽  
Pamela B Teaster
Keyword(s):  
Substance Abuse ◽  
Prescription Drugs ◽  
Thematic Analysis ◽  
Family Relationships ◽  
Employment Status ◽  
Elder Abuse ◽  
Contextual Theory ◽  
Related Substances ◽  
Financial Exploitation ◽  
History Of

Abstract Substance abuse, particularly the diversion/abuse of prescription drugs along with illicit opioid deviates by alleged perpetrators has been identified as is a risk factor for elder abuse. The purpose of this study was to characterize cases of elder abuse substantiated by APS in which the perpetrator used opioids and related substances. Guided by the Contextual Theory of Elder Abuse, we conducted a within-case/across-cases thematic analysis of Kentucky APS caseworkers’ notes on 40 substantiated cases of elder abuse. Financial exploitation was the most commonly identified type of abused associated with perpetrators who abuse opioids. Findings revealed that most cases of elder abuse occurred when the perpetrators’ substance abuse intersected with employment status, complex family relationships, and a history of altercations with the law. Findings provide new insights into a more elaborate conception of the ways in which the opioid epidemic is contributing to the perpetration of elder abuse today.

A First (and Disturbing) Look at the Relationship Between the Opioid Epidemic and Elder Abuse: Insights of Human Service Professionals

2020 ◽  
pp. 073346482094727
Author(s):  
Karen A. Roberto ◽  
Pamela B. Teaster ◽  
Brian W. Lindberg ◽  
Robert Blancato
Keyword(s):  
Older Adults ◽  
Thematic Analysis ◽  
Health Care Professionals ◽  
Human Service ◽  
Elder Abuse ◽  
Intervention Strategies ◽  
Opioid Epidemic ◽  
Opioid Misuse ◽  
Human Service Professionals ◽  
The Relationship

This study explored the relationship between the opioid epidemic and elder abuse. Twenty professionals from four states with working knowledge of elder abuse cases participated in focus groups. Thematic analysis revealed four themes characterizing the relationship between opioid misuse and elder abuse: (a) Opioid-Related Elder Abuse i s an Escalating Problem; (b) Vulnerable Older Adults a re Prisoners in Their Own Home; (c) Health Care Professionals Perpetrate Opioid-Related Elder Abuse; and (d) Older Adults Abuse and Deal Opiates. In addition, all participants noted the lack of reliable, retrievable data to address cases of elder abuse when opioids are involved. Findings lay the groundwork for further research to understand the breadth and depth of the opioid-elder abuse relationship that can ultimately be used to develop prevention and intervention strategies and policies to address this hidden but widespread concern.

scholarly journals Unintended Consequences of Opioid Regulations in Older Adults with Multiple Chronic Conditions

2020 ◽  
Vol 60 (7) ◽  
pp. 1343-1352 ◽  
Author(s):  
Christine S Ritchie ◽  
Sarah B Garrett ◽  
Nicole Thompson ◽  
Christine Miaskowski
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Chronic Conditions ◽  
Unintended Consequences ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Opioid Epidemic ◽  
Management Options ◽  
Policy Responses

Abstract Background and Objectives The opioid epidemic has led to substantive regulatory and policy changes. Little is known about how these changes have impacted older adults, especially those with chronic pain and multiple chronic conditions (MCC). We sought to understand the experiences of older adults with chronic pain and MCC in the context of the opioid epidemic and policy responses to it. Research Design and Methods Purposive sampling of older adults in a West Coast metropolitan area. Semistructured in-depth interviews lasting 45–120 min were digitally recorded and transcribed. Responses were analyzed using the constant comparative method. Participants were 25 adults aged 65 years and greater with three or more self-reported medical conditions and pain lasting for more than 6 months. Results Respondents’ accounts revealed numerous unintended consequences of the opioid epidemic and its policy responses. We identified four main themes: changes to the patient–clinician relationship; lack of patient agency and access in pain management; patient ambivalence and anxiety about existing opioid treatment/use; and patient concerns about future use. Discussion and Implications Older adults have high rates of chronic pain and MCC that may reduce their pain management options. The opioid epidemic and policies addressing it have the potential to negatively affect patient–clinician relationships and patients’ pain self-management. Clinicians may be able to mitigate these unintended consequences by actively conveying respect to the patient, empowering patients in their pain self-management activities, and proactively addressing worries and fears patients may own related to their current and future pain management regimens.

Trends and risk factors of adolescent opioid abuse/misuse: understanding the opioid epidemic among adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Margaret R. Spencer ◽  
Sierra Weathers
Keyword(s):  
Healthcare Providers ◽  
Opioid Abuse ◽  
Opioid Overdose ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Current Crisis ◽  
Adequate Treatment ◽  
National Crisis ◽  
The Past ◽  
Income Status

AbstractOver the past decade, opioid abuse/misuse has grown from a local problem into a national crisis, causing the U.S. Health and Human Services (HSS) to declare a public health emergency. The number of those dying from opioid abuse has increased, especially among adolescents. Since 2014, death rates due to opioid overdose have been highest in persons aged 15–19 years. This systematic review examines past and present research concerning opioid abuse/misuse and seeks to bring more attention to the growing opioid epidemic affecting adolescents aged 12–25 years nationwide. Keywords such as “adolescent”, “opioid”, “overdose”, “opioid misuse”, and phrases including “opioid use and race”, “income status and opioids”, were used to find common demographic trends which can be attributed to this population. The process of gathering and disseminating information currently available on this subject helps highlight a somewhat taboo subject involving vulnerable members of our community. It is imperative that healthcare providers, in particular, those who treat adolescents, have access to current research and resources that support efforts to combat this persistent issue. In addition, this information will prove useful to those who have the ability to change policies and how this current crisis is being managed. Results from the research indicate that opioid abuse/misuse in adolescents is rising and race, gender and income play a role in the abuse/misuse of opioids. Likewise, the research proves that more opportunities for education and access to adequate treatment are paramount to ending the prevalence of opioid abuse/misuse.

scholarly journals Structural equation model of affecting factors on elder abuse to patients under hemodialysis by family caregivers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amaneh Mahmoudian ◽  
Abbas Shamsalinia ◽  
Atefeh Alipour ◽  
Zahra Fotoukian ◽  
Fatemeh Ghaffari
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Structural Equation Model ◽  
Structural Equation ◽  
Goodness Of Fit ◽  
Elder Abuse ◽  
Equation Model ◽  
Care Burden ◽  
Beta Coefficient ◽  
Fit Index

Abstract Background The objectives of the present study were to determine the prevalence of older adults with hemodialysis (HD) abuse by family caregivers and the factors affecting it. Method This is a correlational-causal study, which is conducted in 2018 in Iran. The sample size was 367 in both groups (the older adults and their family caregivers). Data collection was done using an individual-social information questionnaire for the older adults under hemodialysis and their family caregivers, the questionnaire of elder abuse by family caregivers to the older people under hemodialysis, Zarit Burden Interview and the scale of instrumental activities of daily living (IADL). Data were analyzed by the structural equation model (SEM) method. The Fitness of proposed pattern was measured using the following indexes: chi-square/degree of freedom ratio (CMIN/DF), Normed Fit Index (NFI), comparative fit index (CFI), goodness of fit index (GFI), and standardized root mean squared residual (SRMR). The significant level in this study was considered p < 0.05. Results The results of the present study showed that more than 70 % of the older adults suffer from elder abuse by family caregivers on average. The highest median elder abuse was related to emotional misbehavior (21.46 ± 6.09) and financial misbehavior (19.07 ± 5.33), respectively. Moderate care burden was experienced by 63.2 % of caregivers. The percentage of older women and men, who needed help with daily activities was 81.4 and 80.5 %, respectively. The results showed that the caregivers’ level of education and care burden with standard beta coefficient of -0.251 and 0.200 and the educational level of older adults and IADL with the best beta coefficient of -0.299 and − 0.234, had the highest regression effect on elder abuse respectively. According to the results, the model-fit indices of the hypothesized model was meet the criteria, with the NFI = 0.951, GFI = 0.970, CFI = 0.967, and SRMR = 0.041. The outcome was suitable for the recommended level, so the hypothetical model appeared to fit the data. Conclusions The results of the present study showed that the prevalence of elder abuse by family caregivers among the older adults under hemodialysis is high. Providing psychological counseling can reduce the consequences of elder abuse.

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