Gambaran Karakteristik Demografi Lansia Yang Mengalami Pengabaian : Literature Review

Elder neglect is a health problem that still needs attention. This neglect is the family’s failure to meet the needs of the elderly. This abandonment may occur in the form of rejection or failure in providing food, beverages, clothing, residence, self-hygiene, and treatment. The neglect can be carried out by the closest family and relatives, therefore, this research is needed to determine the demographic characeristics of elder neglect. This study aimed to find out an overview of the demographic charahceristics of elder neglect. The method used was a literature review by searching articles on the PubMed database and the Garuda Portal, there were five articles found that matched the criteria. It showed that there were some charahteristics of most respondens who experienced neglect. Most of the respondents were 60-69 years old (55.9% or 390 respondents), female (57.0% or 459 respondents), in lw level of education <5 years (83.0%), and high school (48.2%), living with family (83.4% or 667 respondents), split/widow/widower (45.0% or 235 respondents), unemployed (51.2% or 67 respondents), dependent family member (64.0% or 399 respondents), and living in the urban areas (51.6% or 182 respondents). It cab be concluded that demographic characteristics of elder neglect can be seen in terms of age, gender, level of education, marital status, with which theelderly lives, life dependence, work, and geographical location residence.Keywords : demographic characteristics, elderly, abandonment, neglect Abstrak Pengabaian menjadi masalah kesehatan yang masih memerlukan perhatian.Pengabaian merupakan kegagalan keluarga dalam memenuhi kebutuhan lansia, terwujud dalam bentuk penolakan atau kegagalan untuk menyediakan makanan, minuman, pakaian, tempat tinggal, kebersihan diri dan pengobatan.Pengabaian dapat dilakukan oleh keluarga maupun kerabat terdekat, sehingga diperlukan penelitian untuk mengetahui karakteristik demografi pengabaian. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik demografi lansia yang mengalami pengabaian. Metode yang digunakan adalah literature review dengan mencari pada database PubMed dan Portal Garuda, didapatkan hasil sebanyak 5 artikel yang memenuhi kriteria. Hasil penelitian didapatkan bahwa karakteristik demografi yang terbanyak mengalami pengabaian yaitu usia 60-69 tahun 390 (55.9%), berjenis kelamin perempuan 459 (57.0%), pendidikan rendah <5 tahun (83.0%) dan <SMA (48.2%), tinggal bersama keluarga 667 (83.4%), berpisah/janda/duda 235 (45.0%), tidak bekerja 67 (51.2%), bergantung pada keluarga 399 (64.0%), dan tinggal di perkotaan 182 (51.6%). Berdasarkan hasil penelitian tersebut dapat disimpulkan bahwa karakteristik demografi lansia yang mengalami pengabaian dapat dilihat dari segi usia, jenis kelamin, tingkat pendidikan, status perkawinan, dengan siapa lansia tinggal, ketergantungan hidup, pekerjaan, dan letak geografis tempat tinggal.Kata kunci : karakteristik demografi, lansia, penelantaran, pengabaian

Competências dos médicos no atendimento a idosos em situação de violência: revisão de escopo

Resumo Objetivo descrever, por meio das evidências da literatura, as competências dos médicos de serviços hospitalares diante de situações de violência contra a pessoa idosa (VCPI). Método revisão de escopo com busca em bases de dados/plataformas/buscadores e literatura cinzenta abrangendo Medline; BVS; Embase; CINAHL; Web of Science; BDTD, OpenGrey, OpenThesis, RCAAP, Portal de Teses e Dissertações da CAPES, DART-Europe E-theses Portal e Theses Canada Portal (catálogos Aurora e Voilà). Os descritores e palavras-chave utilizados, combinados com os operadores booleanos OR, AND e NOT, foram: “Physicians”, “Médicos”, “Atitude”, “Attitude”, “Conhecimento”, “Knowledge”, “Behavior”, “Atendimento Médico”, “Cuidados Médicos”, “Medical Care”, “Serviços Hospitalares”, “Hospital Services”, “Hospital”, “Hospitalists”, “Médicos Hospitalares”, “Maus-Tratos ao Idoso”, “Elder Abuse”, “Physical Abuse”, “Elder Neglect”, “Aged Abuse”, “Elder Mistreatment”. Resultados seis trabalhos foram selecionados. Evidenciou-se falta de conhecimento sobre o tema e a abordagem, e de treinamento específico. Quanto às habilidades, os achados que mais levaram os médicos a suspeitarem de abuso foram achados físicos ligados à aparência, higiene e lesões - problemas de comunicação e relacionamento foram pouco apontados. Na atitude houve pesquisa de abusos em apenas 44% das suspeitas e percentuais baixos ou nulos de denúncia de casos. Apenas um estudo explorou a atitude frente às negligências, onde 24,8% relataram aos serviços sociais e 21,3% informaram à polícia. Conclusão a maioria dos casos de VCPI continua não percebida e, consequentemente, não reportada ou manejada. Há múltiplos problemas quanto às competências dos médicos hospitalares ao abordarem tais situações, cenário que expõe a demanda por medidas de sensibilização, capacitação e incentivo ao adequado enfrentamento da VCPI.

Prosecution of Elder Neglect: A Close Examination of Cases From King County, Washington

Elder neglect is common and can have catastrophic consequences. Cases may benefit from integrated responses from multiple sectors. Little research exists describing prosecutorial involvement and its impact, but existing evidence suggests neglect is seldom criminally prosecuted. Our goal was to closely examine neglect prosecution in a jurisdiction that has been a leader in using prosecution to attempt to address it. We quantitatively and qualitatively analyzed legal case files of felony elder neglect prosecuted in King County, Washington from 2008-2011. 13 cases were prosecuted, with a total of 10 victims. 90% of victims were female, with a median age of 88. 90% were unable to ambulate, and 90% had dementia. Defendants were commonly the victim’s adult child (38%). 23% had previous criminal citations/convictions. 46% of cases occurred in an Adult Family Home. 15% of cases went to trial, and all trial cases ended in conviction of some charge. Themes identified included: (1) perpetrators were either professional caregivers receiving compensation or non-professional caregivers financially dependent on the victim, (2) victims were malnourished and severely injured at time of reporting, and (3) medical expert contribution is imperative given complexity of these cases. Victims were unable to participate in prosecution in any case. This research shows that these cases are seldom prosecuted, even in a jurisdiction focusing on this phenomenon, but highlights characteristics of cases and demonstrates they may be prosecuted without victim participation. Future research is needed to examine prosecution’s impact on elder neglect to better understand how it may be optimally used.

Intervenções fisioterapêuticas direcionadas à pessoa idosa em situação de violência: uma revisão de escopo

Resumo Objetivo Identificar as intervenções fisioterapêuticas direcionadas à pessoa idosa em situação de violência. Método Trata-se de uma revisão de escopo, em que foram acessadas as seguintes bases de dados/bibliotecas/buscadores e literatura cinzenta: BVS, PubMed, Web of Science, Scopus, CINAHL, PEDro, BDTD, OpenGrey, OpenThesis, RCAAP, Portal de Teses e Dissertações da CAPES, DART-Europe E-theses Portal e Theses Canada Portal. As buscas utilizaram os descritores e palavras-chave, que foram combinados por meio dos operadores booleanos OR e AND: Fisioterapeutas, Fisioterapia, “Physical Therapists”, Physiotherapy, “Physical Therapy”, “Physical Therapy Specialty”, “Physical Therapy Modalities”, Rehabilitation, Reabilitação, “Elder Abuse”, “Maus-tratos ao Idoso”, “Physical Abuse”, “Elder Neglect”, “Aged Abuse” e “Elder Mistreatment”. Resultados Dos 601 registros encontrados, 46 foram excluídos por serem duplicados, sendo selecionados 555 para leitura dos respectivos títulos e resumos. Foram excluídas 548 publicações por não se adequarem aos critérios de inclusão, sendo pré-selecionados 7 trabalhos. Pela estratégia Snowballing um foi identificado, originando um resultado final de 8 estudos. Conclusão As intervenções fisioterapêuticas direcionadas à pessoa idosa em situação de violência compreendem: educação em saúde, medidas no estresse do cuidador, recursos comunitários, rastreamento/triagem, avaliação, identificação, plano terapêutico/reabilitação e denúncia. Diante dos achados, observa-se que, apesar da lacuna no conhecimento dessa temática, o fisioterapeuta desempenha um papel imprescindível na condução de casos de violência contra a pessoa idosa.

Neglect of Older People: Touching on Forensic and Pathophysiological Aspects

Background and Objectives Neglect of older people is common and may result in fatal and nonfatal outcomes. Normal changes of aging and disease-related symptoms may overlap with markers of neglect and lead to under-detection. This review aims to delineate medical, psychiatric, and pathophysiological indicators in the victim—identified in forensic case reports—to point out areas of overlap and raise awareness in Health Care Professionals. Research Design and Methods Medical and forensic databases were searched with the search terms: neglect, elder, elderly, forensic, homicide for detailed case reports on elder neglect. Cases were reviewed as to victim age, sex, medical/psychiatric diagnosis, perpetrator, victim-to-perpetrator relationship, cause of death (if fatal), location of incident, autopsy findings (if fatal), and ancillary studies. A total of 168 publications were retrieved, of these 11 publications, containing a total of 25 cases, yielded sufficient detail on each case to be included in the qualitative analysis. Results Neglect is associated with poor physical, psychological, and mental health. Neglect can be a direct cause of death or contribute to a fatal outcome by exacerbating existing conditions. Red flags of neglect included malnutrition, dehydration, poor hygiene, untreated decubitus ulcers, hypothermia, contractures, and an uncooperative caregiver. However, incontrovertible evidence of neglect is not always easy to obtain due to age and disease-related changes. Discussion and Implications The findings document the extent and seriousness of elder neglect and highlight the importance of detailed documentation as well as collaboration between clinicians, allied health professionals, law enforcement and medical forensic services to improve patient outcomes and reduce the risk of further incidents.

Exploring Elder Neglect: New Theoretical Perspectives and Diagnostic Challenges

Background and Objectives Neglect of older adults is a complex and important social problem which is difficult to detect. The aim of this review is to explore and categorize different characteristics of elder neglect, to facilitate a uniform conceptualization and provide recommendations for identification of the phenomenon. Research Design and Methods Articles published between January 1990 and February 2019, both from developed and developing countries, were taken into consideration. The literature search was performed in PubMed, Web of Science, and CINAHL using keywords related to elder abuse and neglect. Articles regarding the concept of elder neglect, identifying or measuring this phenomenon were reviewed. The identified indicators were presented according to the Maslow’s hierarchy of needs. Results From 7,207 articles found in the initial search, 63 relevant studies were selected for the final analysis. Indicators most frequently used by researchers (functionality, physical appearance and health, social and psychological background, mental health, and environment) correspond to different aspects of needs. Caregiver’s responsibility, satisfaction of needs, and risk of harm are the core elements to consider in identification of neglect. Discussion and Implications The identified elements and categories of indicators provide the framework for developing standard definitions and measures of elder neglect. The proposed diagram demonstrates gaps in identification and can be useful in detecting potential neglect in various categories of needs. Further research on perceptions and prevalence of elder neglect in different countries would be helpful for cross-country analysis as well as for adaptation of the instruments to cultural specifics.