Clinical Characteristics Associated with Physical Violence in the Elderly: A Retrospective Multicenter Analysis

Background: Elder abuse is predicted to increase with the rapid population ageing in many countries. Violent injury is influenced by individual factors as well as interpersonal and social relationships, with different manifestations based on changes in the socioeconomic position of older adults. We comparatively investigated the clinical and injury characteristics of physical violence in the elderly with those in another age group. Methods: We included elderly patients (age ≥65 years) who visited six emergency departments (ED) with violence-induced injuries in 2017. The control group comprised patients aged 45–64 years, selected by 1:2 matching based on hospital and sex. Data were extracted from the National Emergency Department Information System and electronic medical records. Both groups were compared for injury mechanism, injury location, activity during injury, diagnosis, and clinical outcomes. Results: Among the 316,944 patients who presented to the 6 ED, 89,178 (28.1%) had traumatic injuries, and 1.6% and 4.5% of injuries were sustained due to violence in the ≥65 and 45–64 year age groups, respectively. There were no significant intergroup differences in the perpetrator (P=0.27), body parts affected (P=0.63), and diagnosis (P=0.23), whereas the older adult group had a significantly higher proportion of traumatic injury by fall (P=0.01), at road and traffic facilities (P=0.01), during work (P=0.01), and multiple injuries (P<0.01). Conclusion: The increase in non-regular workers in the elderly after retirement may have increased the risk of traumatic workplace injuries. As workplace injuries may be a new risk factor for physical violence in the elderly, institutional workplace injury prevention policy is needed.

The revictimization of older Mexican women: understanding the accumulation of multiple victimizations throughout a lifetime

Background The victimization of women constitutes a human rights violation and a health risk factor. The central objectives of this study were to analyze the probability of revictimization among older adult Mexican women and to examine whether child abuse (CA) and/or intimate partner violence (IPV) are associated with a greater risk of elder abuse (EA) victimization. Methods We conducted a secondary data analysis of 18416 women 60 and older, based on data from the National Survey on the Dynamics of Household Relationships (2016), which is national and subnational representative. A descriptive analysis was carried out using retrospective self-reports of victimization experiences (CA, IPV, and EA). The prevalence of victimization and multiple victimizations in the various stages of the lives of women, as well as of revictimization among older adult women were obtained. Bayesian logistic regression models were used to examine the associations between victimization, multiple victimization, and EA victimization. Results A total of 17.3% of the older adult women reported EA in the last year; of these, 81.0% had been revictimized and 14.0% reported CA, IPV, and EA. The risk of EA rose among women who reported a combination of psychological and sexual CA, and psychological, physical and sexual CA and psychological and sexual IPV, and a psychological, economic, physical and sexual IPV. EA was higher among women who had suffered more than one type of violence. Conclusion CA and IPV, particularly sexual abuse and psychological violence, can be risk factors for EA. Screening tools used to prevent and detect EA should include questions about domestic violence over the course of a person’s lifetime.

Gambaran Kejadian Tindakan Kekerasan pada Lansia : Literature Review

The increasing elderly population in Indonesia continues to grow. The elderly are individuals who experience physiological, psychological, and social changes. Therefore, the elderly is vulnerable to violence. Elder abuse persists in various areas in Indonesia. However, cases of elder abuse are often hidden because they are considered unimportant and the victims do not know where to report it. The purpose of this study was to describe the incidence of acts of violence in the elderly. The methodused in this study was a literature review by searching for articles in the PubMed and Google scolar database with the keyword: Elderly or Aged or Geriatric or Elder and Abuse or Violence with article limits from 2011-2020. There were five articles found. They had been critically reviewed using Strobe instruments. The results based on the five articles analysed showed some characteristics. Most of the respondents were 60-69 years old (50%), female (60%), education literate or primary (63%), married (67%), lived with other (59%), the elderly do not experience violence2.286, elderly experience violence 807, the type of violence that wa soften experienced by the elderly namely psychological violence is found to be (40%). Based on the five articles analysed, it can be concluded that the most violence experienced by the elderly is psychological violence. Therefore, the role of nurses is needed to provide services for families to prevent acts of violence in the elderly.Keywords: Elderly; persecution, violence AbstrakPeningkatan penduduk lansia di Indonesia terus bertambah. Lansia merupakan salah satu individu yang mengalami perubahan secara fisiologis, psikologis dan sosial sehingga lansia rentan mengalami tindakan kekerasan. Kekerasan terhadap lansia masih terjadi diberbagai wilayah di Indonesia. Namun, kasus kekerasan lansia kerap disembunyikan karena dianggap tidak penting dan korban tidak mengetahui lembaga yang dapat menerima laporan. Tujuan penelitian ini untuk mengetahui gambaran kejadian tindakan kekerasan pada lansia. Metode yang digunakan penelitian ini menggunakan literature review dengan mencari artikel pada database Pubmed dan Googlescholar dengan kata kunci :Elderly OR Aged OR Geriatric OR Elder AND Abuse ORViolencedengan batasan artikel dari 2011-2020 didapatkan 5 artikel yang telah dilakukan telaah kritis dengan menggunakan instrument Strobe. Hasil berdasarkan lima artikel yang dianalisa menunjukkan bahwa data karakteristik usia responden mayoritas 60-69 tahun yaitu (50%), berjenis kelamin perempuan sebanyak (60%), pendidikan literate or primarysebanyak (63%), berstatus menikah yaitu (67%), lived with other sebanyak (59%), lansia yang tidak mengalami kekerasan sebanyak 2.286, lansia yang mengalami kekerasan sebanyak 807 dan jenis kekerasan yang sering dialami lansia yaitu kekerasan psikologis didapatkan (40%). Berdasarkan dari kelima artikel yang dianalisa dapat disimpulkan bahwa kekerasan yang paling banyak dialami lansia yaitu kekerasan psikologis. Oleh sebab itu diperlukan peran perawat untuk memberikan pelayanan bagi keluarga untuk mencegah terjadinya tindakan kekerasan pada lansia.Kata kunci: Kekerasan; penganiayaan; usia lanjut

Informal Supporters of Elder Abuse Victims: Who Are They and What Is Their Experience Seeking Help?

This study examined the characteristics and experiences of informal supporters of elder abuse victims, including family members, friends, and neighbors—referred to as concerned persons. The researchers utilized secondary data from a UK national elder abuse helpline to investigate the profile and help-seeking experiences (including the impact of helping) of concerned persons reporting abuse to the helpline. The researchers focused on one year of data (2017–2018), and 1623 records met inclusion criteria. Of these, 1352 were reported by a concerned person, and descriptive statistics are provided to describe this sample. The help-seeking experience was investigated using qualitative content analysis. Concerned persons were primarily female family members, often adult children of the victim and siblings of the perpetrator. They faced barriers to helping the victim, particularly in relation to formal services. Many also reported impact as a result of knowing about the abuse or helping the victim; particularly to their mental health and their relationship with the victim. Findings indicate that concerned persons often face substantial barriers and negative impact when they support elder abuse victims. There is a need to advance research on concerned persons and identify ways of effectively supporting them, given their essential role in facilitating elder abuse victims’ access to formal services.

Enhancing Well-Being and Social Connectedness for Māori Elders Through a Peer Education (Tuakana-Teina) Programme: A Cross-Sectional Baseline Study

Background: Māori kaumātua (elders) face stark health and social inequities compared to non-Māori New Zealanders. The tuakana-teina (older sibling-younger sibling) peer education programme is a strengths-based approach to enhance well-being and social connectedness. The purpose of this study is to present the baseline data from this programme and identify correlates of well-being outcomes.Method: Participants included 128 kaumātua who completed a self-report survey about health-related quality of life, spirituality, social connection and loneliness, life satisfaction, cultural identity and connection, elder abuse, health service utilisation and demographics.Findings: Multiple regression models illustrated the following correlates of outcomes: (a) self-rated health: needing more help with daily tasks (β = −0.36) and housing problems (β = –0.17); (b) health-related quality of life: needing more help with daily tasks (β = –0.31), housing problems (β = –0.21), and perceived autonomy (β = 0.19); (c) spiritual well-being: understanding of tikanga (cultural protocols) (β = 0.32) and perceived autonomy (β = 0.23); (d) life satisfaction: social support (β = 0.23), sense of purpose (β = 0.23), cultural identity (β = 0.24), trouble paying bills (β = –0.16), and housing problems (β = –0.16); (e) loneliness: elder abuse (β = 0.27), social support (β = –0.21), and missing pleasure of being with whānau (extended family) (β = 0.19).Conclusions: Key correlates for outcomes centred on social support, housing problems, cultural connection and perceived autonomy. These correlates are largely addressed through the programme where tuakana/peer educators provide support and links to social and health services to teina/peer recipients in need. This study illustrates needs and challenges for kaumātua, whilst the larger programme represents a strengths-based and culturally-centred approach to address health issues related to ageing in an Indigenous population.

Staff-to-Residence Abuse in Nursing Homes: A Scoping Review

Background: Elder abuse in long-term care is an important public health concern with social, health-related, and economic implications. Staff-to-resident abuse is of particular interest since institutions should protect residents’ rights and prevent harm. To provide an up-to date comprehensive overview of staff-to-resident abuse in nursing homes, we performed a scoping review considering types of abuse, their prevalence and associated factors, descriptions, experiences, and preventive interventions.Methods: We performed a scoping review following the framework provided by Arksey and O’Malley. We searched MEDLINE (via PubMed), CINAHL, PsycINFO via Ovid, and Cochrane Library. Additionally, we performed free web searching using Google Scholar and checked relevant reviews. Two reviewers independently selected studies. We narratively synthesised the results.Results: Out of 3876 references retrieved by our search, we included 46 studies in 47 reports. The prevalence rates of abuse varied widely, ranging from 0 to 93% depending on the type of abuse. Associated factors of abuse at the staff, resident, and nursing home level were evaluated inconsistently. Abuse was perceived ambiguous: even though it was considered unacceptable, it was underreported. We found only four studies addressing preventive interventions. Of these, four made recommendations for intervention development. Only one study with an experimental design examined a multi-component intervention including education and mutual support.Conclusions: The review yielded heterogenous evidence not allowing a concrete conclusion on prevalence and associated factors. However, the results show the significance of the problem and indicate that there are associate factors of abuse that can be influenced by appropriate interventions. These are amongst other staff education, organisational culture, and conditions. Further research should investigate the composition and content of preventive interventions and their potential to reduce abusive behaviours.

Association of elder abuse, crime victimhood and perceived neighbourhood safety with major depression among older adults in India: a cross-sectional study using data from the LASI baseline survey (2017–2018)

ObjectiveThe study aims to explore the associations of elder abuse, crime victimhood and perceived safety with depression among older adults and examine the interactive effects of sex and place of residence in those associations.DesignA cross-sectional study was conducted using a large survey data.Setting and participantsThe study used data from the Longitudinal Ageing Study in India wave 1 (2017–2018). The effective sample size was 31 464 older adults (aged 60 years or older).Primary and secondary outcome measuresThe outcome variable was major depression, calculated using Short Form Composite International Diagnostic Interview. Descriptive statistics along with bivariate and multivariate analyses were performed to fulfil the objectives.Results5.22% of the older adults (n=1587) experienced abuse in the past 1 year. 1.33% of the older individuals (n=402) were victims of a violent crime, and 14.30% (n=1886) perceived an unsafe neighbourhood. Also, 8.67% of the older adults (n=2657) were suffering from depression. Older adults who were abused had 2.5 odds of suffering from depression (adjusted OR (AOR): 2.47, CI: 1.96 to 3.10) and victims of a violent crime were 84% more likely to be depressed (AOR: 1.84, CI: 1.15 to 2.95) compared with their counterparts. Besides, older individuals who perceived as living in unsafe neighbourhood were 61% more likely to be depressed (AOR: 1.61, CI: 1.34 to 1.93) compared with their counterparts. In the interaction analysis, older women who reported abuse had higher odds of suffering from depression (AOR: 3.27; CI: 2.34 to 4.57) compared with older men who were not abused. Similar result was found in older adults reporting abuse and residing in rural areas (AOR: 3.01, CI: 2.22 to 4.07) compared with those urban residents reporting no abuse.ConclusionsHealthcare providers should pay more attention to the mental health implications of elder abuse, crime victimhood and perceived safety to grasp the underlying dynamics of the symptomology of late-life depression.