Dataset Information

Ability of Older Adults to Report Elder Abuse: An Emergency Department-Based Cross-Sectional Study.

ABSTRACT: OBJECTIVES:To characterize assessments of a patient's ability to report elder abuse within the context of an emergency department (ED)-based screen for elder abuse. DESIGN:Cross-sectional study in which participants were screened for elder abuse and neglect. SETTING:Academic ED in the United States. PARTICIPANTS:Patients, aged 65?years and older, presenting to an ED for acute care were assessed by trained research assistants or nurses. MEASUREMENTS:All patients completed the four-item Abbreviated Mental Test 4 (AMT4), then completed a safety interview (using the Emergency Department Senior Abuse Identification tool) designed to detect multiple domains of elder abuse and received a physical examination. Based on the cognitive assessment and safety interview, assessors ranked their confidence in the patient's ability to report abuse as absolutely confident, confident, somewhat confident, or not confident. To assess interrater reliability, two assessors independently rated confidence for a subset of patients. RESULTS:Assessors suspected elder abuse in 18 of 276 patients (6.5%). Assessors were absolutely confident in the patient's ability to report abuse for 95.7% of patients, confident for 2.5%, somewhat confident for 1.5%, and not confident for 0.3%. Among patients with an AMT4?of 4 (n = 249), assessors were confident or absolutely confident in 100% of patients. Among patients with an AMT4?of less than 4 (n = 27), they were confident or absolutely confident in the patient's ability to report abuse for 81% of patients, including 11 of 12 patients with mild cognitive impairment and 7 of 11 patients with severe cognitive impairment. For patients receiving paired evaluations (n = 131), agreement between assessors regarding patient ability to report abuse was 97% (? = 0.5). CONCLUSIONS:In this sample of older adults receiving care in an ED, research assistants and nurses felt that the vast majority were able to report elder abuse, including many patients with cognitive impairment. J Am Geriatr Soc 68:170-175, 2019.

SUBMITTER: Richmond NL

PROVIDER: S-EPMC7110415 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Ability of Older Adults to Report Elder Abuse: An Emergency Department-Based Cross-Sectional Study.

Richmond Natalie L NL Zimmerman Sheryl S Reeve Bryce B BB Dayaa Joseph A JA Davis Mackenzie E ME Bowen Samantha B SB Iasiello John A JA Stemerman Rachel R Shams Rayad B RB Haukoos Jason S JS Sloane Philip D PD Travers Debbie D Mosqueda Laura A LA McLean Samuel A SA Platts-Mills Timothy F TF

Journal of the American Geriatrics Society 20200101 1

<h4>Objectives</h4>To characterize assessments of a patient's ability to report elder abuse within the context of an emergency department (ED)-based screen for elder abuse.<h4>Design</h4>Cross-sectional study in which participants were screened for elder abuse and neglect.<h4>Setting</h4>Academic ED in the United States.<h4>Participants</h4>Patients, aged 65 years and older, presenting to an ED for acute care were assessed by trained research assistants or nurses.<h4>Measurements</h4>All patient ...[more]

PMID: 31917460

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Project description:ObjectivesThis study examines the association between elder abuse and psychological distress among older adults in India and explores whether this association varies by the level of psychosocial and material resources.DesignThe study uses a cross-sectional survey design.SettingThe data are drawn from a representative sample of 9589 adults aged 60 and above in seven Indian states-Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu-in 2011.Statistical analysesSecondary analysis, using bivariate and multivariate logistic regression models, is conducted using the United Nations Population Fund project Building Knowledge Base on Ageing in India survey. Elder abuse (physical and/or emotional) emanating from family members in the previous month before the survey is examined. Multivariate models are run on the total analytical sample and for men and women separately.ResultsThe overall prevalence of psychological distress among persons aged 60 and over living in the seven Indian States is 40.6%. Among those older persons who experienced some form of physical or emotional abuse or violence in the last month, the prevalence of psychological distress is much higher than that in the general older population, at 61.6% (p<0.001). The results show that the experience of abuse is negatively associated with the mental health of older adults, and this relationship persists even after controlling for demographic and socioeconomic factors (OR=1.60, 95% CI 1.22 to 2.09). The findings also suggest that household wealth has an inverse relationship with mental health, with the association between experiencing elder abuse and reporting poor mental health being strongest among older people in wealthy households.ConclusionsElder abuse in India is currently a neglected phenomenon, and greater recognition of the link between abuse and mental health is critical to improve the well-being of vulnerable older adults, some of whom may be 'hidden' within well-off households.

Project description:Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency. Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships. Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had happened few or many times) correlate among them. For each of these measures we estimated a multinomial model to examine associations with social support, functional impairments, socioeconomic status, food insecurity, depression, and comorbidities, while controlling for key socio-demographic variables. Results: 30.5% of the older women reported psychological abuse, 8.2% financial exploitation, 5.1% caregiver neglect, 3.5% physical abuse, and 1.2% sexual abuse. In terms of frequency, 77.8% of the women self-reported having never been abused or only once in the last 12 months, whereas 13.1% reported abusive experiences repeating few times, and 9.9% repeating many times. In terms of severity, 66.7% of the older women had not been abused, 22.3% had suffered one type of abuse, and 11.1% two or more. Similarly, 15.0% reported one abusive experience, 8.1% two, and 10.3% three or more abusive events during the last 12 months. Severity measures showed similar associations: social support and high socioeconomic level as protective factors among those with less severe abuse, whereas increased depression, food insecurity and functional impairments were associated with more severe experiences of elder abuse. Frequency followed a different pattern, depressive symptoms were significantly associated with those with few experiences (compared to those with none or once), while functional impairments were associated with many experiences of elder abuse. Conclusions: It is relevant to assess elder abuse through its severity and frequency as inter-individual variability and the complexity of the experience shows different determinants suggesting a syndemic approach. This has important clinical and policy implications.

Dataset Information

Ability of Older Adults to Report Elder Abuse: An Emergency Department-Based Cross-Sectional Study.

Publications

Ability of Older Adults to Report Elder Abuse: An Emergency Department-Based Cross-Sectional Study.

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