Patricia Brownell

Prevalence of and Risk Factors for Elder Abuse and Neglect in the Community: A Population-Based Study.

To estimate past‐year prevalence and identify risk and protective factors of elder emotional abuse, physical abuse, and neglect.

Psycho-Educational Support Groups for Older Women Victims of Family Mistreatment: A Pilot Study

Summary Few programs for domestic violence victims have been evaluated for effectiveness. This gap is even more pronounced for elder abuse service interventions. The study presented here is intended to address this gap by using an experimental research design to evaluate outcomes of an elder mistreatment psycho-social support group pilot for cognitively unimpaired older female victims of mistreatment by family members and significant others for whom they are providing care or support. The support group model used for the study adapts a model designed by NOVA House, an elder abuse shelter program in Manitoba, Canada. The study was funded by the Hartford Foundation Geriatric Social Work Faculty Scholars Program. While the significance of study findings is limited by the small number of pilot participants, the model intervention and evaluation instrument developed for the study may be utilized for study replication.

Elder Abuse Intervention Strategies: Social Service or Criminal Justice?

Summary The debate in the field of elder abuse as to whether elder abuse is caused by caregiver stress or abuser impairment has precipitated a discussion as to whether elder abuse should be considered a social service issue, or a criminal justice problem (Wolf, 1999). Even when family violence rises to the level of a crime as defined by state penal code, some professionals argue that a social service approach is best suited to address this social problem. The study presented here compares an elder abuse program providing social services to elder abuse victims with another serving elderly victims of crimes.

A Century of Social Work in Criminal Justice and Correctional Settings

Abstract Throughout the 20th century, forensic social workers have been on the front lines completing pre-sentence reports, risk assessments, mental health and substance abuse counseling, group therapy, community outreach, and social service and employment advocacy for juvenile delinquents, adult offenders, and sexual assault and domestic violence victims. This article bridges the past to the present in terms of social work policies and practices in the criminal justice system. The point of departure is the founding of the first juvenile court in 1899 in Cook County, Illinois. This article examines signifi cant federal funding initiatives which have benefited youths, adult offenders, and crime victims. Emphasis is placed on the emerging role of forensic social workers in probation departments, law enforcement agencies, state and fed eral correctional facilities, addiction treatment programs, and domestic violence programs.

Developing a Research Agenda on Resident-to-Resident Aggression: Recommendations From a Consensus Conference

This article provides an overview of the development of a research agenda on resident-to-resident aggression (RRA) in long-term care facilities by an expert panel of researchers and practitioners. A 1-day consensus-building workshop using a modified Delphi approach was held to gain consensus on nomenclature and an operational definition for RRA, to identify RRA research priorities, and to develop a roadmap for future research on these priorities. Among the six identified terms in the literature, RRA was selected. The top five priorities were: (a) developing/assessing RRA environmental interventions; (b) identification of the environmental factors triggering RRA; (c) incidence/prevalence of RRA; (d) developing/assessing staff RRA education interventions; and (e) identification of RRA perpetrator and victim characteristics. Given the significant harm RRA poses for long-term care residents, this meeting is an important milestone, as it is the first organized effort to mobilize knowledge on this under-studied topic at the research, clinical, and policy levels.

Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol

Introduction Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences. Methods and analysis This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression. Ethics and dissemination The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.

A cluster randomized trial on improving nurses detection and management of elder abuse and neglect (I NEED): study protocol

AIM The aim of this study was to describe a trial protocol of an educational intervention for nurses to improve their awareness and practice in detecting and managing elder abuse and neglect. BACKGROUND Knowledgeable and skilful nurses are crucial amidst the growing numbers of maltreated older patients. DESIGN This trial is a multi-site, three-armed, community-based cluster randomized controlled trial with 6-months follow-up. METHODS This study will involve 390 community and registered nurses from government health clinics in Negeri Sembilan, Malaysia (protocol approved in October 2013). This three-phased study, premised on the Precede-Proceed Model, comprises baseline focus group discussion and survey (Phase 1), development of training module (Phase 2) and implementation and evaluation of the training (Phase 3). Eligible participants will be randomized to the control group (continuous nursing education), intervention group A (face-to-face intensive training programme) or group B (face-to-face intensive training programme and an educational video). Outcome measures include improvement in knowledge and awareness on elder abuse and neglect and the number of cases identified and managed during follow-up. Data will be collected at baseline, immediate postintervention, 3- and 6-month follow-up. CONCLUSION Findings from this study will provide empirical support for the development of a training module for nurses on the detection and management of elder abuse and neglect, towards improving healthcare delivery and the well-being of vulnerable older adults. This study is funded by the University of Malaya Research Grant (RP001C-13HTM), (FL002-13SBS) and University of Malaya Grand Challenge (PEACE) Grant (GC001C-14HTM) awarded in May 2013, July 2013 and September 2014.

Madrid 2002: Global Ageing and Violence against Older Persons Post 9/11

Abstract 9/11 challenged the sense of security felt by people in the United States. However, many older people live with violence, deprivation and fear. Population ageing is a global phenomenon. The Second World Assembly on Ageing was held in April 2002 in Madrid, Spain, to focus attention on the need for nations to begin planning for this dramatic population shift. The Madrid 2002 International Plan of Action on Ageing includes resolutions adopted by the Assembly to serve as guides for nations in protecting their older populations. Two sections of the Plan, Emergency Situations, and Neglect, Abuse and Violence, are highlighted.

International movement to promote human rights of older women with a focus on violence and abuse against older women

Population ageing around the world has drawn increased attention to the issue of human rights of older people. Extended old age is a women’s issue, considering women’s longevity advantage over men. Gender inequalities across the life course often make women more vulnerable to violence, abuse and poverty in old age than men. The human rights framework provides a solid foundation to approach the issue of violence and abuse against older women. This article critically reviews the United Nations instruments, with a focus on the international movement to promote human rights of older women, and provides implications for global social work practice.

Letter From the Guest Editors: Elder Abuse as a Gendered Issue

Given the longer life expectancy of women, the aging population is predominately a female one. Living longer, however, does not necessarily mean living well. Compared to older men, older women are more likely to outlive their spouses, live in poverty and rely on social welfare, and suffer chronic health conditions, disabilities, and limitations in activities of daily living. All of these factors marginalize older women in society, increase their risk of abuse and neglect, and limit their access to services and support. Cumulative disadvantages acquired throughout a lifetime of gender discrimination, combined with ageism, which diminishes and renders older women invisible or subject to negative stereotyping, can lead to the abrogation of their right to live free of abuse (U.N. General Assembly, 1991). This was recognized as a gap in the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) by the United Nations General Assembly, which ratified General Recommendation No. 27 on older women and protection of their human rights in December 2010. In this document, states parties are charged with the obligation to recognize and prohibit violence against older women in legislation on domestic violence, sexual violence, and violence in institutional settings and resulting from traditional practices and beliefs (Martin, Rodrigues-Pinzón, & Brown, 2015). Despite older women being the likely victims of abuse, violence against older women has not been adequately represented in the literature. The Abuse and Violence against Older Women (AVOW) study is one of few prevalence studies to address this issue. The AVOW study investigated neglect and abuse experienced by older women in five European countries: Austria, Belgium, Finland, Lithuania, and Portugal. Among the 2,880 women surveyed, 28.1% reported experiencing some kind of violence or abuse. The highest rate was reported in Portugal (39.4%) and the lowest in Lithuania (21.8%). Emotional abuse was the most common form of violence reported (23.6%), followed by financial abuse (8.8%), violation of rights (6.4%), neglect (5.4%), sexual abuse (3.1%), and physical abuse (2.5%; Luoma et al., 2011). In view of the knowledge gap in violence against older women, the United Nations focal point on ageing organized an expert group meeting (UN EGM) on “Neglect, Abuse and Violence of Older Women” in New York