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Clearinghouse on Abuse and Neglect of the Elderly (CANE)
Elder Abuse: A Global Issue
Elder abuse as a societal problem continues to gain recognition worldwide. During the past year, both the United Nations Economic Council and the World Health Organization launched initiatives to increase awareness of elder abuse as a human rights issue. In keeping with the conviction that the mistreatment of elders is a global concern requiring international attention in addition to local, regional and national interventions, the Clearinghouse has compiled the following bibliography of international references.
To Order Articles from the Annotated Bibliography:
CANE (Clearinghouse on Abuse and Neglect of the Elderly) is the nation's largest and most utilized computerized collection of elder abuse materials and resources. With over 3,000 holdings, CANE has the ability to perform customized searches of over 100 keywords producing annotated bibliographies available to the professional community and to the public.
CANE is a service of the National Center on Elder Abuse (NCEA), which is supported by the U.S. Administration on Aging.
The following articles addressing Elder Abuse: A Global Issue are available by request from CANE. Please be aware of each article's file number. The digits following the hyphen in the file numbers indicate the total number of photocopied pages. For example, if the file number is A78-11, then this article (number A78-11) is 11 pages in length. Articles of interest will be forwarded to you at a cost of $.20 per page.
Department of Consumer Studies
University of Delaware
Newark, DE 19716
PLEASE NOTE THAT A CHECK MADE OUT TO CANE-UD MUST ACCOMPANY YOUR ORDER. For further information on ordering materials, contact CANE at (302) 831-3525, or at [email protected].
Research Agenda on Ageing for the 21st Century
United Nations Office on Aging and the International Association of Gerontology, April 2002
The Research Agenda of the Valencia Forum in Madrid, Spain, April, 2002, was submitted to the Second World Assembly on Ageing. It outlines the Forum's major priorities, critical research arenas, the key methodological issues and the Implementation of Research Agenda for global concerns of the aging population. Specific themes identified include ageism in different societies, intergenerational issues, active aging, economic security, and macro-societal changes and development. This research agenda, along with the Valencia Report, are available online.
The Valencia Report
Valencia Forum, International Association of Gerontology, April 2002
The Valencia Forum was held under the auspices of the International Association of Gerontology in Valencia, Spain, April 1-4th, 2002. This report, submitted to the Second World Assembly on Ageing, provides an outline of the key recommendations from participants (scientists, educators and practitioners of gerontology) in three areas of global prioritization: (1) Older Persons and Development; (2) Advancing Health and Well-being Into Old Age; (3) Ensuring and Enabling Supportive Environments. Specific topics outlined include active participation in society and the work force, intergenerational solidarity, eradication of poverty, universal access to health care, mental health needs of older persons, care and support of caregivers, and addressing neglect, abuse and violence of older individuals. This report, along with the Research Agenda on Ageing for the 21st Century, is available online.
Helen (Manchester Care Home Owner)
In this editorial, a care home owner and manager makes a point that institutional abuse of elders quite often begins at a governmental level in the U.K. health care system, due to inadequate funding, poor monitoring and lengthy waits for services and service approval. (Available online)
Elder Abuse to be Tackled
The Canberra Times; Canberra, Australia, June 6, 2002
This brief news article reports on the successful effort of Rosalyn Dundas of the ACT Assembly to have the government respond to the evidence presented in the committee report: Elder Abuse in the ACT (2001). Chief Minister Stanhope is expected to soon appoint members to The Older Persons' Advisory Council. (Available online)
Ending the Silence on Abuse of Elders
Toronto Star; Toronto, Canada, June 4, 2002
This brief news article describes recent efforts to address elder abuse in the city of Toronto. Mayor Lastman proclaimed June, 2002, the first annual Elder Abuse Awareness Month and urged citizens to be alert to physical, emotional and psychological symptoms of abuse and neglect. The article also notes that Toronto Residents in Partnership, a volunteer group, is coordinating efforts with the city to increase public awareness. In March, 2002, the Ontario government earmarked $4.3 million over the next five years for enhanced community services, training and education of front-line workers who deal directly with the province's 1.5 million senior residents. (Available online)
U.S. Delegation to the Second World Assembly on Ageing April 8-12, 2002, Madrid, Spain
This is a transcript of the address given by Josefina G. Carbonell (U.S. Assistant Secretary for Aging of the Health and Human Services Department) at the Second World Assembly on Aging conference. In her speech, Ms. Carbonell outlines the concerns and initiatives of the United States. She discusses the newly implemented USA Freedom Corps and the National Family Caregiver Support Program. (Note: This report is available online through the Administration on Aging)
Komter, A. & Vollebergh, W.
Solidarity in Dutch Families - Family Ties Under Strain?
Journal of Family Issues; 23(2), 171-188, 2002
Assuming that the exchange of interpersonal care may be an indicator, this article examines the nature and determinants of intergenerational solidarity in the context of societal changes. This study, based on data gathered in the Netherlands in 1992 regarding gift exchange, focuses specifically on exchanges involving care and service. Feelings accompanying the exchange, of either love or obligation, were labeled along with the relationship to care recipient. Overall, parent and family members received twice as much assistance as friends. The researchers conclude that solidarity towards friends is generally accompanied by feelings of love while solidarity towards parents tends to be based more on Durkheimian norms of moral obligation, or inner duty. The impact of obligation and dependency on future caregiving trends are considered.
Reay, A. & Browne, K.
The Effectiveness of Psychological Interventions with Individuals Who Physically Abuse or Neglect Their Elderly Dependents
Journal of Interpersonal Violence; 17 (4), 416-431, April 2002
The purpose of this study, conducted in the U.K., is to evaluate the effectiveness of education and anger management as an intervention (suggested by Bolton and Bolton, Novaco, Deschner, McNeil) for elder maltreatment. Nineteen caregivers, who had admitted to maltreatment, were referred to clinical psychology and assigned to either a group of abusers or neglectors. All victims resided with their perpetrators and none were diagnosed with dementia. All caregivers were retired, generally healthy and none were using psychotropic medication. Perpetrators were assessed pre-intervention, post-education, post-anger management and six months post treatment with the following instruments: Conflict Tactics Scale (CTS); Machin's Strain Scale (SS); Beck Depression Inventory (BDI); Beck Anxiety Inventory (BEI); Cost of Care Inventory (CCI). The results indicate a significant reduction of conflict among the abusers after anger management and at a six month follow-up. There appeared to be no significant change in conflict scores, which remained low throughout the study, among the neglectors. Overall reductions were observed in other scales in both groups.
United Nations Economic and Social Council
Abuse of Older Persons: Recognizing and Responding to Abuse of Older Persons in a Global Context
Commission for Social Development Acting as the Preparatory Committee for the 2nd World Assembly on Ageing, January 9, 2002
This report to the Secretary-General provides an overview on elder abuse as a global human rights issue. Prevalence is discussed with the acknowledgement that very little information is available regarding incidence in less developed countries and rural areas. Policy implications include meeting the needs of individuals throughout the lifespan, encouraging societies to foster anti-ageist environments, enhancing the quality of life by cultivating social and economic development, and establishing intergovernmental resolutions for global actions that may serve as the foundation of national initiatives for prevention and abuse policies. (Note: This report is available online)
World Health Organization Ageing and Life Course Unit and the International Network for the Prevention of Elder Abuse (WHO/INPEA)
Missing Voices: Views of Older Persons on Elder Abuse
Geneva, World Health Organization, 2002
The World Health Organization (WHO) invited the International Network for the Prevention of Elder Abuse (INPEA) to assist in developing a global strategy to address elder abuse. This paper presents the research design along with the results of studies conducted in eight countries as part of this initiative: Argentina, Austria, Brazil, Canada, India, Kenya, Lebanon and Sweden. A unique part of the design is the focus group format that allows elders from a variety of countries to express their perceptions of violence and mistreatment. This report also includes recommendations that evolved from the project and include the need to develop a screening and assessment tool for use in primary health care settings, an educational program for primary health care providers, a Minimum Data Set addressing violence in the elderly, and a global inventory of good practices.
(Note: This overview and the entire series of reports from individual participating countries are available online or through CANE.)
Horl, J., in conjunction with WHO/INPEA
National Report on Elder Abuse in Austria (from Missing Voices: Views of Older Persons on Elder Abuse)
Geneva, World Health Organization, 2002
This paper, written by a member of the Institute of Sociology at the University of Vienna, presents a report of the perceptions of elder abuse in Austria. The findings of five focus groups of elders involving 45 participants and two focus groups of 18 health care professionals are discussed. Cultural tendencies of conflict avoidance and introversion appear operant as clients discussed, in vague terms, their awareness of mistreatment. Issues of gender discrimination, ageism, domestic violence in later life, intergenerational issues are among the themes explored. Financial abuse was the most commonly mentioned form of mistreatment, followed by neglect. Other issues included loss of autonomy, isolation and overprotection.
(Note: The entire Missing Voices series is available online or through CANE.)
Daichman, L., in conjunction with WHO/INPEA
Argentina (from Missing Voices: Views of Older Persons on Elder Abuse)
Geneva, World Health Organization, 2001
This report from Argentina is one of eight from the Missing Voices series. In Buenos Aires, 48 elders and 18 health professionals participated in a total of eight focus groups. Approximately 85 percent of the elders described different types of abuse, 35 percent admitted to having experienced some type of mistreatment, and 70 percent were aware of another elder who had been mistreated. Of the health professionals, 90 percent could offer detailed examples of mistreatment from various settings. Argentina's recent economic crisis has sent many adult children and grandchildren back to the homes of the elderly, and many elders are being displaced within their own environments. Health professionals also reported being mistreated by patients and families, as well as being overworked and under compensated. Concerns regarding "community orientated abusive situations" such as inadequate bus transportation and waiting in the oppressive heat to receive pension checks were also identified. "Proteger," a government program developed in 1998 for the protection of elders is described. (Note: The entire Missing Voices series is available online or through CANE.)
Machado, L., Gomes, R., Xavier, E., in conjunction with WHO/INPEA
Report on Elder Abuse in Brazil
Geneva, World Health Organization, September 2001
This paper presents findings from a study carried out in Brazil as part of the Missing Voices series. The qualitative research was conducted by the Institute of Gerontology, Candido Mendes University/UCAM. Eight focus groups (six comprised of 51 elders and two comprised of 17 health professionals) were conducted in Rio de Janeiro. Elders identified gender differences in accepting the maturation process and reported feeling "useless" and exploited after retirement. Governmental abuses and societal barriers, such as discrimination while using public transportation and public health services, resident to resident abuse in nursing homes, and abandonment to public facilities, are among the forms of mistreatment identified. The impact of economic stress upon the family structure is seen as a contributing factor to caregiver stress, abuse and neglect. Ignorance on the part of family members regarding the aging process, and elder behavioral problems are seen as causes of abuse by both the professional and elder participants. Empowerment of the elderly, public gerontological education and a consensus guideline for health professionals for identification, prevention and intervention of elder abuse are among the recommendations developed.
(Note: The entire Missing Voices series is available online or through CANE.)
Podnieks, E., in conjunction with WHO/INPEA
Global Response Against Elder Abuse Report from Canada
Geneva, World Health Organization, 2001
This paper presents the findings of a study conducted in Canada (8/1/01-9/12/01) as part of the Missing Voices series. The report is divided into synopses of findings from eight focus groups (two older women groups, two older men groups, two older men and women groups and two groups of health care providers). Each section details responses to topics such as: challenges facing elders; definitions and types of abuse; the acceptability of abuse; risk factors and how they may differ with gender; indicators; causes; whether elder abuse exists in Ontario; whether ageism and/or stress triggers are factors; how is it seen as a health care issue; and possible solutions. Many of the non-health care participants revealed minimal knowledge regarding elder abuse and were surprised to learn of current available resources. Recommendations included enhanced and accessible long-term care services, enhanced relationships between the mental health and social service systems, and increased public awareness and professional education regarding elder abuse. Appendices include protocols and guidelines for the establishment and management of the focus groups.
(Note: The entire Missing Voices series is available online or through CANE.)
Soneja, S. in conjunction with WHO/INPEA
Elder Abuse in India Country Report for World Health Organization
Geneva, World Health Organization, 2001
This paper presents research from India, one of eight countries included in the Missing Voices initiative. The research was conducted in conjunction with the HelpAge India in New Delhi. Six focus groups of 58 elder participants (two male groups, two female groups, two mixed groups) and two groups of eight health care workers were conducted throughout various urban areas in Delhi. The elder groups identified economic difficulties, mental health issues and a lack of emotional support along with health problems as concerns. Older couples being separated to live with different children was identified as a significant problem. Another unique problem that the elders recognized was that daughter-in-laws were falsely reporting them to the police for harassment (related to dowry deaths) and the elders were then mistreated by the police. The participants appeared in denial of abuse, but acknowledged neglect and other forms of maltreatment. Health care workers identified mental health concerns, especially in the form of psychosomatic problems, related to psychological abuse. The recommendations offered by elders were for the development of recreation and day care centers while health care workers indicated that counseling services would be beneficial to elders and their families, and could also be used to screen patients presenting with psychosomatic problems.
(Note: The entire Missing Voices series is available online or through CANE.)
HelpAge International - Africa Regional Development Centre and HelpAge Kenya, in conjunction with WHO/INPEA
Elder Abuse in the Health Care Services in Kenya
Geneva, World Health Organization, September 2001
This paper presents findings from Kenya, one country participating in the Missing Voices project. In August 2001, a total of nine focus groups were conducted among elders (three female groups, one male group, two male and female groups) and health care workers (three groups) on the topics related to the problems of elders and elder abuse. In particular, the abuse and neglect that elders experience in relationship to the health care system is explored. The role of the elderly as caretakers of the vulnerable, especially HIV/AIDS patients, and the accompanying economic and personal hardships in tending to sick adult children and raising their dependent grandchildren is discussed. Issues of abuse that emerged in this research include abandonment, particularly while hospitalized, marginalization, malnutrition related to food scarcity and neglect, ageism on the part of health care providers, and inadequate resources. Specific recommendations regarding health policies are included.
(Note: The entire Missing Voices series is available online or through CANE.)
Social Welfare Institutions, Omr al Madid Institution for Elderly in conjunction with
National Report of Elder Abuse Study - Beirut, Lebanon
Geneva, World Health Organization, 2001
This paper presents findings of research conducted in Lebanon as part of the Missing Voices series. Six focus groups comprised of 52 elders (two male, two female, two mixed groups) and two focus groups comprised of 13 health care workers were conducted during August, 2001. Elderly participants identified the presence of emotional abuse and neglect, environmental abuse, physical abuse (which is considered rare) and financial abuse (considered more common, and contributing to other types of abuse). Issues between daughters-in-law and mothers-in-law were frequently discussed. The elderly felt that the government was taking no steps to prevent abuse and enhance their lives. Health care workers reported that emotional abuse and neglect appeared to have the greatest impact on the mental health of the elderly, and indicated that economic conditions significantly contributed to abusive and neglectful behaviors. The lack of any government initiative in terms of health care was considered a paramount difficulty for elders.
(Note: The entire Missing Voices series is available online or through CANE.)
Berg, A., Erlingsson, C., Saveman, B., in conjunction with WHO/INPEA
Global Response Against Elder Abuse Report from Sweden
Geneva, World Health Organization; October, 2001
This paper presents the preliminary findings from a pilot study conducted by the Department of Health and Behavioral Sciences at Kalmar University in Sweden as part of the Missing Voices series. Seven elders participated in one focus group and seven health care professionals participated in another, both addressing perceptions regarding elder abuse. (Other focus groups were pending at the time of this publication.) The study was conducted in a heavily populated region of southern Sweden, where 18 percent of the inhabitants are over 65. The main theme that emerged was that of "Public Responsibility" with the sub-themes of "Issues of Ageism," "Issues of Elder Abuse," and "Suggested Interventions and Recommendations." Ageism within the healthcare system and themes of displacement related to changing family values were specifically discussed by participants. Researchers indicate that both the health care professionals and senior participants displayed a degree of naivet? regarding this topic when their perceptions are compared to recent studies, and that this will need to be addressed in developing intervention and prevention strategies.
(Note: The entire Missing Voices series is available online or through CANE.)
Cohen, C., Sokolovsky, J. & Crane, M.
Aging, Homelessness, and the Law
International Journal of Law and Psychiatry; 24 (2-3), 167-181, 2001
Although the aging homeless are relatively invisible in the media and throughout the literature, it is estimated that twenty percent of the U.S. homeless and thirty-three percent of London's homeless are aged fifty and over. This article explores the link between the law, aging, and the homeless. The historical evolution of homelessness in Western civilization is traced as the moral economy of charity gave way to the criminalization of this vulnerable group, and then to a modification of criminalization. Perspectives are offered as to how current laws in Great Britain and the U.S. affect the aging homeless, and how the law may be used to address the problem. The compounding factor of mental illness is also considered. (Available electronically through Elsevier Services.)
Consumer Choice in Long-Term Care - What the United States Can Teach and Learn From Others About Decisionally Incapacitated Consumers
International Journal of Law and Psychiatry; 24 (2-3), 199-211, 2001
This article presents an overview of the current American legal trend in allowing greater consumer choice in issues regarding decisional capacity as it relates to home- and community-based long-term care. Germany and the U.K.'s trends are also discussed. Capacity assessment and surrogate decision-making are among the topics addressed. (Available electronically through Elsevier Services.)
Seeking Effective Approaches to Elder Abuse in Institutional Settings
The Journal of Adult Protection; 3 (3), 21-29, August 2001
In this article, the author provides an overview of elder abuse in institutional settings in the U.K. Sexual abuse and resident-to-resident abuse are among the discussed topics. Psycho-social and therapeutic approaches, such as anger management programs and cognitive-behavioral therapy, are presented as promising intervention strategies.
Macdonald, A. & Malouf, P.
Maintaining Older People's Dignity and Autonomy in Healthcare Settings
BMJ Online (British Medical Journal); August 2001
These two letters, one by a professor of geriatric psychiatry and the other by a student of community medicine, are in response to an editorial by Lothian and Phillip regarding dignity and autonomy of older people in the healthcare setting. In the first letter, the professor indicates that he thinks that frontline staff are scapegoated while the entire healthcare system is inadequate, and the second writer emphasizes that what was considered a lack of dignity borders upon elder abuse. (Available electronically at BMJ Online.)
Globalisation and Guardianship - Harmonisation or (Postmodern) Diversity?
International Journal of Law and Psychiatry; 24 (2-3), 95-116, 2001
Recognizing an increase in "global migration" of older individuals, this article explores different models of guardianship and international policy issues that emerge as a result. Three basic types of legal protective mechanisms are discussed: supportive; shared authority; and delegated authority (to either a private or public surrogate). The theoretical origins of those models (medico-legal, welfare, administrative and private ordering) are presented. Communitarianism is proposed as a middle-ground between paternalism and autonomy. Australia's tribunal approach and changes in England's system are among the models highlighted. The importance of the interplay between cultural roots and the success of a guardianship system is also considered. (Available electronically through Elsevier Services.)
Elders in Prison - Health and Well-Being of Older Inmates
International Journal of Law and Psychiatry; 24 (2-3), 325-333, 2001
In May, 2000, offenders over age 50 (both prisoners and parolees) represented 17 percent of the federal inmate population in Canada. That same year, Corrections Canada established a Division of Older Offenders. This research presents demographics regarding the older inmate population in Canada and provides an overview of the literature that examines the impact of incarceration upon the aging process. One common belief is that incarceration accelerates the aging process. (Available electronically through Elsevier Services.)
Adult Protection Legislation in Canada - Models, Issues, and Problems
International Journal of Law and Psychiatry; 24 (2-3), 117-134, 2001
In this article, the author describes three adult protective legislation models from Canada: the Atlantic provinces model; the Ontario model; and the British Columbia model. The Atlantic provinces were the first to introduce adult protective service legislation, including the Neglected Adults Welfare Act (Newfoundland, 1973). This model assigns adult protection personnel to investigate and intervene in suspected cases of maltreatment. A second model of protection based upon adult guardianship legislation was introduced in Ontario in the 1990's when the Substitute Decisions Act was implemented. A third model, from British Columbia, is a hybrid that reflects modern guardianship principles while also using community-based service networks. Variations on these models are found throughout Canada and are also discussed. The concept of "restorative justice," which relies upon healing efforts within the community, is presented as an alternative to criminal justice interventions versus loss of autonomy for seniors. (Available electronically through Elsevier Services.)
Beaulieu, M. & Spencer, C.
The Emergence of Older Adults' Personal Relationships in Canadian Law
International Journal of Law and Psychiatry; 24 (2-3), 213-232, 2001
This article examines the intricacies of the legal interpretations and interventions regarding older adults' personal relationships. In part one, the authors present socio-cultural influences that impact the process of aging in Canada. In part two, the authors present a summary and analysis of Kim v. DeCamillis, a case involving a relationship between a septuagenarian and his late-life partner, a Korean born woman thirty-five years his junior. During their four and a half year live-in relationship, Mr. DeCamillis' children made legal arrangements to safeguard their father from exploitation, despite his apparent competence to make such decisions for himself. In part three, the authors consider how ageist and paternalistic attitudes of practitioners can negatively impact upon the older individual's right to self-determination regarding personal relationships. (Available electronically through Elsevier Services.)
Dunlop, B., Rothman, M. and Hirt, G.
Elders and Criminal Justice - International Issues for the 21st Century
International Journal of Law and Psychiatry; 24 (2-3), 285-303, 2001
This article addresses "the gerontolgical issues that arise when older people have contact with the criminal justice system..." The research is based upon available data from England, Japan, Israel, Germany and the United States. The discussion considers similarities and differences among these countries as it examines the roles that older individuals play not only as victims and offenders, but also as witnesses, judges, jurors and attorneys. Overall, the similarities appear greater than the differences. One interesting point raised when elder victims are offered special consideration through elder justice units, and criminal sanctions against offenders of elders are harsher, is the possibility that this reinforces ageist perceptions and may in turn limit the autonomy of elders. Ferraro's analytical framework for research on aging is outlined as a mechanism for assessing such perceptions. Based upon the book by the authors entitled, Elders, Crime, and the Criminal Justice System: Myth, Perceptions, and Reality in the 21st Century; Springer; New York, 2000. (Available electronically through Elsevier Services.)
Address by Mr. John O'Donoghue, T.D. Minister for Justice, Equality and Law Reform at the Launch of "Reach Out Be A Good Neighbour" Safety and Security Campaign on 28 November 2001
This transcript of Mr. John O'Donoghue's address reports not only on the successful "Reach Out Be A Good Neighbour" campaign, established in 1992, but recent government efforts to protect and enhance the rights of elders. Among other initiatives in Ireland, he highlights the Working Group on Elder Abuse (established in October 1999 under the Department of Health and Children), Muintir na Tire, which operates a community alert program, and the Rural Community Policing Scheme.
Sacco, V. & Nakhaie, M.
Coping with Crime - An Examination of Elderly and Nonelderly Adaptations
International Journal of Law and Psychiatry; 24 (2-3), 305-323, 2001
This paper examines the behavioral measures, rather than the traditional perceptual measures, of fear of crime among elders. Reporting that a number of measures of elders' fearfulness regarding crime are related to hypothetical scenarios (i.e. walking alone at night in dangerous areas) and not related to routine circumstances, this study is designed to compare whether elders are more or less fearful of crime than nonelders, and whether their fear is irrational, pathological or adaptive. Data is drawn from telephone interviews administered in 1993 by Statistics Canada in Cycle 8 of the General Social Survey (GSS) with a sample of over 10,000 respondents. Five questions were asked regarding crime prevention behaviors. The overall findings do not support the conclusion that the elderly are more fearful than younger populations in general, with the exception that they typically restrict evening activities. However, researchers suggest that other factors, such as health status, may contribute to this behavioral tendency. (Available electronically through Elsevier Services.)
Human Rights Enforcement Agencies and the Protection of Older Workers Against Discrimination: The Case of the Quebec Human Rights Commission
Journal of Aging & Social Policy; (12) 3, 65-85, 2001
This article analyzes how the Quebec Human Rights Commission processes cases of age discrimination in the employment sector. Quebec has led Canada in protecting older employees against age discrimination since the enactment of the Act Respecting the Abolishment of Compulsory Retirement (1982). This research provides an in-depth analysis of thirty closed cases (approximately one-third of all cases closed between 1991-1996) to explore the QHRC's methods of investigation and determination. Only 16 percent of the discrimination complaints were substantiated with compensation awards, while another 8.5 percent of complaints were settled out of court. Several case synopses illustrate what the researcher identifies as shortcomings inherent in the conflicting role that the investigative officer plays and the conservative manner of investigation. However, the author finds these problems correctable and states that QHRC's impact on deterrence of ageism in the work place is immeasurable.
Perry, J. & Bontinen, K.
Evaluation of a Weekend Respite Program for Persons with Alzheimer Disease
Canadian Journal of Nursing Research; 33 (1), 81-95, 2001
This study was designed to explore family caregivers' response to a weekend respite program for Alzheimer's clients. It also provides an overview of the literature available on respite care, including the need for, yet under-utilization of, this service. In this pilot study, one western Canadian agency extended its Adult Day Program to include weekend availability. The environment was customized to the preferences of the clients. Twenty-five caregivers used the service over a 6-month period, some more than once, representing a 34 percent utilization rate of beds available. Three themes emerged from the evaluation: self-care for the caregiver; relief for the caregiver; comfort and safety for the client. While family caregivers felt relief as a result of the respite, the relief experienced was temporary. The authors recommend further adaptations that address caregivers' needs for assurances of safety and security for the clients.
Negotiating Care of Frail Elders: Relationships Between Community Nurses and Family Caregivers
Canadian Journal of Nursing Research; 33 (2), 63-81, 2001
Due to the shift from institutional care to home care, funding reductions for services, and an increase in the aging population, home care in Canada often combines formal services with informal family caregiving. In this ethnographic research, based upon a socialist-feminist approach, 23 nurse-caregiver dyads were interviewed regarding the nature and implications of such a necessary coalition of care provision. The community nurse often appears more authoritative (as teacher or supervisor) while the family caregiver appears more attuned to the elder's needs and personality. Four relationship patterns are identified: (1) nurse-helper; (2) worker-worker; (3) manager-worker; (4) nurse-patient. The majority of dyads followed the manager-worker dynamic. This research suggests an unequal division of labor in the care of the frail elderly between the nurse and family caregiver that contributes to exploitation of women in these circumstances.
Coyte, P. & McKeever, P.
Home Care in Canada: Passing the Buck
Canadian Journal of Nursing Research; 33 (2), 11-25, 2001
This article provides an overview of the shift away from institutional health care to in-home services in Canada. The first part of the article discusses the factors and assumptions inherent in the shift, including the assumption that people prefer community care and that the Canadian housing sector and economy can support this. The second part explores the cost effectiveness of such a transition. While scant research is available, one study from the Saskatchewan Health Services Utilization and Research Commission reveals surprising implications. Inequities in actual and projected expenditures across the provinces are compared and private costs of in-home care are discussed. Recommendations to enhance accessibility include nationwide guidelines based upon consensus of medical and social necessities.
The Politics of Home Care: Where is "Home"?
Canadian Journal of Nursing Research; 33 (2), 5-10, 2001
This essay discusses the problem of delivery of home health care services to poor and marginalized populations, including the growing number of poor elderly women, the homeless, and individuals lacking informal support networks in Canada. The author calls for research that addresses the social and political factors that influence home health care in this country.
Ploeg, J., Biehler, L., Willison, K. et al
Perceived Support Needs of Family Caregivers and Implications for a Telephone Support Service
Canadian Journal of Nursing Research; 33 (2), 43-61, 2001
In 1996, a reported 11 percent of the Canadian population aged 15 and over spent an average of four to five hours per week providing informal care to seniors. This article reports on a study designed to identify the support needs of family caregivers, and to describe the types of telephone services that would be most helpful. Thirty-four caregivers, mostly spouses and adult children of care recipients, were surveyed and identified the following needs: (1) social life; (2) instrumental support such as respite, physical assistance, financial compensation; (3) informational support; (4) emotional support. While 71 percent indicated that they would utilize telephone support from professionals, 59 percent indicated that they would utilize telephone peer support.
Aimonino, N., Molaschi, M., Salerno, D. et al
The Home Hospitalization of Frail Elderly Patients
Archives of Gerontology and Geriatrics; Suppl. 7,19-23, 2001
This article summarizes a study conducted at the St. G. Battista Hospital of Turin that was designed to assess the feasibility of home hospitalization of the advanced dementia patient. The Home Health Service (HHS) team, operating since 1985, consists of geriatricians, nurses, physiotherapists and social workers. In this study, 41 hospitalized advanced dementia patients were compared with 41 HHS advanced dementia patients. Mortality, use of anti-psychotic medications and caregiver stress were measured. Stress reduction in the caregivers of the home care patients, coupled with the reduction of anti-psychotic medications used for these patients, imply that this is a viable alternative to hospitalization. (Available electronically through Elsevier.)
Rautio, N., Heikkinen, E. & Heikkinen, R.
The Association of Socio-economic Factors with Physical and Mental Capacity in Elderly Men and Women
Archives of Gerontology and Geriatrics; 33, 163-178, 2001
This study, part of the Evergreen project funded by the Academy of Finland, was designed to analyze the impact of various socio-economic indicators, such as marital status, educational level, and perceived financial situation, on the physical and mental capacity of the elderly. The research compared data on men and women, married and unmarried, aged 75 and 80 (although the two age cohorts were combined). Among other detailed results, this research indicates that socio-economic factors are associated with functional capacity. The finding that higher education is associated with better cognitive capacity for both men and women reinforces earlier research. (Available electronically through Elsevier.)
Tsukada, N., Saito, Y., & Tatara, T.
Japanese Older People's Perceptions of "Elder Abuse"
Journal of Elder Abuse & Neglect; Vol. 13 (1) 2001
Until 1987, elder abuse was considered by the Japanese to be a "foreign" problem. Although research has been gathered since the early 1990's, the subject remains relatively invisible, with no elder abuse reporting agency in the country. This study utilizes the data of 4391 respondents to the 1999 Nihon University Japanese Longitudinal Study of Aging to assess the awareness and perceptions of elder abuse among the population it affects. It also explores how sociodemographic characteristics may impact the elderly person's perceptions. The research indicates that only 51 percent of respondents were aware of elder abuse, at least recognized by this term. Increased social interactions among the elderly and educational initiatives for elders as well as geriatric professionals are recommended as vital prevention strategies.
Nagatomo I., Akasaki, Y., Tominaga, M. et al
Abnormal Behavior of Residents in a Long-Term Care Facility and the Associated Stress of Care Staff Members
Archives of Gerontology and Geriatrics; 33, 203-210, 2001
This study focuses on the relationship between abnormal behavior and depression among Japanese special nursing home residents, and the impact these factors have upon staff. In this research, ninety-nine residents of a Kagoshima Prefecture special nursing home were rated by their caregivers for abnormal behaviors (with the Dementia Behavior Disturbance scale), cognitive abilities, depression (by using the Cornell Scale for Depression in Dementia) and the ability to perform activities of daily living (ADL). Caregivers were also assessed for stress and burnout. The results show a correlation between behavioral difficulties and depression. The researchers postulate that assessment and treatment for depression among this population may decrease behavioral problems that impact negatively upon their care, and on the stress level of caregivers. (Available electronically through Elsevier.)
Demographic Crisis in Japan: Why Japan Might Open Its Doors to Foreign Home Health-Care Aides
Pacific Rim Law & Policy Journal; 10, 749, May 2001
The Japanese senior population is growing rapidly and in proportion to the general Japanese population. Traditionally, multigenerational families have lived together and women have typically been responsible for elder care in the home, however, more women are now in the labor force. Therefore, more elders are requiring formal home health care assistance. The "Gold Plan" of 1989 provides support for subsidized public home health care in lieu of institutionalization but there is a shortage of home health care workers. This comprehensive article discusses the difficult nature of this "unskilled" labor, and possible solutions to this crisis, including a liberalizing of immigration policies. (Available electronically through Lexis-Nexis.)
A Question of Capacity?
Action Points; 9, 2-3, September / October 2001
This article provides a brief overview of the guardianship program in place in New South Wales Australia. In particular, it is noted that the system takes into account over seventeen different aspects of health and welfare decision-making in addition to fiduciary decision-making. The system also recognizes that capacity may fluctuate over time and therefore employs timely reviews of guardianship orders as part of the process. The author suggests this guardianship program may be adaptable throughout the U.K..
Nesci, P. & Iadarola, S.
Eastern Mental Health and the Aged in South Australia, 2000 - 2001
This web article refers to the Mental Health Council of Australia and Carers Association of Australia (2000) research that indicates there are inadequate caregiver resources and respite services in South Australia for the aged mentally ill. In particular, the article addresses frustrations found by non-English speaking individuals seeking support to reduce "carer burnout." The health risks of female caregivers as well as increased risk for elder abuse among this population are discussed. (Available online)
Yan, E. & So-Kum Tang, C.
Prevalence and Psychological Impact of Chinese Elder Abuse
Journal of Interpersonal Violence; 16 (11), 1158-1174, November 2001
In this study, 355 Hong Kong seniors (aged 65 and over) were assessed to explore the prevalence rate, interdependence issues and psychological impact of elder abuse. Researchers used the Chinese version of the Revised Conflict Tactics Scale (CTS2) to assess incidence of physical and verbal abuse and devised a subscale to measure social abuse (forced isolation, inappropriate placements, etc.). The results indicate that 21 percent of these participants had experienced at least one instance of abuse (predominantly verbal abuse) within the past year, a rate higher than previously estimated in Hong Kong. Researchers identify a number of limitations of the study and suspect that the Chinese tradition of preserving the privacy of the family may contribute to an underestimation of elder abuse.
Kyung Chee, Y. & Levkoff, S.
Culture and Dementia: Accounts by Family Caregivers and Health Professionals for Dementia-affected Elders in South Korea
Journal of Cross-Cultural Gerontology; 16, 111-125, 2001
Until the 1990's, dementia was seen in South Korea as part of the "normal" aging process. Modernization and demographic shifts have resulted in the nuclearization of the family structure. However, inadequacies in social welfare programs and home-based and long-term care institutions continue to place the caregiving burden on families. One study indicates that 55 percent of dementia caregiving in Korea is provided by daughter-in-laws. This article presents the findings of fifteen in-depth interviews (ten with family caregivers, five with researchers and service providers) relating to perceptions of dementia, cultural influences in the practice of caregiving, and utilization of formal service for dementia clients and their caregivers.
Chiu, S. & Yu, S.
An Excess of Culture: the Myth of Shared Care in the Chinese Community in Britain
Ageing and Society; 21, 681-699, 2001
This article explores the concept of "shared care" for Chinese elders living in Britain, while offering an overview of traditional Chinese values. The first section of the paper provides a discussion of Confucian, filial values and emphasizes that the ideal of the multigenerational family living together is impractical for most families due to economic constraints. The second section describes the characteristics of the Chinese in Britain, and the third section draws upon two research studies of care patterns (1991 and 1998) conducted by the authors. Although the authors admit that the samples are small (60 and 55 interviewees in each) and somewhat biased, they identified some common and socially relevant themes. While many elders live with their families, this does not guarantee quality social contacts or adequate personal care. Culturally-sensitive social policies are needed to provide care services and to strengthen families in order to enhance their care provision and insure that the elder population does not get lost in the "twilight zone" between public and private assistance.
Oh, K.M. & Warnes, A.
Care Services for Frail Older People in South Korea
Ageing and Society; 21, 701-720, 2001
The rapidly growing economy, accompanied by socio-cultural changes, has complicated the health care needs of the aging population of South Korea. The consequences of the broken "silent promise" (that the eldest son cares for his aging parents) in the face of inadequate health and home care provisions for the frail elderly are explored in this article. Demographic trends and developments in universal health insurance that have accompanied modernization and economic growth, are traced. Despite such programs as the Livelihood Protection, the current generation of elders is expected to feel the greatest impact of this societal transition. In addition, the media appears to be reporting more instances of elder mistreatment.
Stress, Conflict, Elder Abuse and Neglect in German Nursing Homes: A Pilot Study Among Professional Caregivers
Journal of Elder Abuse & Neglect; 13(1), 1-27, 2001
During the past several years, elder abuse and neglect in German nursing homes have been highly publicized. In this 1999 pilot study, 80 employees working in nursing related capacities in German nursing homes responded to a questionnaire that combined standardized and open-ended measures. The five items of the survey focused on the following: (1) stress/burnout in long-term care; (2) conflict within the workplace; (3) self-reported abuse/neglect; (4) witnessed incidents of abuse/neglect of residents; (5) perceived causes of and reasons for resident abuse/neglect. The results of the survey are discussed and theories of elder abuse within this setting are explored.
Elder Abuse: A Survey of Managers of Residential Care Facilities in Wellington, New Zealand
Journal of Elder Abuse & Neglect; 13 (1), 91-99, 2001
Noting the almost complete absence of research on elder abuse in New Zealand, a country with no mandatory reporting requirement, the author indicates that the purpose of this study is to document the existence of elder abuse by interviewing residential care managers. Twenty-four of twenty-six managers were able to identify at least one client who had experienced abuse; however, in most cases the incidents were referred for "service coordination and assessment" programs that arrange for home support and respite care. Age Concern New Zealand, which runs the Elder Abuse program, was infrequently contacted. The article also provides a description of the residential care system and notes that it often involves respite care and day care, and that few clients can afford long-term residency.
Governance and Autonomy in Alternatives to Hospital Care
Age and Ageing; 30 (S. 3), 15-18, 2001
This article discusses alternatives to hospital care to better meet the needs of autonomy for the elderly requiring medical management in the U.K. The author proposes that governance can be achieved by the integration of health and care resources, systematic organization of rehabilitation and long-term care, and preventative measures rather than crisis-oriented medical management. It is recommended that a "franchiser" provide organization and auditing functions for this process.
Mental Capacity and Medical Decisions
Age and Ageing; 30, 5-7, 2001
In this commentary, recent changes in British law regarding mental capacity and medical decision-making are discussed. Physicians will be asked to certify that a patient is competent to appoint a Continuing Power of Attorney. The article also addresses the use of advance directives and efforts to enhance the residual capacity of patients themselves versus "benign medical paternalism."
Making Connections: Good Practice in the Prevention and Management of Elder Abuse - Learning From SSI Inspection Reports in Community and Residential Care Settings
King's College London, Age Concern Institute of Gerontology, Department of Health Publications, London, 2001
Using information from England's Social Services Inspectorate reports on elder abuse gathered since 1994, this publication identifies "good practices" in the following areas: developing awareness of abuse; inspection units; policies; risk assessment and management; financial management; use of restraints; training; adult protection procedures; information sharing; referral; assessment; care planning and monitoring of abuse cases. The reports addresses elder abuse in both residential and institutional care settings. (The publication can be freely downloaded. For more information contact Department of Health Publications, P.O. Box 777, London SE 1 6XH or e-mail [email protected])
Making Decisions: Implications for Practice of the Government's Proposals for Making Decisions on Behalf of Mentally Incapacitated Adults in England and Wales
Age and Ageing; 30 (S. 1), 7-9, 2001
This paper outlines the implications that Britain's new mental capacity laws have for geriatricians. The physician will need to know more about the patient's past and present wishes, whom (family/friends) to consult, be satisfied that previous wishes were not the result of undue influence, and weigh these against the patient's prognosis. The new Continuing Power of Attorney, an extension of the old Enduring Power of Attorney, requires that a physician certify the patient's competence at the time of appointment.
Jenkins, G., Asif, Z. & Bennett, G.
Listening is Not Enough - An Analysis of Calls to Elder Abuse Response - Action on Elder Abuse's National Helpline
Journal of Adult Protection; 2 (1), 2000
This report is an analysis of over 1,500 telephone contacts regarding specific incidents of abuse taken by England's national confidential helpline, Elder Abuse Response, between 1997-1999. Differences in abuse by family members versus abuse by practitioners are among the trends highlighted.
Preventing Abuse of Vulnerable Adults
The Journal of Adult Protection; 2 (1), 35-38, 2000
This is a policy paper of United Kingdom Central Council (U.K.CC) regarding professional ethics and elder mistreatment. The U.K.CC, the regulatory body for nursing, midwifery and health visiting, garnered input from practitioners, care users and care providers in developing expanded definitions of mistreatment and practical guidelines to assist in prevention, detection and management of abuse. The expanded definitions and principles are outlined.
Learning From Experience
The Journal of Adult Protection; 2 (1), 30-34, 2000
In this article, the lead training manager from East Sussex draws upon his experience and describes the evolution of one county's multi-agency adult protection educational program. The AIMS (Alerting, Investigating, and Managing) approach evolved in the mid-nineties as courses were developed for each of these core areas. The table provided outlines the courses offered, the level the course is designed for, and the agencies involved.
Walsh, K & Bennett, G.
Financial Abuse of Older People
Journal of Adult Protection; 2 (1), 21-29, 2000
This article presents an overview of financial abuse of elders. In addition to offering guidelines to distinguish between "reasonable exchanges" and misappropriation, potential indicators related to abusers and victims are listed. Prevention tips from the British Geriatric Society are included. Complexities of financial issues surrounding long-term care placement and recommendations by the Royal Commission on Long Term Care (1999) are also discussed.
NHS Trust "Condoned" Abuse of Elderly Patients
BMJ Online (British Medical Journal); November 2000
This news article reports upon the Commission for Health Improvement's investigation of elder abuse at the Garlands Hospital near Carlisle, run by the North Lakeland Healthcare NHS Trust. An initial complaint that elders were tied to commodes, often denied food and other necessities were lodged by student nurses, but the trust did not take action after an internal investigation. A second complaint, by agency nurses, was lodged in 1998. Three other inquiries are noted, and the article indicates that the commission is due to report upon 500 trusts and health authorities in England and Wales over the next four years. (Available electronically at BMJ Online.)
The Needs of Older Women: Services for Victims of Elder Abuse and Other Abuse
Published by the Joseph Rowntree Foundation; York, May 2000
This article summarizes a project designed to identify women who had been victims of elder abuse and various other abuses and to consider present needs in light of their life experiences. The study was conducted in three social service departments in the North of England. (The full report, by Jacki Pritchard is part of the Community Care into Practice series and can be obtained from Marston Book Services, P.O. Box 269, Abingdon, Oxon OX14 4YN or email: [email protected])
The Nature and Scope of Elder Abuse
Generations; Summer 2000
In this overview, written as an introduction for the Generations issue dedicated to the awareness of elder abuse, the author and guest co-editor provides a history of the recognition of elder mistreatment as a social problem. It includes not only discussion of definitions, theoretical explanations and consequences of different types of abuse, but also reviews the findings from surveys conducted in the United States, Canada, Finland and the Netherlands. The introduction concludes with an outline of other articles included in this volume. (Available online)
Giurani, F. & Hasan, M.
Abuse in Elderly People: the Granny Battering Revisited
Archives of Gerontology and Geriatrics; 31, 215-220, 2000
Focusing on the aging population in the U.K., the authors of this article provide a succinct overview of the topic of elder abuse, including the history of its recognition as a societal problem, theories of causation, victim and abuser characteristics, and a synopsis of international prevalence studies. It concludes with discussion regarding recent government efforts to increase financial support and social services to the elderly and their caregivers and families, while increasing awareness on the part of health care professionals. (Available electronically through Elsevier Services.)
Nahmiash, D. & Reis, M.
Most Successful Intervention Strategies for Abused Older Adults
Journal of Elder Abuse & Neglect; 12 (3/4), 53-70, 2000
This article reports on an evaluation of intervention strategies of the multidisciplinary team approach of Project CARE. Located in Montreal, the project utilizes a five element intervention model based upon the Empowerment Theory. In this study, 83 cases of abuse by a caregiver are analyzed. A total of 473 intervention strategies are categorized and evaluated for acceptance and successfulness by a multidisciplinary health and social service team. Results indicate that the most successful intervention strategy was medical/nursing assistance for victims, and the second most successful strategy was supportive service for caregivers, including individual supportive counseling and family counseling. In particular, individual strategies were rated more successful than group interventions. Detailed description of the model and various screening tools (the Brief Abuse Screen for the Elderly/BASE; the Indicators of Abuse/IOA; the Abuse Intervention Description Form Example/AID) are also included.
Almberg, B., Grafstrom, M., Krichbaum, K. & Winblad, B.
The Interplay of Institution and Family Caregiving: Relations Between Patient Hassles, Nursing Home Hassles, and Caregivers' Burnout
International Journal of Geriatric Psychiatry; 15, 931-939, 2000
The authors present the findings of a longitudinal Swedish study. Caregiver burnout and role change was assessed among 37 caregivers as their care recipients transferred from informal to formal caregiving settings. The Burnout Measure, Patient Hassles Scale, and Nursing Home Hassles Scale were used to measure burnout. Decline in care recipients' cognitive status was reported as being the most stressful factor to caregivers regardless of their level of burnout. In the formal setting, burnout was experienced through interactions with staff and the relationships between the staff and care recipient. A lack of participation in the decision-making process also appeared linked to caregiver burnout.
Malley-Morrison, K., You, H.S. & Mills, R
Young Adult Attachment Styles and Perceptions of Elder Abuse: A Cross-Cultural Study
Journal of Cross-Cultural Gerontology; 15, 163-184, 2000
The purpose of this research is three-fold: to examine the role of culture in young adults' perceptions of various types of elder abuse; to explore any gender differences in perceptions of elder abuse, within or across cultures; and to examine any relationship between attachment styles and perceptions of elder abuse, within or across cultures. In this study, 100 Caucasian American students (from a northwestern American university) and 115 Korean students enrolled in psychology courses (at a Seoul university) participated by completing demographic questionnaires, the Elderly Caregiving Questionnaire, Attachment Style Questionnaire and other attitude measures. While both cultural groups held similar views regarding acceptability of aggression and neglect, Korean students judged psychological abusiveness to be more offensive than other forms of elder mistreatment and American students found physical abuse, physical neglect and material abuse to be the more offensive. Cultural factors and attachment style appear to impact upon perceptions of elder abuse.
Models of Intervention for �gElder Abuse and Neglect": A Canadian Perspective on Ageism, Participation, and Empowerment
Journal of Elder Abuse & Neglect; 10 (3/4), 1-17, 1999
This article identifies six models of intervention to alleviate specific situations of elder mistreatment: the psychopathological model, the systems model, the hierarchical model, the quasi-legal model, the child welfare model, and the participatory model. These six models are discussed in terms of the ageist context for interventions in elder abuse and neglect, limitations on interventions, and how the construct of elder abuse and neglect as a social problem relates to ageism in the models.
Bond, J., Cuddy, R., Dixon, G., Duncan, K., and Smith, D.
The Financial Abuse of Mentally Incompetent Older Adults: A Canadian Study
Journal of Elder Abuse & Neglect; 11(4), 23-38, 1999
Results of a pilot study on the financial abuse of mentally incompetent clients of the Office of Public Trustee, Manitoba, Canada, are presented. The study sought to establish incidence of suspected financial abuse, identify the characteristics of mentally incompetent older adults at risk, and identify indicators of financial abuse. Women over the age of eighty were over-represented as victims of financial abuse. A list of financial abuse indicators is included as a potential reference for professionals and service providers.
Scandalous Care: Interpreting Public Enquiry Reports of Scandals in Residential Care
Journal of Elder Abuse and Neglect; 10 (1/2), 13-27, 1999
(Co-published simultaneously in Elder Abuse and Neglect in Residential Settings: Different National Backgrounds and Similar Responses; Glendenning, R. & Kingston, P., eds.; The Haworth Press, Inc., 1999)
In this article, the author summarizes the findings of two reports on scandals in residential care settings for elders in the U.K. (part of more extensive research submitted to the Wagner Committee, 1988). The research identifies deficits such as institutionalized practices, an authoritarian lifestyle, neglect, overcrowding, disharmony among the staff, and misappropriation of goods or money. In addition, the author recommends that resident abuse towards other residents and staff be addressed in future research. He also emphasizes the need for study of the complexity and intimate nature of direct care.
Hightower, J., Smith, M.J., Ward-Hall, C., and Hightower, H.
Meeting the Needs of Abused Older Women? A British Columbia and Yukon Transition House Survey
Journal of Elder Abuse & Neglect; Vol. 11(4), 39-57, 1999
Results of a survey of domestic violence services in British Columbia and the Yukon are presented with regard to the services they provide to women between the ages 50-59, and to women over 60. Results suggest that older victims of violence are more often categorized as victims of elder abuse than victims of family violence. The needs of these older victims of family violence are not often met by social and health agencies alone and better interaction is needed between these agencies and providers of support and advocacy for abused women.
Lithwick, M., Beaulieu, M., Gravel, S., in collaboration with Stratka, S.
The Mistreatment of Older Adults: Perpetrator-Victim Relationships and Interventions.
Journal of Elder Abuse & Neglect; 11(4), 95-112, 1999
This article reports on the responses to a questionnaire examining the characteristics of the mistreatment of older adults completed by practitioners in three community-based agencies in Quebec. Quantitative and qualitative data are presented and examined with regard to difficulties in identifying mistreatment, interventions and outcomes, and reasons for the refusal of services. Associations between the type of mistreatment and the circumstances related to the mistreatment are discussed. A harm reduction model is outlined as a useful approach in applying interventions.
Influencing the Future: Intergenerational Programming on Elder Abuse
This article discusses two Canadian programs on the topic of elder abuse prevention: a drama kit developed by the Ontario Network for the Prevention of Elder Abuse in Toronto; and "Building Bridges," developed by the NDG Community Committee on Elder Abuse. The premise of both programs is that the creative education of youths will foster positive intergenerational relationships and lay the foundation for respectful treatment of elders. (Available online)
Pritchard, J., editor
Elder Abuse Work - Best Practice in Britain and Canada
Jessica Kingsley Publishers, London; 1999
In the introduction, the editor emphasizes that this book is intended to foster effective practice in addressing elder abuse. The eleven chapters dealing with practical concerns in Great Britain cover such topics as policy development, training strategies, clinical issues, and the protection of the mentally incapacitated. The twenty-two chapters focusing on Canada's best practices also include the topics of alcohol abuse in elder abuse cases, community response to abuse of seniors, and the planning of a shelter for abused seniors (including model floor plans). Contributors include: Rachel Aber-Schlesinger, Daphne Nahmiash, Elizabeth Podnieks, Charlotte Salvesen, Jacqueline Senning, Charmaine Spencer, as well as the editor. (Note: This book is not available through CANE.)
A Fit Person to Run a Home: Registered Homes Tribunal Interpretations of the Fit Person Concept in the United Kingdom
Journal of Elder Abuse & Neglect; 10 (1/2), 119-131, 1999
This article discusses the Registered Homes Tribunal, a group that has the authority to hear appeals regarding the operation of registered and nursing homes in the United Kingdom. The tribunal is approached with many cases which address whether or not certain individuals are fit to operate homes. This article explores the workings and decisions of the Tribunal.
Saveman, B., Astrom, S., Bucht, G., & Norberg, A.
Elder Abuse in Residential Settings in Sweden
Journal of Elder Abuse & Neglect; 10 (1/2), 43-60, 1999
(Co-published simultaneously in Elder Abuse and Neglect in Residential Settings: Different National Backgrounds and Similar Responses; Glendenning, F. & Kingston, P., eds.; The Haworth Press, Inc., 1999)
Using data gathered from 499 nursing staff members, this study was conducted to investigate the phenomenon of elder abuse in residential settings in Sweden. Eleven percent of respondents were aware of abusive incidents, and two percent admitted to abusive acts. In many reported situations, abusers were considered to be tired, burned out, or short-tempered. Those abused were often reported as mentally or physically handicapped and usually over 80 years old.
McLaughlin, J. & Lavery, H.
Awareness of Elder Abuse Among Community Health and Social Care Staff in Northern Ireland: An Exploratory Study
Journal of Elder Abuse & Neglect; 11(3), 53-72, 1999
This article reports on one of the first surveys of multi-disciplinary staff awareness of elder abuse in Northern Ireland. Participants represented eight professional groups and numbered forty respondents total. Surveys sought to determine respondents' knowledge of elder abuse, the types of help they thought they could offer the abused and the abuser, and the level of abuse in their current caseload. Findings suggest that further training and education is necessary.
Soeda, A. and Araki, C.
Elder Abuse by Daughters-in-Law in Japan
Journal of Elder Abuse & Neglect; 11 (1), 47-58, 1999
The purpose of this article is to review and discuss the findings of two studies conducted in Japan in 1993 and 1997 on the issue of domestic elder abuse. Social workers and home aides were surveyed and identified neglect, particularly by daughters-in-law, to be the most prevalent type of elder mistreatment occurring in Japanese homes. This phenomenon was attributed to poor relationships between in-laws.
A Telephone Counseling Program for Elder Abuse in Japan
Journal of Elder Abuse & Neglect; 11(1), 105-112, 1999
A brief overview of the impact of post-World War II societal changes in Japan is followed by a report on the cases fielded, over an 18-month period, by a Help Line initiated by the Japan Elder Abuse Prevention Center. From the cases reported through the Help Line, statistics regarding the types of abuse and the elders' relationships to the perpetrators were constructed. Based on these statistics, recommendations are made regarding the need for new laws and social welfare policies to assist the elderly in Japan.
Older and Isolated Women and Domestic Violence Project
Journal of Elder Abuse & Neglect; 11(1), 59-77, 1999
This report documents the results of an Australian organized national phone-in, designed to elicit responses to a questionnaire from older and isolated women who live with domestic violence. A copy of the questionnaire is included as an appendix. Significant themes and responses that emerged from the phone-in are reported, as are the logistics of organizing a phone-in of this magnitude. Issues regarding women from rural and remote communities are explored in detail. Recommendations are made for policy development, improved service provision, and prevention strategies.
Bruises on the Soul: Older Women, Domestic Violence, and Elder Abuse
Journal of Elder Abuse & Neglect; 11 (1), 1-22, 1999
A general examination of the abuse of older women is presented. The author, a social work practitioner and manager in the United Kingdom, provides case studies from her own experience. All six cases involve women over the age of eighty and are assessed with regard to type of abuse, relationship to abuser, gender of abuser, risk factors and interventions used. The focus of the article is to increase understanding of abuse and specific abusive situations and to provide insights that may be used to reduce and prevent such incidences.
Potential for the Abuse of Medication of the Elderly in Residential and Nursing Homes in the U.K.
Journal of Elder Abuse & Neglect; 10 (1/2), 79-89, 1999
This article describes the circumstances leading to the potential abuse of elderly residents' medication, and the measures that may be taken to avoid or minimize such abuse.
Reis, M. & Nahmiash, D.
Validation of the Indicators of Abuse (IOA) Screen
The Gerontologist; 38 (4), 471-480, 1998
This article describes the Indicators of Abuse (IOA) screening measure. The study supports the validity of the 29-item set of indicators of the IOA, which distinguishes abuse cases from nonabuse cases and is intended for use by practitioners. This research was funded by Health Canada, Family Violence Prevention Division.
Harbison, J. & Morrow, M.
Re-examining the Social Construction of �eElder Abuse and Neglect': A Canadian Perspective
Ageing and Society; 18, 691-711, 1998
This article examines three competing constructs of elder abuse and neglect: as adults in need of protection; as victims of family violence; and as persons susceptible to illegal acts. Additionally, a fourth construct is discussed, that of the elderly as active agents in defining their own experiences as a necessary condition toward a better understanding of their mistreatment. These constructs are discussed in terms of Canadian public policy and political economy.
Salient Factors that Influence the Meaning of Family Caregiving for Frail Elderly Parents in Japan from a Historical Perspective
Scholarly Inquiry for Nursing Practice: An International Journal; 12 (2), 123-134, 1998
In this article, the author discusses a number of cultural norms, based in part upon Confucianism and Buddhism, that affect care provision within the family for frail, elderly parents in Japan. Concepts of filial devotion, harmony, dependence, valuation of healthiness are among the factors explored in terms of implications for nursing practices.
Legal Developments in England: A New Agenda for Change?
Paper prepared for an Adult Protective Services Conference, 1998
This handout contains details of statutory provision and case law, including recent developments, and proposals for reform, referred to in the workshop.
Ross, M.M., Hoff, L.A., & Coutu-Wakulczyk, G.
Nursing Curricula and Violence Issues
Journal of Nursing Education; 37(2), 53-60, 1998
This article presents the findings of a survey of Canadian schools of nursing to determine the extent to which violence-related content is addressed in nursing curricula. Findings suggest the number of hours of instruction dedicated to the following topics: child abuse, suicide, woman abuse, sexual assault, and elder abuse. Recommendations regarding inclusion of violence-related content are included.
Comijs, H., Pot, A., Smit, J., et al
Elder Abuse in the Community: Prevalence and Consequences
JAGS; 46, 885-888, 1998
The purpose of this article is to assess the prevalence and consequences of chronic verbal aggression, physical aggression, financial mistreatment, and neglect in a community-based sample, and to investigate the circumstances that led to abuse. Research was based upon a sample of 1,797 older individuals living independently in Amsterdam, the Netherlands. The one-year prevalence rate of abuse was 5.6 percent, with verbal aggression the most common type experienced at a 3.2 percent rate. The report also examines how the victims dealt with the abuse.
McCreadie, C., Bennett, G., and Tinker, A.
Investigating British General Practitioners' Knowledge and Experience of Elder Abuse: Report of a Research Study in an Inner London Borough
Journal of Elder Abuse & Neglect; 9 (3), 23-39, 1998
This article discusses a research study conducted in the London borough of Tower Hamlets to assess the instances of elder abuse encountered by a sample of practitioners over a period of time. Instances of elder abuse, and general practitioner characteristics, such as gender, age, ethnicity, practice size, and home visiting, were also investigated.
Comijs, H.C., Smit, J.H., Pot, A.M., Bouter, L.M. & Jonker, C.
Risk Indicators of Elder Mistreatment in the Community
Journal of Elder Abuse & Neglect; Vol. 9(4), 67-76, 1998
This article focuses on the risk indicators of elder mistreatment in a one-year study of 1,797 elders living independently in Amsterdam. The results indicate that chronic verbal aggression is associated with elders living with a partner or someone else in poor health. Physical aggression appears connected with elders living with a partner or someone else displaying symptoms of depression. Financial maltreatment appears associated with males, living alone, being somewhat dependent for daily living activities and displaying depressive symptoms. These results suggest that because the risk indicators for victims of financial abuse differ from those of verbal abuse and physical aggression, that financial abuse may occur more often as a single form of abuse and that verbal and physical abuse appear more coincidentally.
Ferguson, S. and Koder, D.
Geropsychology: Some Potential Growth Areas in Psychological Research and Practice
Australian Psychologist; 33 (3), 187-192, 1998
This article reviews the issues of depression, suicide, and management of behavioral problems due to dementia among the elderly. The article emphasizes the role of psychologists in identifying risk factors, creating treatments, and monitoring treatment effectiveness.
Institutional Respite Care: Breaking Chores or Breaking Social Bonds?
The Gerontologist; 38(5), 610-617, 1998
This article examines the reason why respite care seems to be positively viewed by caregivers, yet is under-utilized by those who seem to be in need of it. One-hundred-forty-four caregivers from Canberra, Australia, provided the data for examining the relationships between five appraisal dimensions in the use of respite care in the past and in the future. The data shows that respite care usage is higher when caregiving demands are high and when the relationship between caregiver and recipient is dysfunctional. The previous quality of the caregiver-care recipient relationship appears to have an impact upon future use of respite services.
Meshefedjian, G., McCusker, J., & Bellavance, F. & Baumgarten, M.
Factors Associated with Symptoms of Depression Among Informal Caregivers of Demented Elders in the Community
The Gerontologist; 38 (2), 247-253, 1998
This Canadian study explores the impact of specific variables upon depression among caregivers of demented older adults living in the community. A sample of 321 caregivers were assessed for depression using the Center for Epidemiologic Studies Depression Scale (CES-D). Higher depressive scores were associated with the following caregiver characteristics: being the spouse or child of the patient; having an ethnic background other than English and French-Canadian; and having lower education levels. Patient characteristic associated with higher caregiver depressive scores were greater behavioral disturbance levels and moderate to severe functional impairment.
Brown, H. & Stein, J.
Implementing Adult Protection Policies in Kent and East Sussex
Journal of Social Policy; 27 (3), 371-396, 1998
This article discusses data gathered in the Social Service Departments of Kent and East Sussex, England, describing the extent and nature of adult protection cases occurring over a twelve month period. With funding from the Nuffield Foundation, these departments have been working together to implement and evaluate the effectiveness of newly revised generic policies on abuse of vulnerable adults.
McCreadie, C. & Hancock, R.
Elder Abuse: Can the British OPCS Disability Surveys Throw Any Light?
Journal of Elder Abuse & Neglect; 8 (4), 31-42, 1997
This article draws upon data collected from the Office of Population Censuses and Surveys and the Data Archive at the University of Essex (1985-1987) to explore potential links between the disabled elderly who are exposed to violence, their residential circumstances and abuse risk factors. The sample consisted of 11,000 adults, aged 16 and over, living in private homes, and having at least one of twelve sub-types of disability. The severity of disability was rated from mild to severe. One sub-type, behavioral disability, was then rated on an eight point scale for severity and violence/aggressiveness. Three research questions were examined: (1) how many potentially aggressive younger adults were living with older residents and therefore posing an increased risk of elder abuse; (2) how many elders demonstrated aggression that could potentially provoke aggression from younger residents; (3) and how many older residents with the potential for aggression were residing with other older residents, who were therefore at greater risk of abuse or of becoming abusive in response. Older households with documented histories of behavioral problems appear an appropriate starting point for preventative efforts.
Recognising the Financial Abuse of Older People
Professional Nurse; 12 (4), 256-258, 1997
This article discusses the issue of financial abuse of the elderly in the U.K., which is increasingly recognized as a social problem and a form of family violence. Definitions of financial elder abuse are given, along with suggestions to those who suspect financial abuse of the elderly.
Cooney, C. and Hamid, W.
The Use of Health Legislation to Deal With Abuse of Community Based Elderly People With Dementia
Medicine, Science & Law; 37 (1), 41-45, 1997
This article discusses recent health legislation used in situations of actual and potential abuse of community dwelling elderly with dementia in England. An analysis of recommendations from The Law Commission is reviewed, and the contribution of current health legislation dealing with abuse is assessed. Sections 2, 3, and 135 of the Mental Health Act of 1983, the NHS and Community Care Act of 1990, and Section 147 of the National Assistance Act of 1948 are highlighted.
Compton, S., Flanagan, P., Gregg, W.
Elder Abuse in People with Dementia in Northern Ireland: Prevalence and Predictors in Cases Referred to a Psychiatry of Old Age Service
International Journal of Geriatric Psychiatry;12, 632-635, 1997
This study examines whether or not there is a difference in caregiver and patient characteristics between abused and non-abused community-dwelling elders with dementia. This study was conducted in Ireland and included 49 dependant/caregiver pairs, and 38 caregivers. Participants were interviewed over a two-year period and data regarding abuse and caregiver/dependant relationships was gathered. Conclusions do not support other research findings that caregiver characteristics such as financial dependence, criminal or psychiatric history, lifestyle changes, and/or substance abuse were associated with elder abuse. Results of this study suggest that elder abuse is associated closely with aspects of the patient/caregiver relationship and patient's risk for abuse should be considered when they are referred to an old age service.
Pot, A.M., Deeg, D.J.H. & Van Dyk, R.
Psychological Well-Being of Informal Caregivers of Elderly People with Dementia: Changes Over Time
Aging & Mental Health; 1(3), 261-268, 1997
This article discusses research, conducted in the Netherlands, on the psychological well-being of caregivers of demented elderly persons. Following a baseline analysis, three groups were established and assessed over a two year period. Groups consisted of individuals providing support for two years after the baseline analysis, individuals whose care-recipient had died within one year of the initial assessment, and those whose care-recipient was institutionalized within one year of the initial assessment. It was found that all caregivers indicated a significant amount of psychological distress. No continuing changes were observed among the groups whose recipient had either died or been institutionalized. However, the group who continued to care for the elder showed a deterioration of psychological well-being as the elder's functioning declined.
Saveman, R. & Hallberg, I.R.
Interventions in Hypothetical Elder Abuse Situations Suggested by Swedish Formal Carers
Journal of Elder Abuse & Neglect; 8 (4), 1-19, 1997
This article explores three hypothetical cases of elder abuse and potential interventions by Swedish formal caregivers. The scenarios included spousal elder abuse, elder abuse by a dependent adult child and elder abuse by a caregiving relative. Elder abuse is not viewed as a public issue in Sweden, therefore some respondents suggested minimal interventions, indicating it is a social problem that should be dealt with by voluntary organizations. The profession of the respondent appears to be one factor that significantly influences the type of intervention suggested.
Kurrle, S., Sadler, P., Lockwood, K. and Cameron, I.
Elder Abuse: Prevalence, Intervention, and Outcomes in Patients Referred to Four Aged Care Assessment Teams
Medical Journal of Australia; 166 (3), 119-122, 1997
This article reports on a study that attempts to replicate and expand upon prior research on the prevalence and patterns of elder abuse among patients of four Aged Care Assessment Teams in Perth, Brisbane, Sydney, and New South Wales, Australia. This study identifies a 1.2 percent prevalence rate with psychological abuse as the most common form of mistreatment.
Identifying and Addressing the Issues in Elder Abuse: A Rural Perspective
Journal of Elder Abuse & Neglect; 8 (4), 21-30 1997
This article reports on a study of domestic elder abuse in rural communities in New South Wales, Australia. During May of 1995, twenty community nurses and home care workers visited a total of 598 clients and assessed them for victimization of physical, financial, psychological/emotional abuse, neglect and self-neglect (defined by the official report of the NSW Task Force on Abuse of Older People, 1/93). A total of thirty-three elders were identified as experiencing some form of abuse, with nearly half (fifteen) experiencing psychological abuse, and one-third (twelve) experiencing financial abuse, nine experiencing physical abuse, nine being neglected, three experiencing self-neglect and one experiencing a violation of rights. The findings for this non-metropolitan population are similar to findings of prevalence and type of abuse in metropolitan areas; however, lack of services and geographic isolation present barriers to prevention and treatment to those in rural communities.
Sharon, N. & Zoabi, S.
Elder Abuse in a Land of Tradition: The Case of Israel's Arabs
Journal of Elder Abuse & Neglect; 8 (4), 43-58, 1997
The Arab community comprises eighteen percent of the Israeli population. This study explores the nature of elder abuse within this traditional group, currently undergoing cultural changes. One-hundred twenty-eight health and human services professionals were asked to report on identified incidents of elder abuse occurring over an eighteen month period of time. Findings were based on four-hundred thirty-four cases of physical, psychological, material abuse and neglect (excluding self-neglect) and demonstrated an incidence rate of 2.53 percent for Arab elders, in the lower range established by prior international incidence studies. In urban areas, higher incidence rates were reported. While characteristics of abuse victims appear generally similar to Western profiles, a notable difference in the abuser profile is that sons, rather than spouses, were found to be the most common perpetrators.
Krueger, P. and Patterson, C.
Detecting and Managing Elder Abuse: Challenges in Primary Care
Canadian Medical Association Journal; 157 (8), 1095-1100, 1997
This article describes a study designed to determine family physicians' perceptions of barriers that impede effective detection and management of elder abuse cases. To assess perceptions, 120 family physicians in the Regional Municipality of Hamilton-Wentworth, Ontario, were surveyed. Results indicate that physicians believed the following barriers were significant: denial of abuse; resistance to intervention; lack of awareness of resources; lack of protocols to assess and respond to abuse; lack of guidelines regarding confidentiality; fear of reprisal; and lack of knowledge of the prevalence and definition of elder abuse.
Trevitt, C. & Gallagher, E
Elder Abuse in Canada and Australia: Implications for Nurse
International Journal of Nursing Studies; 33 (6), 651-659, 1996
This article reports on a comparison of Canadian and Australian registered nurses' knowledge about, and comfort level in dealing with, elder mistreatment. Using the questionnaire developed for the Elder Abuse Project in Victoria, British Columbia, Canada, 56 registered nurses from various health care settings in Victoria and 36 registered nurses from similar settings undertaking advanced study at the University of Canberra were asked to self-rate their level of skill, knowledge and comfort in addressing multiple aspects of elder abuse. While 53.5 percent of the Canadian participants had encountered elder abuse, only 38.3 percent of the Australians had. Otherwise, few differences were noted. Results indicate an overall deficit in nurses' perceived ability to address this problem. Implications for educational and community policies are discussed.
Goodridge, D., Johnston, P., & Thomson, M.
Conflict and Aggression as Stressors in the Work Environment of Nursing Assistants: Implications for Institutional Elder Abuse
Journal of Elder Abuse & Neglect; 8 (1), 49-67, 1996
This paper describes the results of a Canadian study that examines conflict, aggression and burn-out in one group of nursing assistants. Findings indicate a slight correlation between burn-out and conflict and also between burn-out and reported aggression from residents. A statistically significant relationship was noted between conflict with residents and resident aggression from residents.
Caring for Older People: Ethnic Elders
BMJ Online (British Medical Journal); September 1996
This article describes some of the barriers between ethnic minorities and health and social service delivery in England. Cultural beliefs, language, socio-economic status and racism exacerbate health problems of the ethnic elders. (Available electronically at BMJ Online.)
Older Battered Women - Integrating Aging and Domestic Violence Services
Produced by the San Francisco Consortium for Elder Abuse Prevention/ Mount Zion Institute on Aging for the National Center on Elder Abuse, Washington, D.C., January 1996
This manual consists of: (1) a primer on domestic violence to assist adult protective service providers; (2) current information regarding the causes and manifestations of abuse to enhance the understanding of older battered women; (3) information regarding six model programs for older battered women in Canada and the U.S. For publication order form, contact the Institute on Aging, 3330 Geary Blvd., San Francisco, CA 94118, or by telephone at (415) 447-1989 ext. 513 or via e-mail at el[email protected]">[email protected]. Price: $15.00. (CA residents add 8.5% sales tax.)
Caregivers Sensitivity to Conflict: The Use of the Vignette Methodology
Journal of Elder Abuse & Neglect; 8 (1), 35-47, 1996
This researcher used "vignette methodology" with a sample of 30 female caregivers of the elderly in order to allow them to explore conflicts and coping strategies in domestic situations, and to determine if there was consensus about these typical situations. The article describes three interpersonally complex hypothetical situations that were presented to these women, who lived in the Australian Capital Territory (ACT). The respondents were asked to choose a solution and then to participate in an in-depth interview regarding their response. In particular, married daughters who participated appeared to be affected the most by the demands of caring for two generations. The author suggests this tool be used to further study family dynamics in developing countries where intergenerational issues appear undetected.
Pittaway, E.D., Westhues, A. & Peressini, T.
Risk Factors for Abuse and Neglect Among Older Adults
Canadian Journal on Aging; 14 (2), 20-44, 1995
This article discusses research on the risk for abuse and neglect based on four theoretical perspectives: the situational model, social exchange theory, symbolic intereactionism and feminist theory. Risk factors associated with physical abuse appear related to the situational and feminist models; factors associated with chronic verbal abuse appear related to the symbolic interaction model; factors associated with neglect appear related to the symbolic interaction model and the feminist model; material abuse does not appear to be explained by any of the theoretical perspectives.
Aronson, J., Thornewell, C. & Williams, K.
Wife Assault in Old Age: Coming Out of Obscurity
Canadian Journal on Aging; 14 (2), 72-88, 1995
This article, based on research conducted by McMaster University's "Woman Abuse Curriculum Project," addresses the tendency to view spousal abuse and elder abuse as two distinct problems and therefore overlook an isolated group of victims, older battered women. The focal point of the article is the oral history of "Eve," a 79 year old woman who left her abusive spouse after almost 50 years of marriage. Using Eve's story as a means to explore barriers to identifying this problem, focus group participants also identify the key elements that enable Eve to eventually disclose her abusive circumstances and to seek help.
Suwa-Kobayashi, S., Yuasa, M. & Noguchi, M.
Nursing in Japan - Caregivers of Elderly Family Members With Dementia
Journal of Gerontological Nursing; 21 (1), 23-30, January 1995
This article discusses the difficulties that caregivers must address when dealing for elderly family members suffering from dementia. The difficulties are divided into five categories, and nurses must decide which stage of the developmental process families are going through in order to help them with effective interventions.
Lindgren, A., Svardsudd, K. & Tibblin, G.
Factors Related to Perceived Health Among Elderly People: The Albertina Project
Age and Ageing; 23, 328-333, 1994
The Albertina Project is an epidemiological study of the medical, social, and economic situation among people aged 75 and older in Upsala, Sweden. In this article, health conditions, quality of life measures, and housing problems are presented. The most important factors related to perceived health were activity score, contentment, and mobility problems. The practical implication of these findings is that more attention could be focused on efforts to improve older people's satisfaction with their life situation, rather than focusing on marginal improvements of their medical situations.
McInnes, E. & Powell, J.
Drug and Alcohol Referrals: Are Elderly Substance Abuse Diagnoses and Referrals Being Missed?
BMJ online (British Medical Journal); February 1994
In this study, the medical staff from three hospitals in New South Wales, Australia, were surveyed regarding their practices in assessing and diagnosing substance abuse among elders. Two-hundred sixty-three patients were classified by researchers as problem substance users. Overall, medical staff diagnosed only 25 percent of the problem users that researchers identified, and considered referring only 10 percent for substance abuse treatment. (Available electronically at BMJ Online.)
Researching Elder Abuse in Britain
Journal of Elder Abuse & Neglect; 5 (2), 37-54, 1993
This article explains the lack of British elder abuse research by examining two aspects of the research process: methodological difficulties and ethical problems. As a result, the experience of using an American research methodology is described.
Pittaway, E. & Westhues, A.
The Prevalence of Elder Abuse and Neglect of Older Adults Who Access Health and Social Services in London, Ontario, Canada
Journal of Elder Abuse & Neglect; 5 (4), 77-93, 1993
In this prevalence study, 385 residents (aged 55-100) of London, Ontario were interviewed regarding their personal experience of physical, verbal, material abuse and neglect. Over 14 percent of the respondents indicated that they had experienced at least one episode of physical abuse after turning 55. One factor that may account for higher prevalence than previously established (Podnieks,1990) is that this sample was drawn from individuals who had accessed health and social services.
McCreadie, C. & Tinker, A.
Review: Abuse of Elderly People in the Domestic Setting - A U.K. Perspective
Age and Ageing; 22, 65-69, 1993
This article reports on a small exploratory study of elder abuse to determine if further research is needed in the U.K.. Problems identified included variations in definitions, fragmentation of the law, and poor coordination between professional services. Therefore, researchers believe further research is warranted in order to establish prevalence rate as well as policies and interventions.
The Elder Abuse Resource Centre, A Coordinated Community Response to Elder Abuse: One Canadian Perspective
August 31, 1993
This paper provides a description of the Elder Abuse Resource Centre in Winnipeg, Manitoba, Canada, which officially opened in 1990 as a program under a United Way agency, the Age and Opportunity Centre. The goal of the EARC is the coordination of existing services to the victims of elder abuse and their families. Two interventions discussed are the Centre's multidisciplinary team which provides consultation for practitioner and service providers, and the use of support groups for older battered women. The paper also includes socio-demographic information regarding Canadian population trends (specifically regarding the elderly), as well as a summary of the Canadian research on elder mistreatment and the country's response, including a history of the Manitoba Gerontology Network's efforts to address this problem.
Malmberg, B. & Zarit, S.H.
Group Homes for People with Dementia: A Swedish Example
The Gerontologist; 33 (5), 682-686, 1993
This article describes the development and evaluation of group homes for dementia patients in Sweden. Group homes have been established on a social model of care to provide a better quality of life than that found in institutional settings, at a slightly lower cost. An enriched program of activities uses familiar everyday household tasks, with staff trained to model appropriate behaviors. An evaluation of four homes showed that residents could be well accommodated in the setting, even as their disabilities increased. Although there were some initial problems, staff satisfaction was high and turnover was low.
Family Financial And Household Support Exchange Between Generations: A Survey of Chinese Rural Elderly
The Gerontologist; 23 (4), 468-480, 1993
This study examines the pattern of social support exchange between Chinese elderly and their adult children, based on a 1989 rural Chinese household survey. The elderly with greater resource capacity (good health, income, education and social network) appear more likely to provide than to receive assistance, whereas those with fewer resources had the opposite patterns. A formal pension and elderly care system is needed to supplement the informal support system, since only 42 percent of the elders with one or two adult children lived with them.
National Survey on Abuse of the Elderly in Canada
Journal of Elder Abuse & Neglect; 4 (1/2), 5-58, 1992
This study, utilizing data collected through a modified random sample telephone survey of 2008 community-dwelling elders, sought to identify the prevalence and circumstances of elder abuse in Canada. Four major categories were defined: material abuse, psychological abuse, physical abuse and neglect. The study's findings have implications for action on the part of the policy makers, researchers, service providers, law enforcement agencies and elderly persons and their organizations in four key areas: education, new services, examination of future legislation needs and future research.
Comparing Practice in the United States and the United Kingdom
Ageing International; XIX (3), 15-28, 1992
By comparing the experience of two countries at different stages in their development of response systems, the author show that some practices simply work better than others no matter where they are carried out.
Elder Abuse: Levels of Scientific Knowledge in Quebec
Journal of Elder Abuse & Neglect; 4 (1/2), 135-149, 1992
The purpose of this article is to give a historical perspective of the scientific knowledge on elder abuse in Quebec. The first part reviews the major studies concerning criminal victimization and elders' fear of crime. The second part presents the level of knowledge about abuse. The last part contains a critical overview of the development and progress of knowledge on elder abuse.
Emerging Themes From a Follow-up Study of Canadian Victims of Elder Abuse
Journal of Elder Abuse & Neglect; 4 (1/2), 59-111, 1992
This article summarizes the findings of a follow-up study to the National Survey on Elder Abuse in Canada. Of the original 2008 interviewees, 80 were identified as abuse victims and 42 of these were re-interviewed. Analysis of multiple characteristics of the victims and their circumstances provides strong evidence that these people develop adaptive strengths, labeled by the authors as hardiness, when coping with their maltreatment.
Kivela, S., Kongas-Saviaro, P., Kesti, E. et al
Abuse in Old Age - Epidemiological Data From Finland
Journal of Elder Abuse and Neglect; 4 (3), 1-18, 1992
This article reports on a research study conducted in Ahtari, a semi-industrial town in Finland, in 1989. A total of 1,086 Finns aged 65 and older participated in interviews and clinical examinations to determine what types, if any, of elder abuse occurred and in what contexts. Three percent of the men and nine percent of the women interviewed indicated that they had been abused. Physical and psychological abuse were the most common types of mistreatment, and the home was the most common place of occurrence.
Podnieks, E., Pillemer, K. Nicholson, J.P., Shillington, T. & Frizzel, A.
National Survey on Abuse of the Elderly in Canada
Ryerson Polytechnical Institute; Toronto, Ontario, 1990
This study establishes a challenging agenda for researchers, policy-makers, legislators, law enforcement agencies, financial institutions, and legal, health and social service practitioners in the coming decade. It underscores the importance of a carefully constructed and multi-dimensional approach that is sensitive to protective overkill: the abuse of rights and freedoms that may flow from a benign but misguided application of child protection principles in the adult context. The recommendations stress the importance of professional and public education.
?Wolf, R. & Bergman, S., eds.
Stress, Conflict and Abuse of the Elderly
JDC-Brookdale Institute of Gerontology and Adult Human Development, Jerusalem, 1989
This entry contains the introduction and table of contents of Stress, Conflict and Abuse of the Elderly, a monograph that is a collection of papers presented at a workshop held at the Brookdale Institute of Gerontology and Adult Human Development in Jerusalem on August 25-27, 1986. One of a series of international workshops commemorating the founding of organized gerontology in Israel, it represents one of the earliest attempts to consider elder abuse within a cross-cultural context. (Note: The book is not available through CANE.)
Bristowe, E. & Collins, J.B.
Family Mediated Abuse of Noninstitutionalized Frail Elderly Men and Women Living in British Columbia
Journal of Elder Abuse & Neglect; 1 (1), 45-64, 1989
The characteristics of 66 frail elderly men and women and their family caregivers in British Columbia were studied to determine which caregiving situations were appropriate and which were abusive. It was found that caregiver characteristics were more important than victim characteristics. Male caregivers' use of alcohol appeared to be directly related to abuse.
Last Updated: January 11, 2006
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