Elder Abuse and Self-neglect

Abstract

Elder mistreatment encompasses a range of behaviors including emotional, financial, physical, and sexual abuse, neglect by other individuals, and self-neglect. This article discusses the range of elder mistreatment in community-living older adults, associated factors, and consequences. Although self-neglect is not considered a type of abuse in many research definitions, it is the most commonly reported form of elder mistreatment and is associated with increased morbidity and mortality. The case on which this article is based describes a 70-year-old woman who neglects herself and dies despite multiple contacts with the medical community. Despite significant gaps in research, enough is known to guide clinical practice. This article presents the practical approaches a health care professional can take when a reasonable suspicion of elder mistreatment arises. Public health and interdisciplinary team approaches are needed to manage what is becoming an increasing problem as the number of older adults around the world increases.

Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population

“…‘Red flags’ for potential elder abuse should be raised for vulnerable, cognitively impaired individuals, especially those without the support needed to meet their most basic day-to-day needs. Health care professionals, social services agencies, law enforcement agencies, policy makers and other relevant disciplines should work closely with dementia organizations at the community, state and national levels to promote awareness of the association between cognitive impairment and elder abuse [28]. …”

A Systematic Evaluation of a Multidisciplinary Social Work–Lawyer Elder Mistreatment Intervention Model

“…Given the emergency nature of mistreatment situations, referrals must be responded to immediately; there is little time for screening and consent protocols or administering study instruments; and ethical issues arise in assigning subjects into a research arm that denies optimal services. Elders with cognitive impairment are at higher risk for mistreatment (Mosqueda & Dong, 2011). There are difficulties obtaining consent from an elder lacking capacity; proxies are reluctant to provide consent; and there can be concern that the family proxy may also be a perpetrator.…”

“…The elder mistreatment literature advocates for a multidisciplinary model of intervention to alleviate cases of elder mistreatment (Imbody & Vandsburger, 2011;Mosqueda & Dong, 2011). A multidisciplinary approach provides the necessary diversity of professional resources and skills, used at different points along the assessment and intervention process, to problem-solve and resolve complex, multifaceted cases of elder mistreatment.…”

Making and Executing Decisions for Safe and Independent Living (MED-SAIL): Development and Validation of a Brief Screening Tool

“…Capacity assessments commonly used among clinicians focus on decisional components of capacity such as short-term memory, attention/concentration, and spatial orientation. 7–10 These tools do not address the overlap of function, cognition, and judgment; capacity for independent living lies at the confluence of these domains. 7,9 Even when more comprehensive methods of capacity assessment are utilized, they are often time-intensive and involve multidisciplinary teams in a medical setting.…”

“…7,9 Even when more comprehensive methods of capacity assessment are utilized, they are often time-intensive and involve multidisciplinary teams in a medical setting. 10 …”