Elder Mistreatment in U.S. Residential Care Facilities: The Scope of the Problem

Phillips, Linda R.; Guo, Guifang; Kim, Haesook

doi:10.1080/08946566.2012.712851

Cited by 12 publications

(15 citation statements)

References 28 publications

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“…3 However, in our study only 6.8% of the forensic medical findings were suggestive of physical abuse, according to the following criteria: (a) the explanation provided did not suit the injury's characteristics; injuries located in typical non-accidental areas; (b) patterned injuries; (c) injuries in different stages of healing; (d) delay between injury production and seeking for health care. It is important to emphasize that even with these criteria, the differential diagnosis between intentionally inflicted injuries, accidental injuries, self-inflicted injuries and pathological or age related lesions is particularly difficult.…”

Section: Alleged Abuse and Forensic Medical Findingsmentioning

confidence: 74%

“…2 Physical abuse consists of "wilful infliction of physical pain or injury, including hitting, striking, pinching, slapping, shaking, pushing, grabbing, handling in a rough manner, or injuring someone in another way". 3 Physical coercion and sexual abuse are also included as a subset of physical abuse. 2 With the progressive increase in life expectancy, people over 65 years are estimated to represent 25% of the European population by 2050, against the 14% in 2010.…”

Section: Introductionmentioning

confidence: 99%

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Physical abuse against elderly persons in institutional settings

Frazão

Correia

Norton

et al. 2015

Journal of Forensic and Legal Medicine

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a b s t r a c tIntroduction: People over 65 years old are expected to be an increasing group exposed to abuse. Despite the well-studied intra-familial abuse, institutional abuse still lacks a proper understanding about its determinants and characteristics. Aim: The general objective of this study is to provide a better knowledge about physical abuse against elderly people in institutional settings, in order to contribute to a timely detection, correct forensic diagnosis and prevention of these cases. Methods: A retrospective study was conducted through the analysis of forensic medical exams performed in the North Forensic Medical Services of Portugal, between 2004 and 2013, to elderly persons allegedly victims of physical abuse in an institutional setting by a caregiver (n ¼ 59). Results: All the alleged cases occurred in nursing homes and in most of them (93.2%) the charges were against the institution and not focussing on a particular individual. The alleged victims were mainly female (79.7%), 75 years or older (75.9%), presenting a severe disability (55.9%) and 47.2% being unable to communicate. No injuries or post-traumatic pain were found in 55.9% of the cases to support the charge of physical abuse. Only in 6.8% of the cases were the forensic medical findings suggestive of physical abuse and, although this was not the object of the examination, 69.1% were considered suggestive or highly suggestive of neglect. A statistically significant association was found between the alleged victim's degree of disability and the occurrence of neglect (p ¼ 0.003). Conclusion: The sample's size seems to be underestimated, probably due to lack of detection and/or reporting. The condition of these persons, mainly related with their inability to perceive abusive behaviours and/or to disclose them (mostly by physical and/or mental disability), as well as their reluctance to press charges due to fear of reprisal, affects significantly the detection and diagnosis of physical abuse, particularly in whom injuries are not obvious. In anticipation to the rapid ageing of the population, it is urgent to analyse and understand this emerging issue so that social policies and regulation may be developed, in an effort to protect the elderly, as well as to make improvements in the professionals' skills.

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Section: Alleged Abuse and Forensic Medical Findingsmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Physical abuse against elderly persons in institutional settings

Frazão

Correia

Norton

et al. 2015

Journal of Forensic and Legal Medicine

View full text Add to dashboard Cite

show abstract

“…These impairments may hinder reporting and recognition of elder mistreatment and are one of many reasons that elder mistreatment in supervised settings has been historically difficult to assess (Hawes, 2002). Other factors complicating recognition and reporting include inspector biases, lack of alternative facilities, and differing reporting protocols across states (Phillips, Guo, & Kim, 2013). Centralization or standardization of Adult Protective Services' guidelines would be an ideal start to understanding the true prevalence and incidence of elder mistreatment in assisted living facilities.…”

Section: Discussionmentioning

confidence: 98%

Screening Elders in the Emergency Department at Risk for Mistreatment: A Pilot Study

Eulitt

Tomberg

Cunningham

et al. 2014

Journal of Elder Abuse & Neglect

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Impaired functional status is associated with risk of elder mistreatment. Screening for functional impairment in elderly patients admitted to emergency departments could be performed to identify patients at risk for elder mistreatment who might benefit from further evaluation. This study utilized a modified Identification of Seniors at Risk (ISAR) screening tool to identify the proportion of elderly at risk for mistreatment due to functional difficulties presenting to two emergency departments in southeastern Virginia, one urban, the other rural. Of a 180-patient cohort (90 per site), 82 screened positive (46%), ISAR > 2 (range 0-6), indicating nearly half of all patients enrolled are at risk for mistreatment. Patients presenting to the urban emergency departments were potentially more at risk than their rural counterparts (p < 0.01). Health care professionals, particularly in urban settings, should consider screening seniors with a simple tool to identify patients at risk of elder mistreatment.

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“…N u r s O u t l o o k 6 8 ( 2 0 2 0 ) 1 1 4 À1 2 2 (4À25 beds) are often exempt from the ALF regulations, and these make up a substantial portion of ALFs (Caffrey, Harris-Kojetin, Rome, & Sengupta, 2014;Phillips, Guo, & Kim, 2013). For training requirements, states have tended to increase the initial hours for CNAs, but training hours required for DCWs lagged behind in almost all states.…”

Section: Discussionmentioning

confidence: 99%

Comparing residential long-term care regulations between nursing homes and assisted living facilities

et al. 2020

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Background: Nursing homes (NHs) are federally regulated under uniform standards, whereas assisted living facilities (ALFs) use individual state regulations for staffing, training, and oversight of care quality and safety. Purpose: To describe ALF staffing, training, inspection, and enforcement regulations for 50 U.S. states and the District of Columbia, and compare them to NH regulations. Publication of ALF quality and safety outcomes data also was assessed and compared to NHs. Methods: Regulatory data were compiled from administrative and regulatory data sources, state websites, and regulatory compendia. Findings: NHs followed a standard set of regulations, whereas ALF regulations varied widely. Overall, state ALF regulations were less stringent than NH in all categories. Discussion: As ALF populations and acuity levels increase, staffing, training, nursing presence, and outcomes data requirements are warranted, and could be tailored from NH regulations to protect ALF quality and safety.

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Elder Mistreatment in U.S. Residential Care Facilities: The Scope of the Problem

Cited by 12 publications

References 28 publications

Physical abuse against elderly persons in institutional settings

Physical abuse against elderly persons in institutional settings

Screening Elders in the Emergency Department at Risk for Mistreatment: A Pilot Study

Comparing residential long-term care regulations between nursing homes and assisted living facilities

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