Asunto(s)
Abuso de Ancianos/diagnóstico , Anciano , Abuso de Ancianos/etiología , Familia/psicología , HumanosRESUMEN
OBJECTIVE: To establish the rate of occurrence and patterns of elder abuse, and outcomes of intervention, in an Australian population. DESIGN: Retrospective review of medical records over a 12-month period from July 1990 to June 1991. SETTING: An area-based geriatric and rehabilitation service attached to a district hospital. PATIENTS: Referred patients over 65 years of age, who lived in private homes and who met a predetermined definition of elder abuse. RESULTS: The rate of occurrence of elder abuse in the study population was 4.6%, with 29 cases of psychological abuse, 25 cases of physical abuse, 16 cases of neglect, and 13 cases of material/financial abuse. Patterns of abuse were identified and related to dependency of the older person (42%), psychopathology of the abuser (37%), family violence (14%), and carer stress (5%). Interventions and outcomes varied according to the pattern of abuse. CONCLUSION: The rate of occurrence and patterns of abuse of the elderly have been established for the first time in an Australian population. Intervention aimed at reducing the impact of elder abuse is effective, and should be tailored to the pattern of abuse that is occurring.
Asunto(s)
Abuso de Ancianos/epidemiología , Anciano , Australia/epidemiología , Cuidadores , Demencia/complicaciones , Abuso de Ancianos/etiología , Abuso de Ancianos/psicología , Familia , Femenino , Humanos , Masculino , Derivación y Consulta , Estudios Retrospectivos , Estrés Psicológico/complicaciones , ViolenciaRESUMEN
This study describes the prevalence of violence and the putative risk factors for violence in 184 Alzheimer patients and their primary caregivers living in the community. Analysis of the severe violence subscale of the Conflict Tactics Scale indicated that 15.8% of patients had been violent in the year since diagnosis. A total of 5.4% of caregivers reported being violent toward the patient. The overall prevalence of violence was 17.4%. The variables most associated with violence were caregiver depression and living arrangement.
Asunto(s)
Enfermedad de Alzheimer/terapia , Cuidadores , Abuso de Ancianos/etiología , Familia , Violencia , Anciano , Anciano de 80 o más Años , Abuso de Ancianos/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de RiesgoRESUMEN
This final installment of a three-part panel discussion on aging and mental health reviews the role of the primary care physician in issues of caregiver burden, elder abuse, and nursing home placement. Federal regulations and reimbursement policies have some effect on how the physician manages these concerns. A teamwork approach to geriatric case management that includes other health professionals is also discussed.
Asunto(s)
Envejecimiento , Cuidadores/psicología , Salud Mental , Estrés Psicológico/prevención & control , Anciano , Abuso de Ancianos/epidemiología , Abuso de Ancianos/etiología , Abuso de Ancianos/prevención & control , Geriatría/métodos , Geriatría/normas , Humanos , Medicare , Casas de Salud , Planificación de Atención al Paciente , Rol del Médico , Médicos de Familia/normas , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Estados UnidosRESUMEN
Elder abuse encompasses physical, psychological, and financial abuse and also includes the violation of an individual's rights, or social abuse. Detection of elder abuse is often obstructed by the denial or shame of the abused older adult and the denial or improper assessment by health care professionals. The ethical struggle professionals face when they suspect abuse may also impede assessment or intervention. Preliminary data on etiologic factors related to elder abuse suggest that misinformation, the caregiver's lack of understanding of the needs of older adults, social isolation, a history of dysfunctional family relationships, and the psychopathologic factors of the caregiver are salient factors for understanding elder abuse. In addition, caregiver burden related to the care of the impaired elder and other external life events is a risk factor for elder abuse. Self-neglect is the type of elder abuse most often reported and the most difficult to handle, because older adults have a right to refuse services. Home care providers often face practical and ethical dilemmas in cases of self-neglect. When making an assessment for elder abuse, it is best to use a multidisciplinary approach. In addition to physical indicators (bruises, malnutrition, fractures), attention must be paid to the social, family, and sexual history of the patient. The psychological history of the patient and caregiver is also important. Reporting laws exist in all states, and health care practitioners must become familiar with the laws in their states. Awareness of elder abuse by professionals working in home care is essential, because the failure to detect abuse can interfere with interventions and in some cases lead to death.