Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-11T03:29:43.160Z Has data issue: false hasContentIssue false
  • English
  • Français

Elder abuse in long-term care residences and the risk indicators

Published online by Cambridge University Press:  16 March 2010

MIRI COHEN ,
SARAH HALEVY-LEVIN ,
RONI GAGIN ,
DANA PRILTUZKY  and
GIDEON FRIEDMAN
MIRI COHEN*
Affiliation:
Department of Gerontology, University of Haifa, Haifa, Israel.
SARAH HALEVY-LEVIN
Affiliation:
The Geriatric Unit, Hadassah Medical Center, Jerusalem, Israel.
RONI GAGIN
Affiliation:
Social Work Department, Rambam Medical Center, Haifa, Israel.
DANA PRILTUZKY
Affiliation:
Department of Gerontology, University of Haifa, Haifa, Israel.
GIDEON FRIEDMAN
Affiliation:
The Geriatric Unit, Hadassah Medical Center, Jerusalem, Israel.
*
Address for correspondence: Miri Cohen, School of Social Work, Haifa University, Mount Carmel, Haifa31905, Israel E-mail: cohenm@research.haifa.ac.il
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of the study was to assess the prevalence of abuse among the residents of long-term care facilities in Israel, and its associations with risk indicators. Seventy-one such residents aged 70 or more years were assessed in the internal and orthopaedic departments of two university medical centres for possible abuse by carers at the long-term facilities from which they were admitted. The study collected socio-demographic and health profiles and a list of maltreatment or abusive acts, and administered the Signs of Abuse Inventory and the Expanded Indicators of Abuse Questionnaire. Among the 71 residents, 31 per cent reported some form of maltreatment, most being instances of disrespectful behaviour. Signs of abuse, mostly of neglect, were detected in 22.5 per cent of the sample. Hierarchical regression analysis revealed that higher scores on risk indicators and higher dependence on others for the activities of daily living significantly associated with reported abuse, while age, gender, risk indicators and lower blood albumin level (being an indicator of worse nutritional and health status) significantly associated with identified signs of abuse. It is concluded that direct questioning mainly discloses instances of disrespectful behaviours and humiliation, while the assessment of signs of abuse is more sensitive to cases of neglect. Risk indicators were found to be reliable indicators of abuse. Routine screening for these indicators is recommended to improve detection and thereby to prevent abuse in long-term care facilities.

Keywords

elder abuselong-term facilitiessigns of abuserisk indicators
Type
Research Article
Information
Ageing & Society , Volume 30 , Issue 6 , August 2010 , pp. 1027 - 1040
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ansen, P. and Breckman, R. 1988. Elder Mistreatment Guidelines for Health Care Professionals: Detection, Assessment and Intervention. Mount Sinai/Victim Services, New York.Google Scholar
Baker, M. W. and Heitkemper, M. M. 2005. The roles of nurses on interprofessional teams to combat elder mistreatment. Nursing Outlook, 53, 5, 253–9.CrossRefGoogle ScholarPubMed
Bartlett, M. S. 1954. A note on the multiplying factors for various chi-square approximations. Journal of the Royal Statistical Society, 16, Series B, 2, 296–8.Google Scholar
Beer, S. 2004. A National Census of Long-term Care Institution Residents, 1999–2000, and Trends in the Institutionalization Patterns of the Elderly, 1983–2000. JDC-Brookdale Institute, Jerusalem. (In Hebrew)Google Scholar
Brodsky, J., Shnoor, Y. and Bewer, S. 2008. The Elderly in Israel: Statistical Abstract 2008. JDC-Brookdale Institute, Jerusalem. (In Hebrew)Google Scholar
Cohen, M. 2008. Assessment of elder neglect and its risk factors in a hospital setting. Internal Medicine Journal, 38, 9, 704–7.CrossRefGoogle ScholarPubMed
Cohen, M., Halevi-Levin, S., Gagin, R. and Friedman, G. 2006. Development of a screening tool for identifying elderly people at risk of abuse by their caregivers. Journal of Aging and Health, 18, 5, 660–85.CrossRefGoogle ScholarPubMed
Cohen, M., Halevi-Levin, S., Gagin, R. and Friedman, G. 2007. Elder abuse: disparities between elders' disclosure of abuse, evident signs of abuse, and high risk of abuse. Journal of the American Geriatrics Society, 55, 8, 1224–30.CrossRefGoogle ScholarPubMed
Conlin Shaw, M. M. 1998. Nursing home resident abuse by staff: exploring the dynamics. Journal of Elder Abuse and Neglect, 9, 4, 1–21.CrossRefGoogle Scholar
Dixon, J., Manthorpe, J., Biggs, S., Mowlam, A., Tennant, R., Tinker, A. and McCreadie, C. 2010. Defining elder mistreatment: reflections on the United Kingdom Study of Abuse and Neglect of Older People. Ageing & Society, 30, 3, 405–22.CrossRefGoogle Scholar
Fulmer, T., Paveza, G., Abraham, I. and Fairchild, S. 2000. Elder neglect assessment in the emergency department. Journal of Emergency Nursing, 26, 5, 436–43.CrossRefGoogle ScholarPubMed
Gibbs, L. M. and Mosqueda, L. 2004. Confronting elder mistreatment in long term care. Annals of Long Term Care, 12, 4, 30–5.Google Scholar
Goergen, T. 2001. Stress, conflict, elder abuse and neglect in German nursing homes: a pilot study among professional caregivers. Journal of Elder Abuse and Neglect, 13, 1, 1–26.CrossRefGoogle Scholar
Harnett, T. and Jönson, H. 2010. That's not my Robert! Identity maintenance and other warrants in family members' claims about mistreatment in old-age care. Ageing & Society, 30, 4, 631–52.CrossRefGoogle Scholar
Hawes, C. 2003. Elder abuse in residential long-term care settings: what is known and what information is needed? In Bonnie, R. J. and Wallace, R. B. (eds), Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. National Academies Press, Washington DC, 446–500.Google Scholar
Joshi, S. and Flaherty, J. H. 2005. Elder abuse and neglect in long-term care. Clinics in Geriatric Medicine, 21, 2, 333–54.CrossRefGoogle ScholarPubMed
Kaiser, H. 1974. An index of factor simplicity. Psychometrika, 3, 39, 31–6.CrossRefGoogle Scholar
Kottwitz, D. and Bowling, S. 2003. A pilot study of the elder abuse questionnaire. The Kansas Nurse, 78, 7, 4–6.Google ScholarPubMed
Lachs, M. S. and Pillemer, K. 2004. Elder abuse. Lancet, 364, 9441, 1263–72.CrossRefGoogle ScholarPubMed
Lachs, M. S., Williams, C. S., O'Brien, S., Pillemer, K. and Charlson, M. E. 1998. The mortality of elder mistreatment. Journal of the American Medical Association, 280, 5, 428–32.CrossRefGoogle ScholarPubMed
Liang, B. 2006. Elder abuse detection in nursing facilities: using paid clinical competence to address the nation's shame. Journal of Health Law, 39, 4, 527–50.Google ScholarPubMed
Lowenstein, A. 1999. Elder abuse in residential settings in Israel: myth or reality? Journal of Elder Abuse and Neglect, 10, 1, 133–51.CrossRefGoogle Scholar
Lowenstein, A., Eisikovits, Z., Band-Winterstein, T. and Enosh, G. 2009. Is elder abuse and neglect a social phenomenon? Data from the first national prevalence survey in Israel. Journal of Elder Abuse and Neglect, 21, 3, 253–77.CrossRefGoogle ScholarPubMed
Malmedal, W., Ingebrigtsen, O. and Saveman, B. I. 2008. Inadequate care in Norwegian nursing homes: as reported by nursing staff. Scandinavian Journal of Caring Sciences, 23, 2, 231–42.CrossRefGoogle Scholar
Payne, B. K. and Burke-Fletcher, L. 2005. Elder abuse in nursing homes: prevention and resolution strategies and barriers. Journal of Criminal Justice, 33, 2, 119–25.CrossRefGoogle Scholar
Phaneuf, C. 1996. Screening elders for nutritional deficits. American Journal of Nursing, 96, 3, 58–60.Google ScholarPubMed
Pillemer, K. and Bachman-Prehn, R. 1991. Helping and hurting: predictors of maltreatment of patients in nursing homes. Research on Aging, 13, 1, 74–95.CrossRefGoogle Scholar
Pillemer, K. and Moore, D. W. 1989. Abuse of patients in nursing homes: findings from a survey of staff. Gerontologist, 29, 3, 314–20.CrossRefGoogle ScholarPubMed
Reis, M. and Nahmiash, D. 1998. Validation of the indicators of abuse (IOA) screen. The Gerontologist, 38, 4, 471–80.CrossRefGoogle ScholarPubMed
Saveman, B. I., Astrom, S., Bucht, G. and Norberg, A. 1999. Elder abuse in residential settings in Sweden. Journal of Elder Abuse and Neglect, 10, 1, 43–60.CrossRefGoogle Scholar
Shugarman, L., Fries, B., Wolf, R. S. and Morris, J. N. 2003. Identifying older people at risk of abuse during routine screening practices. Journal of the American Geriatrics Society, 51, 1, 24–31.CrossRefGoogle ScholarPubMed
Tanner, R. and Bercaw, L. 2005. Long-term care: nursing home quality and safety 2005. End of year issue brief. Issue Brief Health Policy Tracking Service, December 31, 1–17.Google ScholarPubMed
Wan, J. J., Tseng, H. F. and Chen, K. M. 2007. Development and testing of screening indicators for psychological abuse of older people. Archives of Psychiatric Nursing, 21, 1, 40–4.Google Scholar
Weatherall, M. 2001. Elder abuse: a survey of managers of residential care facilities in Wellington, New Zealand. Journal of Elder Abuse and Neglect, 13, 1, 91–9.CrossRefGoogle Scholar