Elder Mistreatment

Elder mistreatment is any abuse or neglect of persons 60 years old or older by a caregiver or another trusted individual/group.1 Mistreatment of older adults may take the form of physical, sexual, psychological, or emotional abuse. Neglect, abandonment, and financial exploitation are other significant forms of abuse and mistreatment. Elder mistreatment is associated with physical and mental health problems, including physical injuries, depression, poor control of chronic diseases, and functional disability. Vulnerability of older adults to mistreatment is often related to higher rates of impairment of physical and cognitive functioning resulting in variable dependence of older adults in the context of their relationships with others (i.e., caregivers and trusted individuals/groups). However, elder mistreatment occurs among individuals with no significant physical or cognitive impairments. Family physicians should be aware of individual, relationship, community, and societal factors that increase the risk for experiencing elder mistreatment.2,3 Family physicians who provide ongoing care for patients and communities have a unique opportunity to help break the cycle of mistreatment by working with families and within their communities to prevent abuse. Family physicians should be aware of the prevalence of abuse in all sectors of society; be alert for risk factors as well as signs of elder mistreatment with each patient encounter; be capable of providing an appropriate response when these issues are identified; and be able to work to prevent mistreatment of patients who are at risk within their practices and communities. Family physicians should be aware of state regulations for reporting concerns of elder mistreatment and should be familiar with the process of referring cases of elder mistreatment to local protective services designated to evaluate the care of older adults. Family physicians can teach or help to establish education in their communities on caregiver stress and conflict resolution skills that promote respectful and peaceful personal relationships. Clinicians can obtain additional information at the National Center on Elder Abuse (http://www.ncea.aoa.gov/(www.ncea.aoa.gov)), the Center of Excellence on Elder Abuse and Neglect (http://www.centeronelderabuse.org/(www.centeronelderabuse.org)), and the AAFP’s clinical recommendation on screening for elder abuse (http://www.aafp.org/patient-care/clinical-recommendations/all/domestic-violence.html).

References

1. Centers for Disease Control and Prevention. Elder Abuse: Definitions. http://www.cdc.gov/violenceprevention/eldermaltreatment/definitions.html(www.cdc.gov), June 14, 2013.
2. Centers for Disease Control and Prevention. Elder Abuse: Risk and Protective Factors. http://www.cdc.gov/violenceprevention/elderabuse/riskprotectivefactors.html, June 14, 2013.
3. Acierno R, Hernandez MA, Amstadter AB, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Pub Health Feb 2010;100(2):292-297.

(2014 COD)