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Essay on Elderly Abuse: Nursing Home Abuse and Neglect
The Older Americans Act (OAA) became law on July 14, 1965. Among the OAA’s primary objectives was advancing the physical, mental, and financial well-being of older persons living independently in the community and in group residential settings and institutions. Title VII of the OAA explicitly includes protection against abuse, neglect, and exploitation. Congress established the Administration on Aging (AoA), the only federal agency responsible for the administration of programs under the OAA, to accomplish the act’s objectives. These programs include training medical professionals and law enforcement officers to identify and respond to elder abuse, providing technical assistance, creating state and local elder abuse prevention programs and coalitions, and conducting public awareness and educational promotions (AoA 1965). AoA funds the National Center on Elder Abuse (NCEA), which serves as a source of information and assistance on elder abuse (NCEA website 2006).
All fifty states have some form of elder abuse prevention laws. In general, states define elder abuse as abuse against a person aged sixty or older who is handicapped by the infirmities of aging or who has a physical or mental impairment which prevents the person from providing for his/her own care or protection and who is (1) being abused physically or (2) sexually, (3) exploited financially/materially, (4) neglected, including (5) self-neglect, or (6) has been abandoned (see Bonnie and Wallace 2002; Brandl and Cook-Daniels 2002). Domestic elder abuse (DEA) generally refers to any of these several forms of maltreatment of an older person by someone who has a special relationship with the elder. This may be a spouse, a sibling, a child, a friend, or a caregiver in the older person’s own home or in the home of a caregiver (NCEA website 2006).
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There is a paucity of studies that explicitly examine DEA and its consequences on older victims’ physical and mental health. Isolating the source of DEA can be a daunting measurement task, as DEA can be a continuation of lifelong domestic violence incidents perpetrated by a chronic batterer, may have begun at the onset of the aging process due to dementia or caregiver stress, may change from physical abuse to neglect, or may be a function of all of these factors. Wolf (1997) asserts that unlike domestic violence experienced by younger women, the consequences of elder abuse may be confounded with the aging process and diseases common among the elderly. Disentangling the causal nature of these relationships, she argues, is not only very difficult but costly.
Supportive of the results from these studies done in the United States are studies conducted in Australia (Schofield and Mishra 2004), Ireland, Italy, the United Kingdom (Ockleford et al. 2003), and the Netherlands (Comijs, Penninx, Knipscheer, and van Tilburg 1999). To illustrate, Comjis et al.’s (1999) study of psychological distress as a result of verbal, physical, and financial abuse and neglect examined both older men and older women in the Netherlands. Using a case-control design, participants were selected from a larger random sample of four five-year strata groups between the ages of sixty-five and eighty-four; non-abused elder controls were matched. The abused elders had significantly higher rates of psychological distress, lower emotional support, less mastery and feelings of self-efficacy, and a more passive and avoidant style of coping than their non-abused counterparts. Similar to Mouton et al. and Zink et al., this study was cross-sectional; consequently causal inference cannot be established.
Abuse and Neglect in Long-Term Care Essay Sample
As many as 1 in 10 older adults neglect themselves, and rates are higher among black Americans and the poor. This rate will probably increase as the population ages, because American families have become smaller and more geographically dispersed. In the United States, persons 50 to 74 years of age provide the majority of informal caregiving to persons 85 years of age or older, and the ratio between the two groups is decreasing (see ). Elder self-neglect has serious consequences, including increased rates of hospitalization, nursing home placement, and death.
Although cognitive impairment is common among self-neglecting elders, many such people do not have moderate or severe dementia and so are not considered legally incompetent to make health care decisions. A geropsychologist or geropsychiatrist can help in evaluating legal competency. When a court rules a patient incompetent, the clinical decision is easier, since we do not allow patients who clearly cannot make informed decisions for themselves to make dangerous or highly risky choices. But self-neglecting patients with cognitive impairment or mild dementia fall into a gray zone. These patients, like Mr. L., challenge clinicians because they have some capacity to make decisions but cannot adequately care for themselves. Clinicians feel stuck between competing ethical concerns — respecting their patient's preferences and protecting the patient from harm.
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The types of elderly abuse and neglect. | Premium Essay …
Ultimately the most alarming consequence of elder abuse is mortality. In a prospective cohort study with a nine-year follow-up of a cohort of 2,812 community-dwelling adults aged sixty-five and older, Lachs, Williams, O’Brien, Pillemer, and Charlson (1998) reported that older people seen for elder mistreatment had significantly higher mortality than self-neglecting or non-abused subjects at the end of the study. Those who suffered self-neglect also had significantly higher mortality than those with no substantiated abuse reports.
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Despite these limitations, each year hundreds of thousands of older persons are abused, neglected, and exploited by family members (most likely spouses or children) or other caregivers (AoA website 2006). This finding is based largely on four sources: (1) state APS reports, (2) a review of the fifty-four elder abuse and domestic violence studies done between 1988 and 2002 (see Brandl and Cook- Daniels 2002), (3) the results from national studies such as the National Elder Abuse Incidence Study (NEAIS) (see NCEA 1998) or the National Crime Victimization Survey (Rennison and Rand 2003), and (4) a growing body of single-state studies using data from women living in domestic or institutional settings (see, for example, Burgess 2000; Mouton, Rodabough, Rovi, Hunt, Talamantes, Brzyski, and Burge 2004; Teaster and Roberto 2004; Teaster, Roberto, and Duke 2000; Zink, Fisher, Regan, and Pabst 2005). Even with these resources, many elder abuse advocates have long suspected that any studies estimating elder abuse, especially DEA, are likely underestimating the ‘‘true’’ amount of abuse elders experience (NCEA 1998).
Essays about elderly abuse and neglect in nursing homes
A final key aspect of the care of neglected elders is creating plans for worst-case scenarios. The physician might say to Mr. L., “I want to help you prepare in case things don't go as well as we hope. What if you fell, broke your hip, and needed 24-hour care? How would you want your care to proceed?” Such advance care planning is a natural next step after the immediate care plan has been put in place. If Mr. L.'s goal is to remain at home for the rest of his life, even as his condition declines and despite the risk of serious harms such as hip fracture, hospice may be an appropriate intervention that aligns with his goal.
The neglect of the elderly – Usa Online Essays
A second study of morbidity and mortality, Shields, Hunsaker, and Hunsaker (2004), conducted a ten-year retrospective chart review of morbidity and mortality among elders age sixty and over in a large metropolitan area of Kentucky and Indiana. They reported that of the 1,099 autopsy cases, fifty-two victims age sixty and over were homicide victims and twenty-two persons age sixty and over were victims of neglect. They found that 50 percent of the gunshot victims died at the hand of a spouse or other family member; however, one case involved a wife who shot and killed her husband after being beaten and then doused in Drano by him. Of the twenty-two persons who suffered from neglect, 31.8 percent were living with a family member and 9.1 percent were alone with a family member at the time of death. Nearly 82 percent of the neglect cases were found, postmortem, to have physical injuries, including abrasions and contusions.
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