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To examine the impact of training on detection and reporting cases of elder abuse and neglect perpetrated by staff in LTC facilities and to compare staff with previous training to those with no training. A quantitative study in which questionnaires were collected from 250 multi- professional participants at a training seminar. Trainees with previous training on elder abuse reported higher perceived self-efficacy, higher intention to take action asking residents direct questions on abuse, to refer and report cases of elder abuse. They identified more cases of elder abuse in comparison to trainees without previous training. Findings indicate a positive relationship between perceived self-efficacy and intention to take action, and between perceived self-efficacy and direct questioning and referral for further inquiry. Training professionals is essential in coping effectively with elder abuse and neglect in LTC facilities.

There continues to be lack of public awareness about elder abuse. To help address this issue, we developed and piloted an elder abuse peer educator training program from an educational gerontology and health empowerment perspective. We describe the process employed to train older adults as peer educators. We present evaluation results from data collected from trained peer educators and those who attended educational sessions led by the trained peer educators. The results of the evaluation are useful in the continued development of our peer educator program and in identifying topics for further research.

Background: Health education is one of the proven ways to improve knowledge and change health attitudes and behaviors. This study is intended to assess the effectiveness of five health workshops in a Chinese community, focusing on depression, elder abuse, nutrition, breast cancer and stroke. Methods: A community-based participatory research approach was implemented to plan and organize the workshops. A total of 236 Chinese community-dwelling older adults participated in different health workshops. Quantitative questionnaires on knowledge, risk factors and outcomes of each health topic were distributed before and after the workshop. Pre and post workshop comparison analyses were conducted to examine the effectiveness of the workshops on knowledge and learning. Results: Overall, the health workshops have significantly improved participants' understanding throughout the five health themes (P<0.05). Whereas Chinese older adults have limited knowledge on depression, nutrition and stroke, their health knowledge regarding depression and elder abuse were significantly improved after attending the workshops. In addition, health education workshops increased older adults' understanding of the risk factors and consequences of depression, elder abuse and breast cancer. Conclusion: This study sheds light on the importance of promoting health education, and the complexity and challenges of designing health education for community dwelling Chinese older adults. Significant implications for researchers, community service providers, health service workers and policy makers are discussed.

Objective: This study aims to adapt "The Hwalek-Sengstock Elder Abuse Screening Test (H-S "East")" (Neale, Hwalek, Scott, Sengstock, & Stahl, 1991) to Turkish and to assess its validity and reliability while determining the factors that affect elder abuse. Method: The sample of the study is composed of 465 elderly women and men (60+ years of age) who live in different cities in Turkey. First, validity and reliability analyses of the H-S "East" are carried out. Subsequently, binary logistic regression analysis is performed to determine the factors that affect elder abuse. Results: In this study, the H-S "East" has a three-factor construction as found in the original scale. Inner consistency coefficient is found as 0.814. Elder abuse is mostly affected by "life satisfaction," "use of social benefits," "satisfaction with income," and "age." Conclusion: The results show that the Turkish version may be used as a valid and reliable tool in determining elderly abuse in social work practice and also for the purpose of early diagnosis and in other relevant research. Moreover, when the factors that affect elder abuse are taken into account, care and support facilities for the social inclusion of elderly should be developed and relevant social policies should be revised.

The purpose of this paper is to illuminate the intersection between institutional requirements for reflection and students' actual reflection initiatives in the social and health care education programmes. A situated perspective makes it possible to illuminate individuals' commitment, curiosity and uncertainty as bases for understanding reflective actions, which can be either supported or constrained by the social environment in which they are enacted. The analysis is based on an ethnographic field study of boundary-crossing activities at a social and healthcare college and the elder care centres where students work as trainees. The paper adds to the creation of a shared language among educators by suggesting a model based on four factors labelled: (i) "salient experiences", (ii) "reflection objects", (iii) "reflection zones" and (iv) "reflection facilitators". A key finding is that students initiate reflection in a range of ways. Yet, these reflections can be overlooked if they do not fit into the required methods. When educators pay attention to these reflective starting points, they can expand their role as reflection facilitators, and the students' potentials for learning through reflection can be enhanced. The paper adds to previous research on boundary crossing in vocational education and highlights the notion of visible reflection.

Treated initially as a social problem, elder abuse has only recently been criminalized. The criminalization of elder abuse involves penalizing offenders for actively abusing offenders as well as for violating mandatory reporting laws. Mandatory reporting laws exist to encourage professionals to report suspected cases of elder abuse. In this study, attention is given to the way that failure to report elder abuse cases are adjudicated in comparison to elder physical abuse cases. Content analysis was performed on a sample of case descriptions of elder physical abuse cases and failure to report cases. Results suggest that mandatory reporting offenses are adjudicated slightly differently than physical abuse cases, and the dynamics surrounding the two offense types vary as well. Implications including the need for broader penalties and better training of human services professionals are suggested. (Contains 4 tables and 3 notes.)

Over the past 40 years, the assessment and scientific study of capacity in older adults has emerged as a distinct field of clinical and research activity for psychologists. This new field reflects the convergence of several trends: the aging of American society, the growing incidence and prevalence of dementia, and the patient rights, deinstitutionalization, and disability rights movements. Because of these forces, capacity issues now permeate the fabric of everyday life, whether in the form of guardianship petitions, questions of capacity to consent to treatment, the ability to make a new will, or participation in human research. In seeking to resolve these issues, families, clinicians, and legal professionals increasingly turn to psychologists to assess a capacity and to provide empirically supported judgments that properly balance autonomy and protection for the individual. Psychologists have taken a leading role in the development of functional assessment instruments that measure important aspects of the capacity construct. In addition, psychology has been a major contributor to the scientific study of capacity. In collaboration with colleagues from medicine and law, psychologists have articulated crucial theoretical frameworks that integrate legal, clinical, and ethical dimensions of the capacity problem. This article focuses on the evolution of theory, law, science, and practice in the evaluation of capacity in older adults and its recent culmination in a series of interdisciplinary handbooks sponsored by the American Psychological Association and the American Bar Association. (Contains 2 figures.)

Purpose: Despite growing awareness of elder abuse, cases are rarely prosecuted. The aim of this study was to examine the effectiveness of an elder abuse forensic center compared with usual care to increase prosecution of elder financial abuse. Design and Methods: Using one-to-one propensity score matching, cases referred to the Los Angeles County Elder Abuse Forensic Center (the Forensic Center) between April 2007 and December 2009 for financial exploitation of adults aged 65 and older (n = 237) were matched to a population of 33,650 cases that received usual care from Adult Protective Services (APS). Results:1 Significantly, more Forensic Center cases were submitted to the District Attorney's office (DA) for review (22%, n = 51 vs. 3%, n = 7 usual care, p less than 0.001). Among the cases submitted, charges were filed by the DA at similar rates, as was the proportion of resultant pleas and convictions. Using logistic regression, the strongest predictor of case review and ultimate filing and conviction was whether the case was presented at the Forensic Center, with 10 times greater odds of submission to the DA (Odds ratio = 11.00, confidence interval = 4.66-25.98). Implications: Previous studies have not demonstrated that elder abuse interventions impact outcomes; this study breaks new ground by showing that an elder abuse multidisciplinary team increases rates of prosecution for financial exploitation. The elder abuse forensic center model facilitates cooperation and group problem solving among key professionals, including APS, law enforcement, and the DA and provides additional resources such as neuropsychological testing, medical record review, and direct access to the Office of the Public Guardian.

The purpose of this study was to understand the relationship among counselors' self-reported multicultural counseling competence and their attitudes of the geriatric population. A statistically significant negative correlation was found between participants' attitudes of the geriatric population and their self-reported multicultural counseling competence. Implications for training and practice are provided.

Purpose: Despite its prevalence and negative consequences, research on elder abuse has rarely considered resident-to-resident aggression (RRA) in nursing homes. This study employed a qualitative event reconstruction methodology to identify the major forms of RRA that occur in nursing homes. Design and methods: Events of RRA were identified within a 2-week period in all units (n = 53) in nursing homes located in New York City. Narrative reconstructions were created for each event based on information from residents and staff who were involved as well as other sources. The event reconstructions were analyzed using qualitative methods to identify common features of RRA events. Results: Analysis of the 122 event reconstructions identified 13 major forms of RRA, grouped under five themes. The resulting framework demonstrated the heterogeneity of types of RRA, the importance of considering personal, environmental, and triggering factors, and the potential emotional and physical harm to residents. Implications: These results suggest the need for person-centered and environmental interventions to reduce RRA, as well as for further research on the topic.

Annually in the United States, 1 to 5 million older adults, 65 and above, are physically or sexually injured or mistreated by their caregivers in family settings. This study examined the prevalence and risk factors involved in elder physical abuse by adult child caregivers, moving from the immediate elderly parent/adult child relationship context to more distal social support contexts, utilizing a subsample of 203 elderly participants from the Midlife Development in the United States study (MIDUS II, 2004-2006). LISREL modeling examined causal pathways between elderly demographic characteristics, physical/emotional health, and behavioral and contextual characteristics from an ecological perspective. Data modeling was accomplished using Mplus, PAXW, and SYSTAT statistical software packages. Results indicate that latent factors including older adult health, social isolation of the older adult, and adult child characteristics were significantly associated with elder physical abuse, as mediated by the quality of the elderly parent/adult child relationship. (Contains 4 tables and 1 figure.)

Due to age-related factors and illnesses, older adults may become vulnerable to elder investment fraud and financial exploitation (EIFFE). The authors describe the development and preliminary evaluation of an educational program to raise awareness and assist clinicians in identifying older adults at risk. Participants (n = 127) gave high ratings for the program, which includes a presentation, clinician pocket guide, and patient education brochure. Thirty-five respondents returned a completed questionnaire at the 6-month follow-up, with 69% (n = 24) of those indicating use of the program materials in practice and also reporting having identified 25 patients they felt were vulnerable to EIFFE. These findings demonstrate the value of providing education and practical tools to enhance clinic-based screening of this underappreciated but prevalent problem. (Contains 2 tables.)

The purposes of this study were to (a) derive prevalence estimates for elder mistreatment (emotional, physical, sexual, neglectful, and financial mistreatment of older adults [age 60 +]) in a randomly selected sample of South Carolinians; (b) examine correlates (i.e., potential risk factors) of mistreatment; and (c) examine incident characteristics of mistreatment events. Random Digit Dialing (RDD) was used to derive a representative sample in terms of age and gender; computer-assisted telephone interviewing was used to standardize collection of demographic, correlate, and mistreatment data. Prevalence estimates and mistreatment correlates were obtained and subjected to logistic regression. A total of 902 participants provided data. Prevalence for mistreatment types (since age 60) were 12.9% emotional, 2.1% physical, 0.3% sexual, 5.4% potential neglect, and 6.6% financial exploitation by family member. The most consistent correlates of mistreatment across abuse types were low social support and needing assistance with daily living activities. One in 10 participants reported either emotional, physical, sexual, or neglectful mistreatment within the past year, and 2 in 10 reported mistreatment since age 60. Across categories, the most consistent correlate of mistreatment was low social support, representing an area toward which preventive intervention may be directed with significant public health implications. (Contains 6 tables.)

Although two recent major studies provide some insight into the prevalence and correlates of elder mistreatment, the relationship between elder mistreatment and mental health remains unclear. This study begins to address this issue by examining the relationship between elder mistreatment (i.e., a recent history of emotional and physical abuse) and negative emotional symptoms (e.g., anxiety and depression) among 902 older adults aged 60 and above residing in South Carolina. Results demonstrate that emotional, but not physical, abuse is significantly correlated with higher levels of emotional symptoms. This relationship is sustained when controlling for established demographic and social/dependency risk factors. These data suggest that mistreated older adults also suffer from greater emotional symptoms and highlight the need for more research in this area. (Contains 1 table and 1 note.)

Purpose: This study tested key psychometric properties of the Older Adult Psychological Abuse Measure (OAPAM), one self-report scale of the Older Adult Mistreatment Assessment (OAMA). Design and Methods: Items and theory were developed in a prior concept mapping study. Subsequently, the measures were administered to 226 substantiated clients by 22 elder abuse staff from 7 agencies in a full-scale field test. The resulting database was used to estimate the psychometric properties of the OAPAM using the Rasch item response theory model and traditional validation techniques. Analyses included tests for dimensionality, model fit, and theoretical construct validation. Results from the OAPAM client report were validated against the adult protective services substantiation decision of abuse and the elder abuse staff assessment of psychological abuse (PA). Results: The client self-report measures met stringent Rasch analysis fit and unidimensionality criteria and had high person (internal consistency) and item reliability. The validity results supported the usefulness of the client measures and led to reconsideration of aspects of the hypothesized theoretical hierarchy. A short form was developed. Cut-points were proposed to distinguish levels of PA. Implications: The measure is now available to aid in the assessment of PA of older adults by both clinicians and researchers. Theoretical refinements developed using the Rasch item hierarchy may help to improve assessment and intervention.

Purpose of the Study: Use archived public data from Arizona to explore relationships among selected institutional and resident risk and situation-specific factors and complaints and substantiated allegations of various types of mistreatment in assisted living facilities (ALFs). Design and Methods: An exploratory/descriptive 2-group design was used. Facilities in the complaint group were identified from narrative data that appeared suspicious for mistreatment based on definitions for physical, verbal, psychological, medication, sexual abuse, neglect, financial exploitation, and physical restraint. Facilities in the comparison group were those that had no citations or complaints in 2007-2008. Narrative data were content analyzed, and chi-square analysis was used to answer 3 research questions. Results: The complaint group was comprised of significantly more assisted living centers, large facilities (51-101+), facilities licensed to provide personal care services, and facilities owned by national corporations. Substantiated allegations were significantly more frequent in assisted living centers, facilities with more than 51 beds, and those owned by national corporations. Facility risk factors were related to some types of substantiated mistreatment and not others. Implications: Findings suggest the need to evaluate use of only unlicensed assistive personnel in facilities, increase oversight of care by professional nurses, rethink the practice of not licensing small facilities, and monitor more closely practices and procedures in facilities operated by national corporations.

A Dialectical Behavior Therapy Skills training manual (DBT Skills) was adapted for use with caregivers of individuals with dementia. Implementation occurred in a community clinic with a heterogeneous caregiver group at risk for elder abuse. Sixteen caregivers completed the 9-week group. The results point to improved psychosocial adjustment, particularly increased problem-focused coping, enhanced emotional well-being, and less fatigue. Caregivers tended to utilize individual therapeutic services at a higher rate during the period of group attendance, indicative of appropriate help-seeking behavior in highly demanding situations. Six of the 16 caregivers repeated the training sequence in "booster" groups. Follow-up data from the booster groups suggest that high-risk caregivers may require continuing support to maintain treatment gains. In addition to demonstrating the feasibility of DBT Skills with caregivers, the results warrant a controlled outcome evaluation. (Contains 2 tables and 4 figures.)

Elder abuse in long-term care has become a very important public health concern. Recent estimates of elder abuse prevalence are in the range of 2% to 10% (Lachs & Pillemer, 2004), and current changes in population structure indicate a potential for an upward trend in prevalence (Malley-Morrison, Nolido, & Chawla, 2006; Post et al., 2006). More than 20 years ago, Karl Pillemer called for sociological research on patient maltreatment in nursing homes and provided an overview model for the conduct of such research (Pillemer, 1988). The research literature since then has not provided the definitive model to account for patient maltreatment that Pillemer hoped for. Instead, it has produced a laundry list of risk factors that includes the patient's functional disability, cognitive impairment, social isolation, age, race, income, family background, life events, dementia, and depression (Dyer, Pavlik, Murphy, & Hyman, 2000; Lachs & Pillemer, 2004; Lachs,Williams, Obrien, Hurst, & Horwitz, 1997; Pavlik, Hyman, Festa, & Dyer, 2001; Schofield & Mishra, 2003). However, no theory exists to place these factors in a causal structure that relates the factors to each other and to whether abuse occurs. This study is a first step in that direction. Nine hypotheses were generated focusing on the effects of two dimensions of impairment--(a) physical and cognitive and (b) age and behavior problems--on susceptibility to abuse among elderly in long-term care. The relationships between factors and from factors to susceptibility to abuse are specified in a structural equation model where "susceptibility to abuse," "physical impairment," and "cognitive impairment" are latent variables, and behavior problems and age are directly measured. (Contains 1 table and 1 figure.)

Purpose: This study was designed to improve the measurement of financial exploitation (FE) by testing psychometric properties of the older adult financial exploitation measure (OAFEM), a client self-report instrument. Design and Methods: Rasch item response theory and traditional validation approaches were used. Questionnaires were administered by 22 adult protective services investigators from 7 agencies in Illinois to 227 substantiated abuse clients. Analyses included tests for dimensionality, model fit, and additional construct validation. Results from the OAFEM were also compared with the substantiation decision of abuse and with investigators' assessments of FE using a staff report version. Hypotheses were generated to test hypothesized relationships. Results: The OAFEM, including the original 79-, 54-, and 30-item measures, met stringent Rasch analysis fit and unidimensionality criteria and had high internal consistency and item reliability. The validation results were supportive, while leading to reconsideration of aspects of the hypothesized theoretical hierarchy. Thresholds were suggested to demonstrate levels of severity. Implications: The measure is now available to aid in the assessment of FE of older adults by both clinicians and researchers. Theoretical refinements developed using the empirically generated item hierarchy may help to improve assessment and intervention.

Purpose: Elder abuse cases are often time consuming and complex, requiring interagency cooperation from a diverse array of professionals. Although multidisciplinary teams (MDTs) offer a potentially powerful approach to synergizing the efforts of different providers, there has been little research on elder abuse MDTs in general or elder abuse forensic centers in particular. This article draws on our experience with the development of an innovative elder abuse MDT model by describing the structure, process, and outcomes of the Los Angeles County Elder Abuse Forensic Center (the Center). Design and Methods: We use a logic model to provide the framework for discussing the Center's components and de-identified client records to report key characteristics of the cases reviewed (n = 313). We summarize surveys of core team members' evaluations of team effectiveness (n = 37) and case presenters' assessments of the Center effectiveness (n = 108). Results: During its first 3 years, the Center reviewed 2-4 cases per week and gained active and regular participation among core team members. Both team members' and presenters' evaluations were highly favorable. Implications: Process outcomes indicate that busy professionals found the model extremely valuable, with added consultation and services aiding elder abuse prevention, protection, and prosecution. The logic model offers structure, process, and outcomes with which to replicate and individualize the elder abuse forensic center model according to the needs and resources in each community.

Purpose: Elder self-neglect (ESN) represents half or more of all cases reported to adult protective services. ESN directly affects older adults and also their families, neighbors, and the larger communities around them. ESN has public health implications and is associated with higher than expected mortality rates, hospitalizations, long-term care placements, and localized environmental and safety hazards. This article describes results from a study using concept mapping to create a conceptual model of ESN. Design and Methods: Two brainstorming sessions were convened with senior services program supervisors, geriatricians, local policy analysts and program planners, elder law practitioners, and university-based researchers (n = 20), and a list of 73 ESN indicators was generated. Using Concept Systems software, the 20 original panelists and an additional 30 practitioners, including case managers and supervisors from local agencies, social workers specializing in working with older adults, and elder abuse investigators, sorted the 73 items and rated them along the dimension of importance for the concept of self-neglect. Results: Using hierarchical cluster analysis and multidimensional scaling, a conceptual map with 7 clusters was produced. Clusters with the highest importance ratings were Physical Living Conditions and Mental Health. Clusters were highly interrelated, with the exception of the Physical Living Conditions cluster. Implications: This research presents a conceptualization of ESN, identifies the constituent domains, and proposes a conceptual model based on the importance for assessing symptoms and indicators. Findings may help focus programmatic and research efforts, leading to the development of measures that open the field for further research and theory generation.

The article explores and evaluates the quality of life, safety, and security of elderly people in Tehran City in Iran. In that, different dimensions of material and social well-being, and abuse of people of the age 65 and above, are assessed. Besides the human rights, the dignity, and the gradual decline of the elderly's social security are reflected. The research also aims to study the elder age-groups in order to find out how these people gradually lose their physical and mental reliance, and as a result, how their dependence on others and various services enhances. The method of research mainly being empirical, it is preceded by theoretical and literature review. Five hundred elderly people were randomly selected for the study. Findings suggest that the aging pyramid shrinks and narrows at the age of 65 or even before in the present study. Research reached the conclusion that the young elderly with new needs and expectations are highly different from those of their previous generations. (Contains 1 table and 5 footnotes.)

Background: Nursing aides' attitudes condoning elder abuse are a possible risk factor for executing abusive behaviors against elder residents of long-term care facilities but have been studied infrequently. Purpose: The purpose of the study was to assess nursing aides' attitudes that condone abusive behaviors toward elderly people, as well as the relationship of these attitudes to demographic variables, work stressors (role conflict, role ambiguity, and work overload), burnout, and perceived control, based on the theory of planned behavior (Ajzen, 1988, "Attitudes, personality and behavior". Milton Keynes: Open University Press) Design and Methods: Two hundred and eight nursing aides from 18 nursing homes in Israel completed demographic, work stressors, burnout, and perceived control questionnaires and a case vignette questionnaire to test attitudes condoning elder abuse. Results: The mean score of the attitudes condoning abusive behaviors was relatively high at 3.24 (SD = 0.59) on a 1-4 scale. Condoning abusive behaviors were closely associated with higher levels of work stressors, burnout, and low income. Multiple regression analyses revealed that demographic variables, work stressors, burnout, and perceived control explained 12% of the variance of condoning abusive behaviors among the nursing aides. Of these, role ambiguity, role conflict, and burnout were significantly associated with attitudes condoning abusive behaviors. In addition, burnout partially mediated the relationship between work stressors and attitudes condoning elder abuse. Conclusions: As nursing aides' attitudes condoning elder abuse may influence their actual behaviors, training and supervision programs should be developed to reduce work stressors and burnout and to modify these attitudes.

Institutionalized elderly who are frail and dependent are vulnerable to be abused by overwhelmed caregivers especially caregiver psychological abusive behavior is a growing but hidden problem with few evidence-based interventions. The purpose of this study was to examine the effectiveness of an educational support group in alleviating caregiver's psychological abusive behavior, reducing work stress and promoting knowledge of geriatric care-giving among a group of caregivers. A quasi-experimental design using a case control pre-post test approach was conducted. A total of 100 participants completed the study with 50 caregivers in each group. The research instruments included the Caregiver Psychological Elder Abuse Behavior Scale (CPEAB), the Work Stressors Inventory (WSI), and the Knowledge of Gerontology Nursing Scale (KGNS). The results showed that the intervention had significant effects in alleviating caregiver psychological abuse behavior and increasing care-giving knowledge in the experimental group (p = 0.048; 0.018). However, the intervention had no measurable effect on work stress (p = 0.66). Findings have important implications for education and programming for facility administers and long-term care policy makers when planning quality improvement for elderly care.

Although the many American Indian tribes of the United States are unique in their own customs, languages, and histories, a common thread throughout their traditions and cultural lifestyles is that they are of a culture that reveres the elder in their communities. Elders are the carriers of the culture/history; they are the storytellers, holders of wisdom, and strength of the community. They assist in raising children; teach languages, customs, and ceremonies; and often comprise leadership groups of spiritual leaders, healers, and council chairs. This article seeks to identify the different types of abuse that are prevalent in American Indian communities both on and off reservations. Implications for mistreatment will be explored because the existence of elder abuse among American Indian populations is an important concern as it could contribute to further health disparities. Recommendations for additional research are made based on the status of the issue discussed. (Contains 35 notes.)

As the number of older adults in the United States increases, so will the expected number of allegations of elder abuse. Adult protective services (APS) staff are likely to handle much more complex situations, and in growing numbers, due to the presence of chronic and life-limiting conditions of their clients. The APS workers, in this national study, identified frequent encounters with older adults with serious illnesses. However, less than one half received educational content about issues of death and dying in their degree programs, and only slightly more than one half reported ever attending a continuing education program on these topics. They perceived the greatest educational need for content about practical resources, the use of advance directives, and making end-of-life decisions. The indication also given by these respondents was that end-of-life issues were among the most difficult situations they faced in practice. This warrants a call for increased end-of-life content in educational degree programs and continuing education. (Contains 3 tables.)

An experiment investigated mock juror perceptions of elder abuse using a community sample from Lexington, Kentucky. Two-hundred six men and women ranging in age from 18 to 88 read a fictional criminal trial summary of a case of elder physical abuse (EPA) in which the accuser was described as healthy, frail, or confused. In addition, the influence of participant age, participant gender, and attitude toward the elderly on juror perceptions of EPA was also investigated. Results showed that women had higher conviction rates than did men. Accuser health status, participant age, participant gender, and attitude toward the elderly affected other rating variables including accuser believability, accuser inaccuracy, defendant believability, and verdict confidence. Results suggest implications for how EPA cases are perceived in court. (Contains 1 table and 1 figure.)

Objective: This study aims to identify the psychometric properties of the Impulsive Feelings to Commit Elder Abuse (IFCEA) scale. Method: The sample included 387 South Korean family caregivers for their older family members with disabilities. Results: The internal consistency of the IFCEA was very good, and claims for the construct validity were demonstrated. Accordingly, the confirmatory factor analysis of the IFCEA confirmed that the scale had two factors: emotional abuse and physical abuse. Conclusion: The IFCEA can be used by professionals to measure caregivers' impulses to commit elder abuse as an early assessment in the caregiving relationship. (Contains 5 tables and 1 figure.)

Purpose: The Family Care Conference (FCC) is an elder-focused, family-centered, community-based intervention for the prevention and mitigation of elder abuse. It is based on a family conference intervention developed by the Maori people of New Zealand, who determined that Western European ways of working with child welfare issues were undermining such family values as the definition and meaning of family, the importance of spirituality, the use of ritual, and the value of noninterference. The FCC provides the opportunity for family members to come together to discuss and develop a plan for the well-being of their elders. Design and Methods: Using a community-based participatory research approach, investigators piloted and implemented the FCC in one northwestern Native American community. The delivery of the FCC intervention has grown from having been introduced and facilitated by the researchers, to training community members to facilitate the family meetings, to becoming incorporated into a Tribal agency, which will oversee the implementation of the FCC. Results: To date, families have accepted and appreciated the FCC intervention. The constructive approach of the FCC process helps to bring focus to families' concerns and aligns their efforts toward positive action. Implications: The strength-based FCC provides a culturally anchored and individualized means of identifying frail Native American elders' needs and finding solutions from family and available community resources.

Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Results: Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost 6 times greater at approximately twice the cost compared to other service users. Implications: The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect. (Contains 6 tables.)

Based on a qualitative study of home care workers, this paper aims to understand elder abuse of Chinese Canadians. The findings show disrespect is the key form elder abuse takes in the Chinese community. As a culturally specific form of abuse, disrespect remains invisible under categories of elder abuse derived from a Western cultural perspective. Applying a social exclusion framework to understand the dynamic of elder abuse, we argue that as a marginalized racial minority immigrant, an elderly Chinese person's vulnerability to abuse is increased under conditions of social isolation.

Purpose: This study assessed the extent of different types of abuse, repeated and multiple abuse experiences among women aged 60 and older, and their effects on the women's self-reported health. Design and Methods: A cross-sectional study of a clinical sample of 842 community-dwelling women aged 60 and older completed a telephone survey about type and frequency of abuse, self-reported health status and health conditions, and demographic characteristics. Bivariate and multivariate analyses were performed using SPSS 11.5 and STATA 7.0. Results: Nearly half of the women had experienced at least one type of abuse--psychological/emotional, control, threat, physical, or sexual--since turning 55 years old. Sizable proportions were victims of repeat abuse. Many women experienced multiple types of abuse and experienced abuse often. Abused older women were significantly more likely to report more health conditions than those who were not abused. Women who experienced psychological/emotional abuse--alone, repeatedly, or with other types of abuse--had significantly increased odds of reporting bone or joint problems, digestive problems, depression or anxiety, chronic pain, and high blood pressure or heart problems. Implications: It is important that health care and service providers acknowledge psychological/emotional, control, threat, physical, and sexual abuse against older women and understand their health implications. In addition, it is important for providers to be trained in both aging and domestic violence services and resources. (Contains 4 tables.)

Purpose: The first Elder Abuse Forensic Center (EAFC) in the United States was instituted in 2003. People from a variety of disciplines, including Adult Protective Services social workers, law enforcement, the district attorney's office, a medical response team, public guardian deputies, ombudsmen, mental health services, a victim advocate, and a domestic violence expert work cooperatively on cases of elder and dependent-adult mistreatment. Researchers conducted an assessment of the EAFC's impact on the efficiency and effectiveness of the collaboration. Design and Methods: Mixed quantitative and qualitative methods included statistical analysis of data from outcome surveys of EAFC collaborators and illustrative case studies developed from case files and structured interviews. Results: Mean survey scores evaluating the efficiency and effectiveness of the collaboration were significantly better than neutral responses. Case studies show efficient and effective case management through cooperation of the collaborating agencies. Survey results clearly support perceptions exemplified in case studies. Implications: An EAFC enhances the efficiency and effectiveness of those who address elder abuse in one community, which in turn leads to improved outcomes. Continued analysis to identify strengths, weaknesses, and cost effectiveness of the EAFC model is ongoing. (Contains 2 figures and 5 tables.)