General practitioners' knowledge and experience of the abuse of older people in the community: report of an exploratory research study in the inner-London borough of Tower Hamlets.
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A pioneering study aimed to quantify general practitioners' (GPs') knowledge of cases of elder abuse in the community. The research found that elder abuse is a problem encountered by GPs, and that a large majority of responders would welcome training in the identification and management of the problem. (+info)
Health screening in older women.
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Health screening is an important aspect of health promotion and disease prevention in women over 65 years of age. Screening efforts should address conditions that cause significant morbidity and mortality in this age group. In addition to screening for cardiovascular disease, cerebrovascular disease and cancer, primary care physicians should identify risk factors unique to an aging population. These factors include hearing and vision loss, dysmobility or functional impairment, osteoporosis, cognitive and affective disorders, urinary incontinence and domestic violence. Although screening for many conditions cannot be proved to merit an "A" recommendation (indicating conclusive proof of benefit), special attention to these factors can decrease morbidity and improve quality of life in aging women. (+info)
Elder mistreatment.
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Elder mistreatment is a widespread problem in our society that is often under-recognized by physicians. As a result of growing public outcry over the past 20 years, all states now have abuse laws that are specific to older adults; most states have mandated reporting by all health care professionals. The term "mistreatment" includes physical abuse and neglect, psychologic abuse, financial exploitation and violation of rights. Poor health, physical or cognitive impairment, alcohol abuse and a history of domestic violence are some of the risk factors for elder mistreatment. Diagnosis of elder mistreatment depends on acquiring a detailed history from the patient and the caregiver. It also involves performing a comprehensive physical examination. Only through awareness, a healthy suspicion and the performing of certain procedures are physicians able to detect elder mistreatment. Once it is suspected, elder mistreatment should be reported to adult protective services. (+info)
Elder abuse: do general practitioners know or care?
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A pilot survey in Tower Hamlets, London, indicated that many general practitioners (GPs) might not be recognizing abuse of elderly patients through lack of training. The survey was replicated on a large scale in Birmingham, to allow further analysis. 561 Birmingham GPs were mailed questionnaires and responses from 291 were analysed, providing data from 95% of the practices. The findings were similar to those in Tower Hamlets: just under half had diagnosed elder abuse in the previous year. Regression analysis of the combined data-sets (n = 363) indicated that the strongest factor predicting GP diagnosis of abuse was knowledge of 5 or more risk situations (odds ratio 6.77, 95% confidence interval 4.19, 10.93). The findings of these surveys suggest that research-based education and training would help GPs to become better at identifying and managing elder abuse. (+info)
Physical abuse of urban Native Americans.
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To ascertain the extent of, and risk factors for, physical abuse among older urban American Indian/Alaska Natives (AI/ANs), we conducted a chart review of 550 urban AI/AN primary care patients >/=50 years old seen during 1 year. Mistreatment was documented in 10%. A logistic regression found younger age (P <.001), female gender (P <.001), current depression (P <.001), and dependence on others for food (P <.05) to be significant correlates of physical abuse. In only 31% of instances of definite abuse were the authorities notified. We conclude that providers should be alert to the possibility of physical mistreatment among older urban AI/ANs. Improvements in detection and management are sorely needed. (+info)
Primitive society, health & elderly.
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Mankind have been ravaged by diseases since primitive age and remedial measures were emprirical learnt either by accident, experience or superstition. But most elderly population were killed and hardly died of diseases. Fate of women were no better. Care for elderly came with civilization. They were little better in the East compared to the West. Although elderly population were better treated in India, China tops the list for elderly care. Even today the oldest man in the family is most respected. Civilized nations even today discriminate elderly population compared to children and adult, but apply the yardstick in a different manner, direct killing alone is not allowed. (+info)
The effect of education on knowledge and management of elder abuse: a randomized controlled trial.
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BACKGROUND: Abuse of older adults may occur to a disproportionate extent in institutions. Lack of familiarity with protocols when managing abuse once it occurs is one of the reasons why it persists. Educational interventions are one of the ways to improve knowledge and management in this area. OBJECTIVE: To compare the effectiveness of attending an educational course (Group 1) to printed educational material (Group 2) in improving management of abuse of older people. To determine if positive attitude and low burnout scores are related to improvement. DESIGN: Randomized controlled trial. SETTING: North London, UK. SUBJECTS: Nurses, care assistants and social workers working with older people. METHODS: Staff answered questionnaires pre- and post-intervention. RESULTS: The study was completed by 64 (81%) of staff. Baseline scores on knowledge and management abusive scenarios were low. Those randomized to Group 1 improved after intervention and Group 2 deteriorated (Group 1=3.7 [standard deviation=8.1], ANOVA F=23.0; P=0.0001 and Group 2=-2.9 [standard deviation=10.0]). There was a ceiling effect with those who knew more learning less. The significant independent variables in regression analysis to predict learning were being randomized to Group 1 (P=0.003; odds ratio=6.8; 95% confidence interval=1.9-24.5) and low baseline knowledge and management score, (P=0.015, odds ratio=4.8, confidence interval=1.4-16.9). Most staff had a positive attitude towards people with dementia; positive attitude score correlated with baseline knowledge, but did not predict learning. CONCLUSION: Identifying, documenting and reporting abuse of older people is not carried out consistently. Whilst an educational course goes some way in improving this, it needs to be targeted to take into account the baseline knowledge. (+info)
Elder abuse and neglect: what physicians can and should do.
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Although reports of elder abuse to official agencies have been steadily increasing, physicians report only 2% of reported cases. Multiple barriers to reporting exist. This article reviews the terminology, epidemiology, and clinical signs associated with elder abuse in the community and offers practical strategies for intervention. (+info)