|
 Elder maltreatment can include physical injury, emotional abuse like
screaming or threatening, illegal use of financial resources, sexual
abuse, intentional or unintentional neglect, as well as using
physical or chemical restraints.
There’s some evidence for the benefits of interventions to help
long-term carers find ways to handle older patients without
physically restraining them, researchers say, but many other
questions remain unanswered by the studies available.
“Prevalence rates vary by country and assessment method, with some
surveys claiming that as many as 1 in 4 older adults is exposed to
some type of maltreatment,” said lead author Liat Ayalon of the
Louis and Gabi Weisfeld School of Social Work at Bar Ilan University
in Ramat Gan, Israel. “No doubt there are a lot of efforts to
increase public attention in this field, but in reality, we know
little about the potential effects of these efforts.”
Bruises, disorganized appearance or isolation may indicate elder
abuse, Ayalon told Reuters Health by email, but many of these signs
resemble general pathology in older adults that are unrelated to
maltreatment.
“The secrecy around abuse, because it tends to occur within the
family is another challenge,” Ayalon said.
The researchers searched through a few thousand studies addressing
elder maltreatment, but only found 24 that met scientific standards
and were published in English between 2000 and 2014.
Two of these studies were designed to help professionals detect or
stop elder maltreatment, three were aimed at intervening with the
older adults who experience maltreatment, and 19 were targeted at
caregivers who maltreat older adults. In the last category, only one
specifically dealt with family caregivers, while most addressed paid
caregivers.
Interventions that targeted use of restraints did appear to help
caregivers to use physical restraints less, the researchers report
in Age and Ageing.
But most of the studies on physical restraint did not assess the
quality of the intervention, and did not describe exactly which type
of caregivers they were targeting, the authors note.
The analysis in found no conclusive evidence for or against the
benefit of interventions targeting the abused elderly to help
prevent maltreatment. Just one study provided evidence for
interventions targeting unpaid caregivers who maltreat.
[to top of second column] |
Elder care in Japan is most often left to family members, even after
the establishment of a public long-term care insurance system across
the nation, said Miharu Nakanishi of the Tokyo Metropolitan
Institute of Medical Science, who was not part of the new review.
“This may sometimes lead to social isolation of family members who
care for the elderly person,” Nakanishi said.
Abuse from family caregivers is technically domestic violence, so
may require different interventions than those used for professional
caregivers, Nakanishi told Reuters Health by email.
Caregiver burnout, high levels of interdependence, financial
dependence and alcohol abuse among caregivers are all risks for
abuse, Ayalon said.
“Cognitive impairment in older adults is another vulnerability
factor that puts older adults at risk for abuse, so are behavioral
problems associated with dementia,” Ayalon said.
“Many times, maltreatment is not a result of a volitional act, but
rather represents the inability of the caregiver to deal with the
task of caring appropriately,” Ayalon said.
Physical restraint may be a necessity in some settings, especially
to prevent falls, but it tends to be over-used, Ayalon said. “As can
be seen by current research, it is one of the only acts we can
actually reduce and prevent at the present time - hence, this is one
place where we, as professionals, can intervene and improve the care
provided to older adults.”
SOURCE: http://bit.ly/1OCdkDN Age and Ageing, online January 6,
2016.
[© 2016 Thomson Reuters. All rights
reserved.] Copyright 2016 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
