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Researchers Call for Better Prevention, Screening, Monitoring, and Managing Elder Abuse in Nursing Homes
For many years, geriatric and aging experts at Rush University Medical Center have studied the prevalence and adverse health outcomes of elder abuse in the United States and globally.

Now, in an editorial letter being published in the June 14 issue of Annals of Internal Medicine, experts at Rush are calling upon federal and state government agencies, health care facilities, and social service and health professional organizations to develop better programs for preventing, screening, monitoring, and managing elder abuse in nursing homes.

The call for action is based on the results of a study where a research group in New York analyzed data collected on elder mistreatment and abuse in nursing homes. The study indicates that the prevalence of resident-to-resident elder mistreatment in 10 New York state nursing homes from 2009 to 2013 was 20.2%.

"Elder abuse is a common, sometimes fatal and costly public health issue that affects as estimated 10% of 64.9 million community-dwelling U.S. elderly adults," says Xinqi Dong, MD, MPH, professor of geriatric medicine at Rush and principal investigator of many elder abuse studies. "An estimated 1.4 million people reside in nursing homes, but little is known about elder abuse among these residents."

The different types of potential mistreatment include:
• 9.1% for verbal abuse;
• 5.2% for physical misconduct;
• 0.6% for sexual misconduct;
• 4% for invasion of privacy;
• 0.9% for menacing gestures or facial expressions; and
• 0.3% for unwanted caregiving.

The study was based on resident self-reports, staff interviews, staff case reports, facility case reports, researcher observations, and medical record reviews.

"Elder abuse is multifaceted and encompasses psychological, physical and sexual abuse," Dong says. "We see neglect as well as financial exploitation. It is a form of violence that is interconnected not only between individuals but also across relationships, generations, and settings."

In the case studies, invasion of privacy and inappropriate caregiving contributed to 21.3% of the 407 cases of resident to resident elder mistreatment and accounted for 4.3% of the overall prevalence of abuse.

More research is necessary to clarify the depth and breadth of resident-to-resident elder mistreatment. There is potential ambiguity in what constitutes elder abuse and a lot of room for interpretation, especially in the category of "invasion of privacy" as being considered elder abuse. Therefore, the categories of what might constitute as elder abuse need to better defined.

In Dong's editorial, he states, "This study will help to pave the road toward elder justice research. At the same time, we need to go beyond cross sectional descriptive studies and to rigorously conduct longitudinal studies to examine the incidence, risk and protective factors and consequences of resident to resident mistreatment."

Evidence-based, culturally appropriate intervention strategies for addressing elderly abuse are needed because they currently do not exist.

"National strategies are needed to engage the collective efforts of federal and state government agencies, health care facilities, social service organizations and health professionals to improve current resources and legislation in order to create more effective ways to monitor, screen and manage elderly abuse in nursing homes," Dong says.
Source: Rush University Medical Center