Alcohol abuse is present in up to 5 percent of older persons and is more common in men than in women. In some cases—gunshot wounds, knife wounds, or rope burns, for instance—it is clear that the older person has been abused.
Within the relevant victimized populations there are similarities and differences among the factors contributing to their vulnerability and victimization.
A few suggestions there are many more for research needed relating to the markers discussed in this paper include the following: Discussion of each factor includes a a definition of the phenomenon, b a discussion of how it is affected by age-related changes, and c what we currently know of clinical and forensic markers indicating abuse and neglect.
In other words, because older victims usually have fewer support systems and reserves—physical, psychological, and economic—the impact of abuse and neglect is magnified, and a single incident of mistreatment is more likely to trigger a downward spiral leading to loss of independence, serious complicating illness, and even death.
In a preliminary analysis by the Texas Department of Protective and Regulatory Services, self-neglect and medical neglect failure to obtain or have obtained appropriate medical care cases were more likely to be associated with other types of elder mistreatment than were cases of physical or sexual abuse Dyer et al.
A spiral fracture of a large bone with no history of gross injury is diagnostic of abuse, as are fractures with a rotational component Medical Tribune, An year longitudinal study of adult protective service use.
Depletion of institutional resources may result in failure to keep reliable and unexpired stores of necessary medications on the premises, including, for example, insulin for insulin-dependent diabetics.
Data could be collected and analyzed from several sites as part of a pilot project as well. Financial fraud and abuse make up Assessment of Decision-Making Capacity. Clinical and Forensic Markers Indicating Abuse or Neglect Malnutrition often is a marker of caregiver neglect, especially in institutional settings.
Incidents of mistreatment that many would perceive as minor can have a debilitating impact on the older victim. Special Issues Relating to Screening Tools Several specific factors make development of appropriate tools to screen for markers of elder abuse and neglect simultaneously vital and very complex.
The EAI has a content validity index of 0.
It is coupled with training and designed to screen elders who are either caregivers or care receivers. The level of suspicion for this type of abuse should be increased for persons with cognitive impairment, which predisposes the victim to be trusting of caregivers, relatives, and acquaintances Tueth, Evans received a medical degree and completed a fellowship in internal medicine and geriatric medicine at the Mayo Clinic.
The ensuing discussion describes several potential forensic markers of elder abuse and neglect, including: Restraints Restraints are means of controlling the behavior of older persons, especially in hospitals and nursing facilities.
Unfortunately, there is a paucity of primary data relating to forensic markers of elder abuse and neglect, or even regarding the phenomena themselves. Is the person physically or mentally incapacitated?
A number of factors have limited the development of screening tools for elder mistreatment. Age-Related Changes Data from the National Fire Protection Association show that persons over the age of 65 have twice the national average death rate due to burns. The high incidence of burns in cases of self-neglect raises the question: The color of the bruise is usually unhelpful for dating because two bruises in the same person may heal at different rates.
In addition, old age often brings medical conditions and physiological attributes that may mimic or mask the markers of elder abuse and neglect, further complicating the analysis and detection. How Postmortem Forensic Markers May Differ from Those Applicable to Living Persons Postmortem examination in many cases provides less information than would a complete physical examination in a living person.
Clinical and Forensic Markers Indicating Abuse or Neglect Abrasions retain the pattern of the causative agent better than any other type of injury, and careful documentation by health care personnel is important for identification of the mode of injury.
Tendency to multiple falls should be verified or refuted through medical records or objective observations if possible. The National Academies Press.Using Bronfenbrenner’s ecological systems model, this study examined allegations of elder abuse made to Kentucky Adult Protective Services (APS) and the investigation that followed, in order to understand how APS addressed the needs of abused elders.
Elder abuse allegations made to APS during the. The Clinical and Medical Forensics of Elder Abuse and Neglect: Since the late s when Congressman Claude Pepper held widely publicized Login Register Cart Help Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America ().
CalEMA Forensic Medical Report: Elder and Dependent Adult Abuse and Neglect Examination USE OF STANDARD STATE FORM Penal Code § established the use of a standard form to record findings from examinations performed for suspected elder and dependent adult.
Review Article A lthough it has probably existed since antiquity, elder abuse Conduct a pelvic examination with collection of appropriate specimens or re- Forms of Elder Abuse and Clinical.
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.
Elder abuse, particularly when it involves a patient in a residential care facility, can be difficult to detect and for every reported case of abuse, more than five cases may go unreported. A congressional report showed that an examination of nursing home records conducted over a two-year period showed that nearly 1 in 3 nursing homes were.Download