Elder Abuse

Abstract

The ever-expanding growth of the geriatric population increases the likelihood of abuse and neglect both in the home and in caregiving institutions. In the United States alone, hundreds of thousands of elders are maltreated each year. Only recently has there been a clear public and governmental awareness of elder abuse in all its forms. Elder maltreatment, including abuse and neglect, comprises an act or omission resulting in morbidity and/or mortality of older persons. Six recognized categories of elder maltreatment include physical, sexual, and psychological abuse; financial exploitation; neglect, and a miscellaneous classification that often includes the violation of the elder’s rights. A strong familial relationship between the abused and the abuser exists. In more than two-thirds of cases, an adult child or spouse is the perpetrator. Domestic violence in the family is also a common underlying factor. Recognition of this phenomenon is the initial step in reaching a correct diagnosis. Despite efforts to educate health care providers of elder maltreatment, physicians in the United States have reported only 2% of all abuse cases in recent years. Achieving full recognition of elder maltreatment requires a multidisciplinary effort from many fields, including clinicians, social workers, medicolegal death investigators, and law enforcement to establish comprehensive research and governmental funding. The ultimate goal of such an agenda is to define evidence-based markers for accurate diagnostic methods, which differentiate causes of injury and death by abuse and neglect from those related to normal aging and senescence. In addition to the painstaking scrutiny of the putative victim’s medical and psychological background, circumstantial and scene findings that may suggest elder maltreatment, in any form, must be meticulously investigated.

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