Elder abuse - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Elder abuse is a common and increasing worldwide phenomenon as populations live longer.
Many different forms of elder abuse exist, including neglect; physical, psychological, sexual, or financial abuse; and self-neglect.
The key to diagnosis is maintaining a high index of suspicion with every geriatric-patient encounter.
Certain patient and caregiver characteristics can help identify high risk for elder abuse.
While the exact procedures may differ, most states and countries have mandatory reporting requirements, so knowledge of local reporting procedures is advisable.

Quick Reference

History & Exam
- Key Factors
- Other Factors
More information...
Diagnostics Tests
More information...
Treatment Options
More information...

Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Lachs MS, Pillemer KA. Elder Abuse. N Engl J Med. 2015 Nov 12;373(20):1947-56.[Abstract][Full Text]
Aravanis SC, Adelman RD, Breckman R, et al; American Medical Association. Diagnostic and treatment guidelines on elder abuse and neglect. Arch Fam Med. 1993 Apr;2(4):371-88.[Abstract]
Fulmer T, Paveza G, Abraham I, et al. Elder neglect assessment in the emergency department. J Emerg Nurs. 2000 Oct;26(5):436-43.[Abstract]
American College of Emergency Physicians. Policy statement: management of elder abuse and neglect. Ann Emerg Med. 1998 Jan;31(1):149-50.[Abstract]

Other Online Resources

WHO: abuse of older people factsheet
National Center on Elder Abuse
Directory of Crime Victim Services
CDC: elder abuse
Cornell Scale for Depression in Dementia
University of Delaware: Clearinghouse on Abuse and Neglect of the Elderly (CANE)
Nursing Home Abuse Guide: elder abuse

Referenced Articles

1. Centers for Disease Control and Prevention (CDC). Elder abuse. June 2021 [internet publication].[Full Text]
2. World Health Organisation. Elder abuse. 2021 [internet publication] [Full Text]
3. Lachs MS, Pillemer KA. Elder Abuse. N Engl J Med. 2015 Nov 12;373(20):1947-56.[Abstract][Full Text]
4. McCreadie C. Introduction: the issues, practice and policy. In: Eastman M, ed. Old age abuse: a new perspective. London: Chapman & Hall; 1994:3-22.
5. O'Malley TA, O'Malley HC, Everitt DE, et al. Categories of family mediated abuse and neglect of elderly persons. J Am Geriatr Soc. 1984;32:362-369.[Abstract]
6. Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health. 2017 Feb;5(2):e147-56. [Abstract][Full Text]
7. Biggs S, Manthorpe J, Tinker A, et al. Mistreatment of older people in the United Kingdom: findings from the first National Prevalence Study. J Elder Abuse Negl. 2009 Jan-Mar;21(1):1-14. [Abstract]
8. Storey JE. Risk factors for elder abuse and neglect: A review of the literature. Aggression and Violent Behavior. 2020 Jan-Feb; 50; 101339. [Full Text]
9. Lindbloom EJ, Brandt J, Hough LD, et al. Elder mistreatment in the nursing home: a systematic review. J Am Med Direc Assoc. 2007 Nov;8(9):610-6.[Abstract]
10. Yon Y, Ramiro-Gonzalez M, Mikton CR, et al. The prevalence of elder abuse in institutional settings: a systematic review and meta-analysis. Eur J Public Health. 2019 Feb 1;29(1):58-67.[Abstract][Full Text]
11. Lachs MS, Williams C, O'Brien S, et al. Risk factors for reported elder abuse and neglect: a nine-year observational cohort study. Gerontologist. 1997 Aug;37(4):469-74.[Abstract]
12. Paveza GJ, Cohen D, Eisdorfer C, et al. Severe family violence and Alzheimer's disease: prevalence and risk factors. Gerontologist. 1992 Aug;32(4):493-7.[Abstract]
13. Pillemer K, Finkelhor D. The prevalence of elder abuse: a random sample survey. Gerontologist. 1988 Feb;28(1):51-7.[Abstract]
14. Melchiorre MG, Di Rosa M, Lamura G, et al. Abuse of older men in seven European countries: a multilevel approach in the framework of an ecological model. PLoS One. 2016 Jan 19;11(1):e0146425. [Abstract][Full Text]
15. World Health Organization. Addressing violence against children, women and older people during the covid-19 pandemic: Key actions. June 2020 [internet publication]. [Full Text]
16. Jones JS, Holstege C, Holstege H. Elder abuse and neglect: understanding the causes and potential risk factors. Am J Emerg Med. 1997;15:579-583.[Abstract]
17. McGarry J, Simpson C, Hinchliff-Smith K. The impact of domestic abuse for older women: a review of the literature. Health Soc Care Community. 2011;19:3-14.[Abstract]
18. Tatara T, Kuzmeskus LB, Duckhorn E, et al. The national elder abuse incidence study: final report. September 1998. http://www.aoa.gov (last accessed 24 March 2016).[Full Text]
19. Beach SR, Schulz R, Williamson GM, et al. Risk factors for potentially harmful informal caregiver behavior. J Am Geriatr Soc. 2005;53:255-261.[Abstract]
20. Buri H, Daly JM, Hartz AJ, et al. Factors associated with self-reported elder mistreatment in Iowa's frailest elders. Res Aging. 2006;28:562-581.
21. Dong XQ. Elder abuse: systematic review and implications for practice. J Am Geriatr Soc. 2015;63:1214-1238.[Abstract][Full Text]
22. American College of Obstetricians and Gynecologists' Committee on Health Care for Underserved Women. Elder abuse and women's health: ACOG Committee Opinion, Number 824. Obstet Gynecol. 2021 Mar 1;137(3):e89-e93.[Abstract][Full Text]
23. World Health Organisation. Elder abuse factsheet. Oct 2021 [internet publication][Full Text]
24. Quinn MJ, Tomita SK. Elder abuse and neglect. 2nd ed. New York, NY: Springer; 1997:9-10.
25. Lowenstein SR, Crescenzi CA, Kern DC, et al. Care of the elderly in the emergency department. Ann Emerg Med. 1986;15:529-533.[Abstract]
26. Kosberg JI, Nahmiash D. Characteristics of victims and perpetrators and milieus of abuse and neglect. In: Baumhover LA, Beall SC, eds. Abuse, neglect, and exploitation of older persons: strategies for assessment and intervention. Baltimore, MD: Health Professions Press; 1996:31-49.
27. Lachs MS, Pillemer K. Abuse and neglect of elderly persons. N Engl J Med. 1995;332:437-443.[Abstract]
28. Steiner RP, Vansickle K, Lippmann SB. Domestic violence: do you know when and how to intervene? Postgrad Med. 1996;100:103-116.[Abstract]
29. Pillemer K, Burnes D, Riffin C, et al. Elder abuse: global situation, risk factors, and prevention strategies. Gerontologist. 2016 Apr;56(suppl 2):S194-205. [Abstract][Full Text]
30. Baker PR, Francis DP, Hairi NN, et al. Interventions for preventing abuse in the elderly. Cochrane Database Syst Rev. 2016;(8):CD010321.[Abstract][Full Text]
31. Ginschel F, Schlüter K. Education on old age and ageing in school: An analysis of students' conceptions of old age and ageing and implications for teaching. Education Sciences 2020;10:307.[Full Text]
32. Aguilera-Hermida P. Fighting ageism through intergenerational activities, a transformative experience. Journal of Transformative Learning. 2020;7(2), 6-18.[Full Text]
33. Aravanis SC, Adelman RD, Breckman R, et al; American Medical Association. Diagnostic and treatment guidelines on elder abuse and neglect. Arch Fam Med. 1993 Apr;2(4):371-88.[Abstract]
34. Rathbone-McCuan E. Elderly victims of family violence and neglect. Soc Casework. 1980;61:296-304.
35. Fulmer T, Paveza G, Abraham I, et al. Elder neglect assessment in the emergency department. J Emerg Nurs. 2000 Oct;26(5):436-43.[Abstract]
36. American College of Emergency Physicians. Policy statement: management of elder abuse and neglect. Ann Emerg Med. 1998 Jan;31(1):149-50.[Abstract]
37. Fulmer T, Street S, Carr K. Abuse of the elderly: screening and detection. J Emerg Nurs. 1984 May-Jun;10(3):131-40.[Abstract]
38. Fulmer T, Wetle T. Elder abuse screening and intervention. Nurse Pract. 1986 May;11(5):33-8.[Abstract]
39. Yaffe MJ, Wolfson C, Lithwick M, et al. Development and validation of a tool to improve physician identification of elder abuse: the Elder Abuse Suspicion Index (EASI). J Elder Abuse Negl. 2008;20(3):276-300.[Abstract]
40. Rathbone-McCuan E, Voyles B. Case detection of abused elderly parents. Am J Psychiatry. 1982 Feb;139(2):189-92.[Abstract]
41. Fulmer T, Birkenhauer D. Elder mistreatment assessment as a part of everyday practice. J Gerontol Nurs. 1992 Mar;18(3):42-5.[Abstract]
42. Cooper C, Manela M, Katona C, et al. Screening for elder abuse in dementia in the LASER-AD study: prevalence, correlates and validation of instruments. Int J Geriatr Psychiatry. 2008 Mar;23(3):283-8.[Abstract]
43. Shugarman LR, Fries BE, Wolf RS, et al. Identifying older people at risk of abuse during routine screening practices. J Am Geriatr Soc. 2003 Jan;51(1):24-31.[Abstract]
44. Levy DB, Hanlon DP, Townsend RN. Geriatric trauma. Geriatr Emerg Care. 1993 Aug;9(3):601-20.[Abstract]
45. National Center for Elder Abuse. Elder abuse screening tools for healthcare professionals. 2016 [internet publication]. [Full Text]
46. Hirst SP, Penney T, McNeill S, et al. Best-practice guideline on the prevention of abuse and neglect of older adults. Can J Aging. 2016 Jun;35(2):242-60. [Abstract][Full Text]
47. American College of Emergency Physicians. Domestic family violence. Apr 2019 [internet publication].[Full Text]
48. Australian Institute of Family Studies. Elder abuse: understanding issues, frameworks and responses. February 2016 [internet publication].[Full Text]
49. National Institute for Health and Care Excellence. Safeguarding adults in care homes. Feb 2021 [internet publication].[Full Text]
50. National Institute for Health and Care Excellence. Domestic violence and abuse: multi-agency working. February 2014 [internet publication].[Full Text]
51. Glasgow K, Fanslow JL. Family violence intervention guidelines: elder abuse and neglect. Wellington, New Zealand: Ministry of Health. 2006.[Full Text]
52. Capezuti E, Brush BL, Lawson WT 3rd. Reporting elder mistreatment. J Gerontol Nursing. 1997 Jul;23(7):24-32.[Abstract]
53. Killick C, Taylor BJ. Professional decision making on elder abuse: systematic narrative review. J Elder Abuse Negl. 2009 Jul-Sep;21(3):211-38.[Abstract]
54. American College of Emergency Physicians. Recognition and management of elder abuse. January 1999 [internet publication].[Full Text]
55. Ploeg J, Fear J, Hutchison B, et al. A systematic review of interventions for elder abuse. J Elder Abuse Negl. 2009 Jul-Sep;21(3):187-210.[Abstract]
56. Jacobs DG. Special considerations in geriatric injury. Curr Opin Crit Care. 2003 Dec;9(6):535-9.[Abstract]
57. Department of Health (UK). Safeguarding adults: the role of health services. March 2011 [internet publication].[Full Text]
58. United Nations Programme on Ageing. The Madrid international plan of action on ageing. New York, NY; UN Department of Economics and Social Affairs: 2002.[Full Text]
59. Lachs MS, Williams CS, O'Brien S, et al. The mortality of elder mistreatment. JAMA. 1998;280:428-432.[Abstract][Full Text]
60. Dyer CB, Pavlik VN, Murphy KP, et al. The high prevalence of depression and dementia in elder abuse or neglect. J Am Geriatr Soc. 2000;48:205-208.[Abstract]
61. Canadian Task Force on the Periodic Health Examination. Periodic health examination, 1994 update: 4. secondary prevention of elder abuse and mistreatment. CMAJ. 1994;151:1413-1420.[Abstract][Full Text]