Introdução: Qualidade de Vida Relacionada à Saúde (QVRS) tem sido considerada como importante medida de avaliação do estado de saúde e de predição de mortalidade em idosos. Diversos estudos detectaram fatores associados à QVRS de idosos, mas, poucos deles, até o momento, propuseram-se a analisar as associações entre violência e QVRS dessa população. Objetivos: identificar a prevalência e as características da violência contra idosos não institucionalizados, residentes no Município de São Paulo; comparar idosos expostos e não expostos à violência em relação a dados sociodemográficos, econômicos, de saúde, de funcionalidade familiar, de incapacidade funcional e dos componentes físico e mental da QVRS; verificar se a violência é um fator independente associado aos escores dos componentes físico e mental da QVRS de idosos. Método: esta pesquisa transversal é parte integrante do Estudo SABE (Saúde, Bem-Estar e Envelhecimento). Os dados foram coletados em 2010 e a amostra compôs-se de 1.147 idosos que responderam o Short-Form 12 Health Related Survey (SF-12), instrumento genérico que avalia a QVRS em seus Componentes Físico (CF) e Mental (CM). O CF e o CM do SF-12 foram as variáveis dependentes do estudo. Utilizou-se a regressão linear múltipla, método stepwise backward, para identificação dos fatores associados aos componentes da QVRS. Resultados: a prevalência da violência contra idosos foi de 10,1% (IC 95% 8,4 12), e o tipo mais comum foi a psicológica (9,3%). As variáveis idade e coabitação não diferenciaram significativamente os idosos expostos e não expostos à violência. Sexo feminino, insuficiência de renda, baixa escolaridade, família disfuncional, saúde percebida como ruim, multimorbidade, dor referida, sintomas depressivos, deterioração cognitiva e dificuldades para executar ABVD ou AIVD foram as características presentes em maior proporção no grupo de idosos expostos à violência, quando comparados ao grupo não exposto. Além disso, os idosos expostos à violência, em comparação aos não expostos, alcançaram menores médias nos escores no CF (44,4, DP=10,8 contra 49,1, DP=9,3) e no CM (50,1, DP=12 contra 55,8, DP=7,5) com p<0,001 em ambos os componentes. Na análise múltipla, a violência contra idosos permaneceu significativamente associada ao CM da QVRS (=-2,69; p<0,001), independente de covariáveis demográficas, econômicas, de saúde, de apoio familiar e de incapacidade funcional. Conclusão: a prevalência da violência contra idosos detectada neste estudo foi elevada; os idosos expostos à violência, em comparação aos não expostos, apresentaram diferenças em relação às suas características demográficas, econômicas, de saúde, de funcionalidade familiar e de incapacidade funcional; e a exposição à violência comprometeu o CM da QVRS dos idosos. Medidas de prevenção e controle desse agravo à saúde devem ser tratadas como prioritárias à população idosa / Introduction: Health-related Quality of Life (HRQoL) has been considered as an important measure of health status assessment and a predictor of mortality in elderly. Several studies found factors associated to elderly\'s HRQoL, however, to date, few have proposed to examine the associations between violence and HRQoL of this population. Objectives: to identify the prevalence and characteristics of violence against non-institutionalized elderly who live in the city of São Paulo; to compare elderly who are exposed and not exposed to violence regarding to following variables: sociodemographic, economic and health data, familiar functionality, functional disability and HRQoL\'s physical and mental components; to verify whether violence is a factor independently associated to scores of the HRQoL\'s physical and mental components in elderly. Method: This cross-sectional study is part of the SABE (Health, Wellness, and Aging Study). Data were collected in 2010 and the sample was composed by 1,147 elderly who responded to the 12-Item Short-Form Health Related Survey (SF-12), a generic instrument that assesses the HRQoL in its Physical (CF) and Mental (CM) Components. The CF and CM of the SF-12 were the dependent variables of this study and we used the multiple linear regression, a method of backward stepwise selection to identify the factors associated to HRQOL\'s components. Results: The prevalence of violence against the elderly was 10,1% (IC 95% 8,4 12) and the psychological violence was the most common (9,3%). The cohabitation and age variables did not significantly differentiate the elderly exposed and those non- exposed to violence. Female sex, insufficient income, low education, dysfunctional family, health perceived as poor, multimorbidity, referred pain, depressive symptoms, cognitive impairment and difficulty to perform ABVD ou AIVD were the features presented with higher proportion in the group of elderly exposed to violence, compared to the unexposed ones. Furthermore, elderly exposed to violence achieved lower scores in HRQoL\'s CF(44,4, SD=10,8 vs. 49,1, SD=9,3) and CM(50,1, SD=12 vs. 55,8, SD=7,5) compared to unexposed ones, with p<0,001 in both components. In multiple analysis, the violence against the elderly remained significantly associated to HRQOL\'s CM (=-2,69; p<0,001), independent of demographic, economic, health, family support and functional disability covariables. Conclusion: The prevalence of violence against elderly identified in this investigation was high; the elderly exposed to violence, compared to non-exposed ones, presented differences concerning their demographic, economic, health, family support and functional disability features; and the exposion to violence undermined the HRQOL\'s CM of elderly. Prevention and control actions for this health hazard should be considered as a priority for the elderly

Background: Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. Objective: The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Methods: Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Results: Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. Conclusion: It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community’s environment, especially if older persons are involved. Scientific Significance: Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.

Lack of elder abuse awareness and underreporting is an increasing problem in the United States in that only 1 in 14 cases of elder abuse is reported. The failure to report incidents of elder abuse and suspected elder abuse allows further abuse of elders and for elder abusers to go unpunished. The purpose of this quantitative nonexperimental study was to understand the relationship between race, gender, and elder abuse awareness and fill the gap in elder abuse literature. Research questions tested mean differences between race and gender, respectively, and elder abuse awareness. The theoretical frameworks for this study were the social cognitive theory, self-perception theory, and Dunning Kruger Effect. The study included a convenience sample of 75 federal corrections retirees with diverse educational and professional backgrounds living in the United States. Data were collected using an online survey that ascertained the respondents' attitudes toward elder abuse and knowledge of elder abuse laws. Independent samples t tests were performed to test the mean differences of elder abuse awareness between different races and genders. Results of the study revealed African Americans have a statistically significant higher mean than Caucasians. However, there was not a statistically significant mean difference between males and females, respectively, and elder abuse awareness. The implications for social change include aiding public and private sector elder abuse prevention advocates adopt programs and policies that will increase elder abuse awareness campaigns, increase elder abuse reporting behavior of different races and genders, and prevent deaths resulting from a lack of elder abuse awareness.

The Adult Protective Services Program is tasked with enforcing the standards and policies created at the federal level relating to how provider agencies should respond to elder abuse. What has yet to be explored is whether the Adult Protective Services Program is efficiently responding to the issue of elder abuse through its monitoring and evaluation protocols, which are based on the current policies. The purpose of this study was to explore the role of the 13 planning and service areas in their response to elder abuse. The response to elder abuse is guided by the current policies and funding strategies and has determined that there is a need for a policy change. The primary research questions sought to determine if the current policies were effective in every aspect, from planning to execution of the policies as well as the funding in guiding the level of response to elder abuse. The narrative policy framework was used to assess the feelings and opinions of the 13 directors of the planning and service areas regarding the current policies and response strategies to elder abuse. The study utilized a qualitative methodology that procured data through methods such as interviews and secondary data. Content analysis and coding were the two main strategies for analyzing the data for this study. Key results indicated that the directors felt restricted in term of the current policies, while funding has remained stagnant despite an increase in new programs. A change of policy that allows more freedom for investigating elder abuse is needed, as well as a reinvigoration of funding in the area of elder abuse.

Increases in the proportion of older people in Canada have focussed needed attention on the issues and concerns for this group. One prevalent issue is the nature of experiences of intimate partner violence (IPV) for older adults. These experiences have been overlooked in the domestic violence theory and research where the focus has been on the needs of younger women and also within the elder abuse research and literature where the emphasis has been placed on aging (dementia) and caregiving. As a result, less is known about the experiences of older adults in intimate relationships and how the power and control dynamics manifest and shift within the context of long-term relationships. How do these dynamics change or remain the same in intimate relationships of older adults? How do the victims resist the violent and controlling tactics of perpetrators and how does this resistance influence and shift the nature of power and control in these intimate relationships? Using techniques borrowed from grounded theory, this study was undertaken with the aim of exploring power and control dynamics in intimate relationships of older adults in long-term abusive relationships. The findings demonstrated by the victims reported that their partners used different forms of violent tactics in the early years of these intimate relationships and typically used more nonviolent coercive controlling tactics in later years. In some of the relationships, control continued past the period of separation and divorce. Victims presented themselves as active agents and demonstrated resistance that was more overt in the early years, which became more subtle and discreet as these relationships matured. For victims, resisting their partners’ efforts to control them provided them with some momentary power in the relationship; however, the participants’ control was mostly situation-specific and temporary. For victims who were still living with their abusive partners, resistance allowed them to set boundaries with their partners and provided them with some space of their own within their relationships to engage in activities of their choice. These boundaries, however, are under constant scrutiny by the abusive partners and although victims demonstrate resistance to assert their dignity, the overarching control continued to be with the abusive partner. Narratives also provided by the participants also demonstrated the impacts of intimate partner violence to their sense of health and well-being. / October 2015

Elder abuse has traditionally been a silent social issue in America. However, with an estimated increase in the older population over the next 50 years, and given the preventable nature of violence, it is quickly becoming a major public health priority area. Each year hundreds of thousands of elderly are abused, neglected, or exploited financially worldwide. In the United States alone, it is estimated that 500,000 cases of elder abuse occur annually—with research indicating that substantiated cases are a mere underreport of the true problem. The US federal government has appointed State Units on Aging to address elder abuse. Georgia’s Division of Aging Services (DAS) is located within the Department of Human Services and administers various services to elderly including advocating for their safety and well being. DAS carries out its work through locally appointed Area Agencies on Aging (AAA). While AAAs serves as a first point of entry for elderly population locally, their involvement in reporting and intervening in elder abuse cases has been limited. The purpose of this capstone project is to examine the AAAs’ stage of readiness to address elder abuse using the Community Readiness Model, developed by researchers at the University of Colorado. Telephone administered surveys were completed with 7 out of the 12 Georgia AAAs. Through a double rater review process, transcripts were coded according to diverse constructs of the Community Readiness Model and ultimately a readiness score was produced. The Community Readiness Score provides insight into evidence-based strategies that can be implemented in order to advance elder abuse intervention and prevention within the AAA communities. The findings from this study provide insights into cost-efficient, tailored strategies that can maximize the use of DAS funding for AAA elder abuse case response and service delivery.

The general objectives of the study were to evaluate a social work support group programme with informal caregivers that aimed to enhance the quality of care provided to older persons in an urban and rural community setting in Namibia. In order to achieve the general objectives of the study, the following specific objectives were formulated: * To explore how informal caregiving situations in urban and rural communities lead to elder abuse and neglect. * To describe existing literature on the various factors that contribute to elder abuse and neglect within community settings. * To develop a support group programme for informal caregivers of older persons in urban and rural community settings that aimed at preventing elder abuse and neglect. * To implement and evaluate the effectiveness of the support group programme for informal caregivers that aimed at preventing elder abuse and neglect. The thesis consists of 5 sections: Section A consists of the problem statement, research objectives, central theoretical argument and the theoretical approaches that underpin the study. Furthermore, the research methodology, the definition of key concepts and the limitation of the study are presented. Section B contains four articles that together formed part of the research outcomes. Each article can function independently with it’s own objectives and distinctive content. However, each article is also a sub-project of the umbrella research study. Therefore, some of the data have to be repeated in different sections. The four articles are: Article 1: Informal caregiving, elder abuse and neglect in urban and rural areas of the Khomas region in Namibia: A needs assessment A needs assessment on informal caregiving situations and how it may lead to elder abuse and neglect of older persons from an urban and rural constituency in the Khomas region was explored. Data was collected through in-depth interviews with professional and community leaders. In addition, focus group discussions were held with older persons and informal caregivers in the urban and rural constituency. Article 2: Factors contributing to elder abuse and neglect in community settings In this article, a comprehensive review of the literature pertaining to the risk and protective factors to elder abuse and neglect was done. The ecological theory was worthwhile to describe the risk factors to elder abuse and neglect. Article 3: Designing a social work support group programme with informal caregivers of older people in Namibia A social work support group programme was developed for informal caregivers of older persons in community settings. The eight-week support group programme was developed based on a needs assessment and a comprehensive literature review, and included the following topics; the normal processes of aging, handling of difficult caregiving situations, caregiver stress, self-care of the caregiver, elder abuse and neglect and caregiver grief and loss. The planning model for group work was also utilised to design the group. Article 4: Evaluation of the effectiveness of a support group programme with informal caregivers to prevent elder abuse and neglect An eight-week support group programme with ten female informal caregivers from an urban group and twelve informal caregivers from a rural group setting was implemented and evaluated. Standardized measuring instruments that assessed the outcome of the group at pre-test, post-test and postponed post-test were the Zarit Burden Interview (ZBI), Potentially Harmful Behaviour (PHB) scale and the Caregiver Abuse Screen (CASE). The Group Engagement Measure (GEM) assessed the group processes at the fourth, sixth and eight group sessions. In addition, open-ended questions were used to collect qualitative data. The quantitative and qualitative evaluations indicated that both the urban and rural groups gained knowledge on aging and caregiving, and caregivers acquired vital qualities such as patience, compassion and communication skills. The process evaluation showed that caregivers from the urban group were more engaged in the group process than the rural group. Elder abuse was underreported in the study, while personal stress of caregivers reduced significantly because of the intervention. Section C consists of the summary of the most important findings and conclusions to the research study. In addition recommendations are provided. Section D consists of the annexures to the research report, such as the measuring instruments and interview schedules used for data collection. Section E contains a consolidated list of references. / PhD (Social Work), North-West University, Potchefstroom Campus, 2014

Una de las formas de violencia más ocultas es la que padecen las personas de edad avanzada. La tesis expone información relacionada con el problema. Se aporta una comprensión teórica y los elementos necesarios para describir esta realidad. La detección, la prevención y la intervención son parte importante del material aportado. Se trata de un estudio exploratorio llevado a cabo con una muestra de 178 personas de 65 años y más, que viven en su domicilio y que han sido víctimas de maltrato durante el año 2002. Se han explorado datos cuantitativos y cualitativos. El objetivo general se centra en identificar, describir y explorar las características y aspectos principales que intervienen en las situaciones de maltrato a las personas mayores. A su vez se persiguen cinco objetivos específicos: A,- Describir los principales problemas asociados al abordaje de los malos tratos, conceptos y tipologías. B,- Elaborar un perfil de la víctima y de la persona que comete el maltrato. C,- Conocer e identificar los factores de riesgo, tanto los que se relacionan con la víctima como con el agresor. D,- Conocer la existencia y la aplicabilidad de la red pública de servicios sociales, sociosanitarios, salud y jurídicos para acceder en situación de maltrato a personas mayores. E,- Obtener un fondo de datos para estimular la investigación.

Thesis (M.G.S.)--Miami University, Dept. of Sociology and Gerontology, 2006. / Title from first page of PDF document. Includes bibliographical references (p. 26-28).

L’objectif de cette recherche a été de montrer comment l’impensé institutionnel de la maltraitance dérive d’une modalité spécifique du pacte dénégatif nommée pacte de désaveu, mettant en échec la déontologie et précipitant ainsi les sujets de l’institution dans une mise en acte répétitive du phénomène.Notre thèse s’articula autour de deux axes majeurs : un axe central autour du désaveu et un axe transversal centré sur la répétition. Celle-ci envisagée comme le corrélat du désaveu. L’examen de l’action de cet opérateur, à travers l’inquiétante étrangeté et la construction métaphoro-métonymique du Double, a permis de démontrer l’existence d’un pacte de désaveu, et l’enjeu de son utilisation lorsque son objet est la maltraitance dans une institution gériatrique : dissimuler l’existence de la maltraitance ; écarter la responsabilité de l’acte ; couvrir la participation des soignants à la maltraitance institutionnelle.L’existence d’un double désaveu a pu être mise en évidence : un désaveu de la parole du résident lié par circularité à un désaveu de l’acte de maltraitance. Ces deux désaveux se sont révélés comme secondaires, dans le sens de témoins d’un désaveu originel : le désaveu de la loi. Ce désaveu originel se basant sur une réalité fondamentale : la perte d’autonomie pouvant aller jusqu’à la grande dépendance.Ce premier axe de notre thèse a conduit nécessairement à prendre en compte un champ supplémentaire : la déontologie professionnelle en évaluant les effets et conséquences de ce désaveu dont nous avons fait mention. L’examen de la déontologie a conduit à formuler l’hypothèse d’une mise en échec de celle-ci, corrélée à cette opération de désaveu. Le second axe de recherche, transversal quand à notre problématique et dont le phénomène de répétition de l’acte de maltraitance constitue le corrélat, a permis de mettre en évidence avec quelle force contraignante, l’institution précipite ses sujets dans la répétition sous l’action du désaveu qui, en entravant la construction du souvenir, entraîne une impossible mise au passé de la maltraitance. / The objective of this research was to show how the institutional’s unthought of elder abuse derives from a specific modality of the pact of denial called pact of disavowal, by defeating ethics and precipitating the subjects of the institution in a formal act repetitive phenomenon.Our argument revolved around two major themes: around a central axis on disavowal and a transverse axis centered on repetition. It considered as the correlate of the disavowal.Examination of the action of this operator through the uncanny and the construction of metonymic-metaphorical of Double, has shown the existence of a pact of disavowal, and the issue of its use when the object is abuse in a geriatric institution: conceal the existence of abuse; exclude liability of the act; cover the participation of caregivers in institutional abuse.The existence of a double disavowal could be highlighted: a denial of the word of resident bound by circularity to a disavowal of the act of abuse. Both disavowals proved to be secondary in the sense of witnessing a repudiation original: the disavowal of the law. The original disavowal based on a fundamental reality: the loss of autonomy up to the high dependency.The first axis of our thesis necessarily leads to consider an additional field: professional ethics in evaluating the effects and consequences of this disavowal we mentioned. The Ethics Review has led to the hypothesis of a hit of this, correlated with the operation of disavowal.The second line of research cross with our problem and that the phenomenon of repetition of the act of abuse is the correlate, helped highlight how binding the institution rushes his subjects in the repetition in the action of disavowal which inhibited the construction of memory, resulting in not putting elder abuse in the past.