The three general types of abuse and neglect are physical, psychologic, and financial. All can be intentional or unintentional. Physical abuse and neglect: This type of mistreatment includes striking, shoving, shaking, beating, restraining, or feeding improperly. Sexual assault requires special emphasis, because many health care providers find this form of violence inconceivable when an older [...]
When family members depend on elders for housing, financial support, emotional support, or other needs, the dependent family members may become/esentful and predisposed to abusive and neglectful behavior. This theory also suggests that elders who are functionally or cognitively impaired and dependent on their families for care are at increased risk for abuse and neglect.
This theory postulates that violence is a learned response to difficult life experiences and a learned method of expressing anger and frustration. The theory has been hard to substantiate because information about family violence that occurred years ago is difficult to obtain.
Financial problems, death in the family, the responsibilities of caregiving, and other tensions may create frustration and anger that some people express through acts of violence. New studies have investigated the relationships between the care recipient’s degree of cognitive impairment and the occurrence of abuse and neglect by the caregiver. A recent study conducted at [...]
Many abusers have been hospitalized repeatedly for serious psychiatric disorders (eg, schizophrenia and other psychoses). Many abuse alcohol or other drugs. When an adult child has a mental illness requiring inpatient psychiatric care, the parents’ home is often the discharge site of last resort. Out of concern that the child will be homeless or have [...]
The epidemiology of elder abuse and neglect has been better understood since the publication of the 1986 survey by the Family Research Laboratory at the University of New Hampshire. In this survey of 2020 randomly selected elderly people living in the Boston metropolitan area, 3.2% reported being abused. Abuse was defined as physical abuse, which [...]
ELDER ABUSE AND NEGLECT Each year, many older Americans are physically injured, psychologically debilitated, financially exploited, or neglected by family members. Much of this abuse and neglect constitutes criminal offenses. Because much of it is perpetrated by spouses, it also must be viewed in the context of domestic violence. Elderly men and women, whether or [...]
THE OLDER DRIVER Safe driving involves the integration of complex motor, visual, and cognitive activities. A single traffic movement results from many decisions and reactions to myriad visual (and often auditory) stimuli. In the USA, more than 13% of drivers are over age 65. Despite moderate deterioration of mental, motor, optic, and auditory functions, the [...]
With age, many functions that affect driving ability may deteriorate, including muscle strength, reaction time, mobility, vision, and cognition (see TABLE 112-1). Muscle Strength and Reaction Time Decreased muscle strength, particularly decreased grip strength, can pose a problem. Dynamometric values of < 35 lb in the dominant hand should raise concern. An increased reaction time [...]
Functional assessment is usually considered more relevant than a medical diagnosis in determining a person’s fitness to drive. Nonethe-less, some conditions—such as coronary artery disease, neurologic disease, and diabetes mellitus—as well as the use of certain medications warrant special consideration Coronary Artery Disease Although the incidence of sudden cardiac events while driving accounts for < [...]
