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October 25, 2006

NCEA

The Source of Information and Assistance on Elder Abuse


Clearinghouse on Abuse and Neglect of the Elderly (CANE)
Selected Annotated Bibliography:


Identifying Elder Abuse: Tools, Techniques and Guidelines for Screening and Assessment

Back to References 1-53

54. N4552-5
Dyer, C. & Goins, A.
The Role of the Interdisciplinary Geriatric Assessment in Addressing Self-Neglect of the Elderly
Generations; Vol. 24, 23-27; Summer 2000.
Journal article (scholarship)
In order to address the apparent relationship between medical conditions and risk factors for elder mistreatment, particularly self-neglect, Baylor College of Medicine Geriatrics Program collaborated with the Texas Department of Protective and Regulatory Services in 1997 to form the Texas Elder Abuse Mistreatment Institute (TEAM). This article describes the role of the interdisciplinary geriatrics assessment team, comprised of physicians, nurses, social workers and other health professionals who provide an integrated approach to prevention, identification and intervention in elder abuse, neglect and self-neglect. (This article is part of a special edition of Generations dedicated to the recognition of the problem of elder abuse.)

55. J4116-8
Fulmer, T., Paveza, G., Abraham, I. & Fairchild, S.
Elder Neglect Assessment in the Emergency Department
Journal of Emergency Nursing; Vol. 26 (5), 436-443; October 2000.
Journal article (research)
This article reports on a pilot study in a Florida hospital that was designed to explore the feasibility of having emergency room nurses screening elderly patients for neglect. Five nurses were trained by the Neglect Assessment Team (NAT) in the use of the Elder Assessment Instrument (EAI) and the Diagnostic and Treatment Guidelines for Elder Abuse and Neglect. During a three-week period, 36 (or 180 admitted) emergency room patients aged 70 and over met the criteria for the study and were screened with the EAI protocol, and then evaluated by the NAT. Seven patients were assessed as positive for neglect, and the nurses were able to assess with approximately 70 percent accuracy. The findings of the pilot study support the plan for future proposed research. A copy of the EAI is included.

56. K4282-7
Marshall, C., Benton, D. & Brazier, J.
Elder Abuse: Using Clinical Tools to Identify Clues of Mistreatment
Geriatrics; Vol. 55 (2), 42-53; February 2000.
Journal article (scholarship)
This article serves as a detailed guide for primary care clinicians in identifying clues of elder mistreatment. Prevalent causes, types, and physical and psychosocial manifestations of elder abuse are discussed. A chart is included detailing potential abuse indicators linked to specific physical systems examinations.

57. J3912-6
Moody, L., Voss, A. & Lengacher, C.
Assessing Abuse Among the Elderly Living in Public Housing
Journal of Nursing Measurement; Vol. 8 (1), 61-70; 2000.
Journal article (research)
This study assessed the construct validity and other psychometric properties of the Hwalek-Sengstock Elder Abuse Screening Test (HSEAST) for use in identifying elder abuse among public housing populations. The sample consisted of 100 elders (49 percent White, 34 percent Hispanic, and 33 percent African American) residing in a public housing high-rise in a southwest Florida city. The factor analysis supported the construct validity of the instrument, and suggests that it may measure more than one dimension of abuse. The results of this analysis are compared with results from earlier research.

58. N4748-10
Nahmiash, D. & Reis, M.
Most Successful Intervention Strategies for Abused Older Adults
Journal of Elder Abuse & Neglect; Vol. 12 (3/4), 53-70; 2000.
Journal article (research)
This article reports on an evaluation of intervention strategies of the multidisciplinary team approach of Project CARE. Located in Montreal, the project utilizes a five element intervention model based upon the Empowerment Theory. In this study, 83 cases involving abuse by a caregiver are analyzed. A total of 473 intervention strategies are categorized and evaluated for acceptance and successfulness by a multidisciplinary health and social service team. Results indicate that the most successful intervention strategy was medical/nursing assistance for victims, and the second most successful strategy was supportive service for caregivers, including individual supportive counseling and family counseling. In particular, individual strategies were rated more successful than group interventions. Detailed descriptions of the model and various screening tools (the Brief Abuse Screen for the Elderly/BASE; the Indicators of Abuse/IOA; the Abuse Intervention Description Form Example/AID) are also included.

59. P5939-3
Walsh, K. & Bennett, G.
Pressure Ulcers as Indicators of Neglect
Nursing & Residential Care; Vol. 2 (11), 536-538; November 2000.
Journal article (scholarship)
This article provides an overview of the topic of pressure ulcers, which can be indicators of elder abuse and neglect in institutional care facilities. Poor standards in assessment and prevention, inadequate documentation, and inadequate staffing and training are among the contributing factors. The authors indicate that most pressure ulcers can be prevented through careful assessment and the use of appropriate support surfaces.

60. P5936-8
White, S.
Elder Abuse: Critical Care Nurse Role in Detection
Critical Care Nursing Quarterly; Vol. 23 (2), 20-25; August 2000.
Journal article (scholarship)
Nurses in critical care units have a responsibility to identify signs and symptoms of elder abuse, which can be caused by physical harm as a result of traumatic injuries or neglect, psychological threats or intimidation, and financial exploitation. Forensic nurses are encouraged to develop protocols to evaluate potential abuse when elderly patients are admitted through emergency departments. The article includes a list of potential indicators of physical and psychological abuse and neglect, as well as material or financial exploitation.

61. E2746-4
Wolf, R.
Risk Assessment Instruments
National Center on Elder Abuse Newsletter; Vol. 3 (1); September 2000.
Newsletter article (online)
This article discusses various risk assessment tools, including screening instruments used to assess future risk of abuse. Some of the instruments described include the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST), the Indicators of Abuse Screen, and approaches used by the Illinois and Colorado Adult Protective Services. (Note: This article is available online through the NCEA Web site at http://www.elderabusecenter.org/default.cfm?p=riskassessment.cfm)

62. C2034-9
Young, M. (Benton, D., Phillips, C., Wayne M., consultants)
Recognizing the Signs of Elder Abuse
Patient Care; p56-p76; October 2000.
Journal article (scholarship)
Observing that the elder abuse victim is generally isolated and dependent upon the abuser/caregiver, this article focuses on the vital role that the primary care physician plays in identification, intervention and possible prevention of elder abuse. The article emphasizes the need for the primary care physician to observe signs and symptoms of depression, burnout, etc. in the caregiver as well as the patient. In addition, it provides profiles of victims and abusers, the Suspected Abuse tool, discussion regarding intentional and unintentional abuse/neglect, and various state legal codes.


1999


63. P5954-5
Comijs, H., Jonker, C., van Tilburg, W. & Smit, J.
Hostility and Coping Capacity as Risk Factors of Elder Mistreatment
Social Psychiatry and Psychiatric Epidemiology; Vol. 34 (1), 48-52; 1999.
Journal article (research)
This control group study considers whether particular personality traits, coping capacity and hostility, are risk factors for elder abuse and neglect. Participants previously involved in the Amsterdam Study of the Elderly (AMSTEL) who had reported being victimized were grouped according to type of elder mistreatment: chronic verbal aggression (n=37); physical aggression (n=38); and financial exploitation (n=55). Standardized interviews were conducted and instruments were administered to assess coping style, locus of control, perceived self-efficacy, and hostility. Findings suggest that an external locus of control (having less control over problem situations) and greater levels of hostility were associated with verbal abuse. Passive and avoidant coping methods appeared to be risk factors for physical abuse. Financial abuse was also associated with passive coping styles and with having negative beliefs about self-efficacy.

64. K4275-2
Gray-Vickrey, P.
Recognizing Elder Abuse
Nursing99; Vol. 29 (9), 52-53; 1999.
Journal article (scholarship, online)
This article provides a succinct overview for nurses that offers guidelines for recognizing, documenting, and reporting suspected cases of elder abuse. Detailed recommendations for photo documentation are provided. (Note: This article, without photos, can be accessed online at: http://www.findarticles.com/p/articles/mi_qa3689/is_199909/ai_n8871345#continue )

65. K4265-14
Greenberg, S., Ramsey, G., Mitty, E., & Fulmer, T.
Elder Mistreatment: Case Law and Ethical Issues in Assessment, Reporting and Management
Journal of Nursing Law; Vol. 6 (3), 7-20; 1999.
Journal article (scholarship)
This article provides an overview of elder mistreatment. Clinical practice guidelines for the assessment and prevention of elder mistreatment are identified. In order to illustrate how legislatures and courts have tried to address elder mistreatment, two case studies are presented dealing with both institutional and community based abuse. Lastly, intervention strategies are discussed.

66. L4525-7
Swagerty, D., Takahashi, P. & Evans, J.
Elder Mistreatment
American Family Physician; Vol. 59 (10); May 15, 1999.
Journal article (scholarship, online)
This article provides an overview of elder abuse identification by the physician. Guidelines for a comprehensive physical assessment include taking a detailed, systematic history using specific questions that also address the emotional and social well-being of the patient. Recommendations for effective documentation and reporting procedures are offered. (Note: This article is available online only at http://www.aafp.org/afp/990515ap/2804.html)

67. K4269-6
Utley, R.
Screening and Intervention in Elder Abuse
Home Care Provider; Vol. 4 (5), 198-203; October 1999.
Journal article (scholarship)
This article discusses guidelines for screening and intervention that can be used by home care health providers to enable them to recognize potential and actual signs of elder abuse. Topics covered include recognizing abuse, risk profiles of elders and their abusers, assessing the relationship between the elder and the abuser, physical and psychological signs of abuse, interventions for the abused, and interventions for the abuser. A continuing education test for home care providers is provided.

1998

68. P5709-00
Blow, F., for the Public Health Service, Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS)
Substance Abuse Among Older Adults Treatment Improvement Protocol (TIP) Series 26
Public Health Service, Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS)Rockville, MD; 1998.
Agency report
This Treatment Improvement Protocol (TIP) presents a literature review of the topic of substance abuse and gerontology. It also provides information on best practices for health care professionals in screening, intervention and referral. Among the topics discussed are abuse of alcohol, abuse and misuse of psychoactive drugs and over-the-counter products, and legal and ethical considerations. Appendices include a review of assessment tools available, including the AUDIT, the Index of Independence in Activities of Daily Living, the Instrumental Activities of Daily Living (IADL) Scale, Geriatric Depression Scale (GDS) Short Form, The Center for Epidemiologic Studies Depression Scale (CES-D), and the Health Screening Survey (HSS), Revised. (Note: This publication is accessible online at http://ncadi.samhsa.gov/govpubs/BKD250/default.aspx.)

69. E2628-7
Koval, K.
Elder Abuse
Archives of the American Academy of Orthopaedic Surgeons; Vol. 2 (1), 45-51; Winter 1998.
Journal article (scholarship)
Written by an orthopedic surgeon, this article presents a case study to demonstrate how physicians should monitor for the signs and symptoms of elder abuse. Definitions, risk factors, interviewing techniques, evaluation (including the use of radiology, toxicological screening and other tests), documentation and reporting are among the topics specifically addressed.

70. A44-10
Reis, M. & Nahmiash, D.
Validation of the Indicators of Abuse (IOA) Screen
The Gerontologist; Vol. 38 (4), 471-480; 1998.
Journal article (research)
Part of the research initiative entitled PROJECT CARE, supported by Health Canada, this study analyzed the validity of the Indicators of Abuse (IOA) screening measure, which was designed to be administered by practitioners. Based upon data from 341 agency case reviews, the research supports the validity of 29 abuse indicators. Results also suggest the following are primary indicators of abuse: marital and family conflict; caregiver mental and/or behavioral problems; and history of victimization.

1997

71. A78-7
Baladerian, N.
Recognizing Abuse and Neglect in People with Severe Cognitive and/or Communication Impairments
Journal of Elder Abuse & Neglect; Vol. 9 (2), 93-104; 1997.
Journal article (scholarship)
As quoted from the abstract: "...This article notes the lack of information about protective services directed to the developmentally disabled population and lack of coordination between agencies serving people with developmental disabilities and those providing protective services..." Topics addressed include the signs and symptoms of abuse among the developmentally disabled (particularly the observation of behavioral changes), alternative communication issues (including a discussion of Facilitated Communication), and federal, state and regional policy recommendations (such as the inclusion of elder and dependent adults in research and demonstration projects, and training for work with developmentally disabled clients).

1995

72. P5703-14
Ramsey-Klawsnik, H.
Investigating Suspected Elder Maltreatment
Journal of Elder Abuse and Neglect; Vol. 7 (1), 41-67; 1995.
Journal article (scholarship)
In this article, the author provides guidelines for investigation of various types of suspected elder abuse. The urgency of the situation must first be assessed to determine whether an emergency screening is warranted. Background information is obtained by interviewing the referral source, reviewing any relevant records, interviewing collaterals (professionals or paraprofessionals who are, or were, involved with the victim), interviewing informants, and interviewing family members. In interviewing the suspected victim, investigators are instructed to provide respect, privacy, and consideration for special needs (such as communication impairment). Interviews with suspected abusers should occur after interviews with the victims, and investigators must use discretion as to when and how to notify them of allegations. The importance of detailed and accurate documentation is emphasized.

73. L4385-9
Reis, M. & Nahmiash, D.
Validation of the Caregiver Abuse Screen (CASE)
Canadian Journal on Aging; Vol. 14 (Suppl. 2), 45-60; 1995.
Journal article (research)
This article presents validation research for the Caregiver Abuse Screen (CASE), an eight-item scale for detecting elder abuse in community caregiving populations. Forty-four abusing caregivers and forty-five non-abusing caregivers completed the scales utilized in the validation process. Significant correlations between the CASE and other measures used provide support for the content validity of this scale. The CASE appears to adequately discriminate between abusive and non-abusive caregivers.

Back to References 1-53

For information on reference materials regarding this topic published earlier than 1995, please visit the CANE online database at

http://db.rdms.udel.edu:8080/CANE .


National Center on Elder Abuse
1201 15th Street, N.W., Suite 350 · Washington, DC 20005-2842
(202) 898-2586 · Fax: (202) 898-2583 · Email: [email protected]
http://www.elderabusecenter.org/