The portrayal of elder abuse in the national media

Over the last two decades, researchers and policy makers have begun to devote more attention to the problem of elder abuse. Still, compared to studies on other types of family violence, research on elder abuse is scarce. To better understand how elder abuse is portrayed in the media and using “newsmaking criminology” as a theoretical framework, this study considers how 11 newspapers describe the phenomenon. In all, 530 articles about elder abuse were content analyzed using standard rules of content analysis. Results suggest that certain types of elder abuse are excluded from the press. In addition, the press tends to define elder abuse as a crime, but not as a domestic violence offense. Implications are provided.     

Public definitions and endorsement of the criminalization of elder abuse

A longitudinal cross sectional ten-year study was conducted measuring public attitudes toward the definition and criminalization of elder abuse. The study found that the public endorsed a fairly broad definition of elder abuse and that this definition of elder abuse was fairly stable over time. Subjects also strongly endorsed the creation of misdemeanor and felony statutes and strongly endorsed the use of prison to punish elder abusers. The subjects also believed that the criminalization of elder abuse would be effective in reducing elder abuse.     

An integrated understanding of elder abuse and neglect

In the past three decades, society has developed interest in what has come to be called elder abuse. Since interest initially appeared, concern about elder abuse has gone through different cycles regarding the conceptualization of the problem, appropriate responses, and explanations. A recent trend has witnessed a call for an interdisciplinary and integrated understanding of, and response to, elder abuse. This article describes what is meant by an integrated response to elder abuse. Ways to promote a broader response to the problem are suggested.     

Analysis of legal cases for prevention of elder abuse: decisions from New Zealand

Elder abuse is a universal concern and is gaining greater public and professional attention. This increased concern to protect elders is internationally evident in policy reform, multidisciplinary research and education. Yet neglect in care settings continues. This research responds by contributing to the international effort to promote humane care for elders who are in a position of dependence, particularly in residential facilities. The legal cases that result from some complaints by aggrieved elders and their advocates may offer insights that are relevant for prevention. While the law is often viewed merely as a system of control, it may also be a resource for learning, particularly in the context of abuse prevention. Although the analysis references New Zealand law, the discussion may have broader application by indicating factors that precede, or trigger, unacceptable conduct. By understanding what went wrong and why, we may decrease the likelihood of future incidents. Also, understanding the legal ramifications may have a deterrent effect. Many advocates and activists have asked how we can ensure that abuses do not recur; some answers may lie within the legal cases themselves. How may recent legal cases be used to prevent mistreatment of elders in residential facilities? This question is applied to select decisions of New Zealand's Health and Disability Commissioner, Human Rights Review Tribunal and Health Practitioners Disciplinary Tribunal. While each body has distinct functions, relevant factors identified within the cases may reveal information that is of interest to elderly people and their advocates, caregivers, health educators and professional registration bodies. The research is timely in light of New Zealand's Review of Elder Abuse and Neglect Prevention Services in New Zealand (Department of Child Youth and Family Services, 2004) and New Zealand's Positive Ageing Strategy (Office of Senior Citizens, 2001). This article incorporates current debates regarding the use and analysis of legal cases and suggests that such analyses offer learning opportunities.     

Knowledge of spouse abuse in the community: A comparison across locations

Of concern to many who study criminality of all kinds is the high level of known abuse in a climate of noninvolvement by others. The research reported in this paper clearly indicates that noninvolvement in spousal assault cases is not dependent on low levels of knowledge of the problem, as many people admit to being aware of its occurrence among relatives, friends, and neighbors. This knowledge does vary, however, by location of the respondents with strong effects of nonmetropolitan residents expressing greater knowledge of the occurrence of this violence than people living in urban areas. We find this in the context of lower levels of self-reported victimization. It could be that these lower levels reflect a reluctance on the part of nonmetropolitan women to admit to researchers that they are victims of this problem. Or, it could suggest that these women have access to a more intricate network of support from friends and family who become involved in discussing this problem with the victims and helping them to reduce its incidence.     

Clinical case management: a strategy to coordinate detection, reporting, and prosecution of elder abuse

Despite civil and criminal sanctions, elder abuse is a prevalent, underreported, and underprosecuted event in the United States. Traditional reporting legislation and common law remedies have had minimal effect on the incidence and prevalence of elder abuse. The epidemic nature of elder abuse is projected to increase exponentially as the elderly population grows disproportionately over the next several decades. The fragmented system of detecting, reporting, and prosecuting this abuse across a wide range of medical and legal settings creates a poor structure to effectively allow a potentially abused patient to have his/her abuse circumstance communicated to the relevant parties to protect the patient, have his/her situation reported and investigated, and, if necessary, have the perpetrator brought to justice. Emergency rooms and other facilities where elders present for care should be staffed by clinically trained persons who have familiarity interacting with patients and providers across settings of care, and who are trained to detect and report abuse. Nursing case managers fill this role well because they are able to coordinate efforts among acute and long-term care facilities while also being able to supply patients with legal and clinical information about elder abuse. In addition they may support prosecution efforts through their clinical observations and expertise. Hence, clinical case managers are able to coordinate efforts lacking in the current system to effectively evaluate, report, protect, and arrange for relevant services for the patient. Through clinical and special training in elder abuse, nursing case managers can provide support to prosecution efforts against the perpetrators of this most egregious crime.     

The impact of juror characteristics and victim health status on the perception of elder physical abuse

An experiment investigated mock juror perceptions of elder abuse using a community sample from Lexington, Kentucky. Two-hundred six men and women ranging in age from 18 to 88 read a fictional criminal trial summary of a case of elder physical abuse (EPA) in which the accuser was described as healthy, frail, or confused. In addition, the influence of participant age, participant gender, and attitude toward the elderly on juror perceptions of EPA was also investigated. Results showed that women had higher conviction rates than did men. Accuser health status, participant age, participant gender, and attitude toward the elderly affected other rating variables including accuser believability, accuser inaccuracy, defendant believability, and verdict confidence. Results suggest implications for how EPA cases are perceived in court.     

Dimensions of Censorship: Reconceptualizing Public Willingness to Censor

First Amendment scholars and advocates have often criticized the American public's inconsistent dedication to free expression. Many studies have attempted to identify variables that predict pro-censorship attitudes, but such relationships remain largely enigmatic. The confusion is due, in part, to the myriad ways in which censorship attitudes have been conceptually and operationally defined. Informed by First Amendment theory and case law, a conceptual and operational approach to measuring these attitudes is proposed and tested. The results show it is important to conceptualize censorship attitudes as multifaceted.     

A media campaign prevention program for child sexual abuse: community members' perspectives

This study examines the face validity and feasibility of materials included in a multimedia child sexual abuse (CSA) prevention campaign. A quantitative survey method assessed participants' comfort level, knowledge gain, and likelihood of behavioral change in response to the media campaign. Furthermore, a focus group method explored participants' attitudes and opinions regarding the campaign and the unique effects of ethnic or cultural norms on participants' acceptance of the media materials. Six groups, established based on participant ethnicity (i.e., three Caucasian groups, two African American groups, one Hispanic group), met at two sites in the Charleston, South Carolina, area. Quantitative data suggest that participants reported increased CSA knowledge and low levels of discomfort or anxiety related to exposure to the materials. Focus group results suggest that study participants, regardless of ethnic background, agreed that the media campaign can have a positive impact on public knowledge of CSA. Implications and directions for future research are discussed.     

Prevalence and correlates of elder mistreatment in South Carolina: the South Carolina elder mistreatment study

The purposes of this study were to (a) derive prevalence estimates for elder mistreatment (emotional, physical, sexual, neglectful, and financial mistreatment of older adults [age 60 +]) in a randomly selected sample of South Carolinians; (b) examine correlates (i.e., potential risk factors) of mistreatment; and (c) examine incident characteristics of mistreatment events. Random Digit Dialing (RDD) was used to derive a representative sample in terms of age and gender; computer-assisted telephone interviewing was used to standardize collection of demographic, correlate, and mistreatment data. Prevalence estimates and mistreatment correlates were obtained and subjected to logistic regression. A total of 902 participants provided data. Prevalence for mistreatment types (since age 60) were 12.9% emotional, 2.1% physical, 0.3% sexual, 5.4% potential neglect, and 6.6% financial exploitation by family member. The most consistent correlates of mistreatment across abuse types were low social support and needing assistance with daily living activities. One in 10 participants reported either emotional, physical, sexual, or neglectful mistreatment within the past year, and 2 in 10 reported mistreatment since age 60. Across categories, the most consistent correlate of mistreatment was low social support, representing an area toward which preventive intervention may be directed with significant public health implications.     

Health care programs: fraud and abuse; technical revision to the scope and effect of the OIG exclusion regulations--HHS. Final rule

This document sets forth a technical revision to OIG regulations on program integrity for Medicare and State Health Care programs, concerning the scope and effect of the OIG's program exclusion regulations. Prior to this revision, the regulations provided that a program exclusion imposed under title XI of the Social Security Act was to affect future participation in all Federal non-procurement programs. This revision specifically amends the language in the existing regulations to clarify that the scope of an exclusion is now applicable to all Executive Branch procurement and non-procurement programs and activities. This rule is consistent with the Federal Acquisition Streamlining Act, and the Department's Common Rule on debarment and suspension which is also being amended and published elsewhere in this issue of the Federal Register.     

Children and young people accused of child sexual abuse: A study within a community

This paper reports on a study of 227 children and young people, all living in a West Midlands city in the UK, who between November 1993 and December 1999 were accused of having sexually abused a child. The study had two main objectives: first to examine the alleged behaviours, family backgrounds and personal characteristics of the young people; and second to discover what factors, if any, may be associated with recidivism later in adulthood. It is still too early to draw firm conclusions regarding recidivism, because half of the sample has not yet reached adulthood. However, preliminary findings contradict the notion that many young people who display sexually abusive behaviour will grow into adult sex offenders.     

Child abuse and chronic pain in a community survey of women

This study examined the relationship between a self-reported history of child physical and sexual abuse and chronic pain among women (N = 3,381) in a provincewide community sample. Chronic pain was significantly associated with physical abuse, education, and age of the respondents and was unrelated to child sexual abuse alone or in combination with physical abuse, mental disorder (anxiety, depression, or substance abuse), or low income. Number of health problems and mental health disorders did not mediate the relationship between physical abuse and chronic pain. Despite considerable evidence from the clinical literature linking exposure to child maltreatment and chronic pain in adulthood, this may well be the first population-based study to investigate this relationship for child physical and sexual abuse independently. The significant association between childhood history of physical abuse and pain in adulthood calls for a greater awareness of the potential for chronic pain problems associated with this type of maltreatment. Further research is needed to understand the mechanism for this complex relationship.     

Pellagra: a rare disease observed in a victim of mental and physical abuse

Lesions of the brain stem and cerebellum due to nutritional deficiencies are mostly seen in chronic alcohol abuse and more rarely in severe malnutrition. We report the case of a 27-year-old woman, found dead in the family flat. She presented cachexia (167 cm, 25 kg) and multiple hematomas of the limbs. Postmortem examination revealed lesions due to peritonitis. Neuropathological examination showed severe atrophy of the corpus callosum and central neuronal chromatolysis, which are observed in pellagra. Inflammatory colitis or celiac disease was not found. Toxicological analysis was negative, in particular no alcohol absorption. Pellagra, which is due to nicotinamide deficiency, is a disease rarely seen in this country. In this case, nutritional deficiency was the consequence of failure to eat in a context of abuse. The woman was born of an incestuous relationship and presented intellectual retardation due to poor affective relations with her mother.