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A scoping review of outcomes in elder abuse intervention research: the current landscape and where to go next
- Authors:
- BURNES David, et al
- Journal article citation:
- Aggression and Violent Behavior, 57, 2021, p.101476.
- Publisher:
- Elsevier
Researchers, practitioners, and policy-makers worldwide recognize elder abuse (EA) as a major threat to the health and well-being of older adults, but rigorous intervention research has greatly lagged behind this interest. A major weakness is the lack of cohesive understanding of appropriate program outcomes to be measured. To address this knowledge gap, we conducted a scoping review of the EA intervention research literature to understand the range of outcomes considered to date and to provide guidance for future research. We searched Ovid MEDLINE, Ovid Embase, Ovid PsycInfo, Ovid Social Work Abstracts, Ebsco AgeLine, Ebsco CINAHL, Wiley Cochrane Central, and Proquest Sociological Abstracts for studies evaluating community-based EA response programs. Two independent reviewers completed record search, screening, and data extraction procedures. We identified 52 eligible studies (1986–2019) that employed a total of 184 outcomes (range: 1–16, mean = 3.5). This study revealed that a large range of outcomes has been employed in EA intervention studies to date, mostly attached to victims or the intervention process itself, with inconsistent operational definitions and measurement procedures. Several key recommendations for future EA intervention research are: 1) implementing intervention outcomes that reflect multiple levels of eco-systemic influence, 2) heightening the analysis of intervention process outcomes beyond description toward modeling them as factors that mediate or moderate successful case outcomes, 3) conducting qualitative research with EA victims and other relevant stakeholders to understand meaningful intervention outcomes from their perspectives, and 4) establishing common EA outcome measures for implementation across studies to facilitate greater data pooling and synthesis. (Edited publisher abstract)
Utilization of formal support services for elder abuse: do informal supporters make a difference?
- Authors:
- BURNES David, et al
- Journal article citation:
- Gerontologist, 59(4), 2019, pp.619-624.
- Publisher:
- Oxford University Press
Background and Objectives: Few elder abuse (EA) victims ever seek or receive assistance from formal support services designed to mitigate risk and harm of revictimization. This study examined whether the presence of third-party “concerned persons” in victims’ personal social networks plays a role in enabling formal support service utilization. Research Design and Methods: A representative population-based survey administered to adults (n = 800) in New York State identified 83 EA cases from the past year. Penalized likelihood logistic regression was used to examine the relationship between availability of a concerned person and victim formal support services usage. Results: EA victims who had a concerned person in their personal life were significantly more likely to use formal EA support services than victims without a concerned person. EA victims who lived with their perpetrator were significantly less likely to use formal services. Discussion and Implications: Third-party concerned persons represent a critical population to target in efforts designed to promote EA victim help-seeking. (Edited publisher abstract)
Elder abuse severity: a critical but understudied dimension of victimization for clinicians and researchers
- Authors:
- BURNES David, PILLEMER Karl, LACHS Mark S.
- Journal article citation:
- Gerontologist, 57(4), 2017, pp.745-756.
- Publisher:
- Oxford University Press
Purpose of the Study: To describe the variation in severity of elder emotional abuse, physical abuse, and neglect and identify factors associated with more severe forms of elder mistreatment (EM). Design and Methods: Population-based study using random digit-dial sampling and telephone interviews with a representative sample (n = 4,156) of community-dwelling, cognitively intact older adults in New York State. The Conflict Tactics Scale and DUKE Older Americans Resources and Services scales were adapted to assess EM subtypes. For each EM subtype, severity was operationalized by summing the number of different mistreatment behaviours and the frequency of each behaviour. Among older adults reporting some degree of mistreatment, ordinal or multinomial regression predicted severity of elder emotional abuse, physical abuse, and neglect. Results: Distribution of EM severity was characterised by a negative/right skew. More severe emotional abuse was predicted by younger age, living with the perpetrator only, Hispanic background, and higher education. Increasing physical abuse severity was associated with younger age and living only with the perpetrator. Higher neglect severity was associated with functional impairment, younger age, living only with the perpetrator, lower income, and lower education. The presence of nonperpetrator others living in the home served a protective function against escalating mistreatment severity. Implications: Extends existing EM risk factor research by operationalising mistreatment phenomena along a continuum of severity. Findings enhance capacity to screen and report particularly vulnerable EM victims and inform targeted interventions to ameliorate the problem. Incorporation of severity into EM research/measurement reflects the clinical and phenomenological reality of the problem. (Edited publisher abstract)
Community elder mistreatment intervention with capable older adults: toward a conceptual practice model
- Author:
- BURNES David
- Journal article citation:
- Gerontologist, 57(3), 2017, pp.409-416.
- Publisher:
- Oxford University Press
Community-based elder mistreatment response programs (EMRP), such as adult protective services, that are responsible for directly addressing elder abuse and neglect are under increasing pressure with greater reporting/referrals nationwide. Our knowledge and understanding of effective response interventions represents a major gap in the EM literature. At the center of this gap is a lack of theory or conceptual models to help guide EMRP research and practice. This article develops a conceptual practice model for community-based EMRPs that work directly with cognitively intact EM victims. Anchored by core EMRP values of voluntariness, self-determination, and least restrictive path, the practice model is guided by an overarching postmodern, constructivist, eco-systemic practice paradigm that accepts multiple, individually constructed mistreatment realities and solutions. Harm-reduction, client-centred, and multidisciplinary practice models are described toward a common EMRP goal to reduce the risk of continued mistreatment. Finally, the model focuses on client–practitioner relationship-oriented practice skills such as engagement and therapeutic alliance to elicit individual mistreatment realities and client-centered solutions. The practice model helps fill a conceptual gap in the EM intervention literature and carries implications for EMRP training, research, and practice. (Edited publisher abstract)