INTRODUCTION:

Considering human right age is not issue, young and old all are entitled to be treated as full members of our communities. However, elder abuse is a challenge to all nations’ in providing justice for all humankind. Elder abuse is prevalent in our society that impacts society as whole. Indeed, it takes away from our public health, public participation and financial resources. The elderly abuse can take forms that include physical, emotional, and sexual abuse, financial exploitation, and neglect^[1]. It has been learnt that 1 in 10 older people are abused each year though it is difficult to get findings on absolute estimation since majority of cases go unreported for many reasons. Indeed reporting about the abuses makes easier to develop social supports and patterning interventions.

Reporting elder abuse, aging and related neglects to the services available can pave a way to further investigations in this area to battle against this social malaise. It has been learnt through literature ensuring a reality through reporting signs of elderly abuse to an Adult Protective Services agency that can investigate potentially abusive situations. Every individual in the social system deserve to be treated justly and as full members of our communities.^[2]

Current study aims at eliciting patterns that will aid in detection of these social malaises.

MATERIAL AND METHODS:

This review study was completed using electronic databases that had analyzed reviewing 100 articles. This review study used articles from 1985 to 2015 that was suitable for tracking reviews that gives information on physical and emotional abuse in elderly from case-control studies, cross-sectional studies, and case series or in medico legal reports were. A review of 63 articles from a total of 100 articles screened draw together different aspects of the physical abuse and emotional abuse.

FINDINGS AND DISCUSSIONS:

Physical and Emotional Abuse Signs and Symptoms: Findings of physical and emotional abuse in elderly increases consciousness regarding health in elderly. The most commonly documented physical impacts of elder abuse include welts, wounds, and injuries; persistent physical pain and soreness; nutrition and hydration issues^[3]. Emotional abuse is defined as “any act including confinement, isolation, verbal assault, humiliation, intimidation and infantilization any such treatment which may diminish the sense of identity, dignity, and self-worth."^[4] Otherwise it is also known as psychological abuse. People who suffer from emotional abuse tend to have very low self-esteem; show personality changes and may even become depressed, anxious or suicidal^[4].

Physical abuse is defined as "the bodily injury, pain, or impairment that is the results of use force or assault that is non-accidental. This includes being slapped, burned, cut and bruised though it’s not limited to only these aspects. It can happen to adults of any age. Neglect is also an aspect of physical abuse in elderly has been considered as type of abuse^[5]. Physical and emotional abuses as an impact on physical and mental health thus need public health focus. In fact, it's rare to find physical abuse without the presence of emotional abuse. Though it is not reported physical and emotional abuse occur together frequently. One of the past literature revels when the physical abuser cannot physically abuse the victim, such as in public, they can emotionally abuse them.^[5]

Emotional and mental abuse is as harmful as physical abuse. Emotional abuse in individuals leads to feeling low self-worth and feel dependent. Emotional abuse symptoms vary but can invade any part of a person's life. ^[6] Signs of emotional abuse include: shouting, insulting, mocking, threatening, bullying, ignoring, isolating, and humiliating someone in such a way that a person get distressed and disturbs his emotional wellbeing^[6]. Emotional abuse tends to take the form of a cycle that starts when one partner emotionally abuses the other, typically to show dominance. The abuser then feels guilt, but not about what he/she has done, but more over the consequences of his actions and also avoid taking responsibility over what has happened.^[6]

Table 1: Shows examples of emotional abuse

Instances of Emotional Abuse

Ignoring abuse

Being fraudulent

Threats of violence

Belittling a person

Threats of abandonment

Unreasonably criticizing

Insulting individuals often

Socially isolating an individual

Making person to feel insecure

Withholding important information

Frightening persons with Intention

Remarking person troublesome or burden

Intentionally misreading actions of person

Unreasonably ordering person and inducing distress

An individual like a servant making them feel inferior

In another study with regard to emotional abuse on older Chinese indicated that 27.5 percent of the Chinese subjects from Taiwan 195 older adults mixed group of institutionalized and community-dwelling score high on Psychological Elder Abuse Scale^[7]. Adding on to the fact, the past literature found out distressing behaviors such as unfulfilled wishes to see relatives in 62.6 percent, economic dependence in 61 percent, and social isolation in 44.1 percent among 6.32 percent psychologically abused participants^[8]. Observation found that range of 20-80 participants indicating their involvement in abusive behaviors. ^[7] Physical and emotional abuse go hand in hand spelt in one of the literature that it is like a relationship in marriage that can leave a person in fear throughout their life, yet too scared to leave the relationship^[6].

Findings Related to Physical Abuse:

The prevention efforts made all over world though the benefits are not up to the remark. Past literature had shown prevention of elder abuse has formed international body and the world health organization is also involved in the management of this public health issue.For the understanding the elder abuse has defined as ‘‘a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person’’^[9].

Further on observation of reviews analyzed 5 types of abuse that had clinically and legally recognized they are neglect, emotional, physical, financial and sexual abuse. Elder abuse is more common in United States with prevalence rate of 17.1 percent in 2008 when physical abuse in same population was 1.6 percent.^[10]

It has been observed that public awareness of the problem is less regarding elder abuse thus increase in reported incidences is not clear with its accuracy. The realization drawn with the fact that physical abuse is most often carried out by caregivers who are offspring, partners, or other relatives but in Canada the majority of elders well in the community are 93 percent. ^[11]In Canadian statistics had depicted that 7900 incidences of elder abuse were reported to police in 2009, an increase of 14 percent from 2004. The rate of elder abuse is expected to increase in many Asian countries at an unprecedented pace. ^[11]

In the series of researches that were carried on extensively in elderly abuse in Asian populations, especially Chinese, Indian, Japanese, Korean, and Singaporean were informative with regard to elder abuse. Special attention was focused in the studies on reflections of unique cultural aspects in Asian countries relevant to the understanding of elderly abuse. ^[12]

Prevalence of Physical and Emotional Elder Abuse Over the Globe:

The growing rate in elder abuse like social malaise has been researched over the globe. Although its awareness with consequences need to be well conceptualized. Indeed, it’s also significant to bringing into consciousness of pervasiveness of physical and emotional abuse in elderly by previous researches. Thus the current study had made an effort to analyze the facts demonstrated in the previous literatures.

Physical or emotional abuse of elderly people by family members or others, in their real homes or aged care homes is one of the growing public health concerns, since there is an increasing numbers of aged people who is more than age sixty^[13]. Observation of the literature on worldwide population of adults 60 years and older found to be growing more rapidly. The current study had observed the prediction made about the rise from 542 million in 1995 to 1.2 billion in 2025. On observation of the past literature, the Canadian populations of senior citizens who are above 60 are expected to comprise 27 percent of by 2025, indeed 14 percent population already encompassed in this category by 2009. ^[14]

The observed statistics in the literature do not necessarily reflect the real picture of elder abuse; indeed this finding has an own significance with regard to public health concern. The current review study observed that physical mistreatment was identified in 27 and psychological mistreatment in 6 among 42 cases reported in the emergency department over a 12-month period. ^[15]

One of the reports observed in the literature analysis of 78 Japanese elders living in an agricultural village, 17.9 percent were reported abuse. Among those 50 percent were found to be abused psychologically that was the most common type where as physical abuse was 21 percent. ^[16]

Current review study has observed the cases reported to social services agencies that give a glimpse on physical and emotional elder abuse in Japan. Here the findings reveal that the 150 elder abuse cases receiving telephone counseling service found with psychological abuse 46 percent and physical abuse 35.3 percent. ^[17]

It has been observed in the literature that representative sample of 15,230 older Koreans residing in Seoul indicated overall prevalence rate of 6.3 percent for elder abuse. Prevalence of emotional abuse was 4.2 percent and the physical abuse was 1.9 percent^[18]. Current review analysis found that prevalence of elder abuse was 13.5 percent among 934 Koreans recovering from stroke. Emotional abuse was the most frequently reported that was 10 percent where as physical abuse was 1.9 percent^[19]. In a sample of 100 older Korean immigrants residing in Los Angeles, psychological abuse was 24 percent and physical abuse was 4 percent^[20].

This study on review analysis indicates that information was reported to the local social welfare department. It was found that 97 Chinese elder abuses reported cases in 1999 came from Hong Kong. Among these cases of elder abuse 35 percent and 28 percent were classified as physical abuse, psychological aggression respectively. ^[21]

Further this study analyses that a large-scale household survey conducted in Shanghai, about 2 million elderly people were found with different forms of abuse in 1986. Among this population 41percent and 24 percent were identified as physical abuse and psychological aggression respectively. ^[22]

While analyzed on research in People’s Republic of China, sampled with 412 elder Chinese who attending an urban medical center in Nanjing, estimated 11.4 and 5.8 percent were found reported as emotional and physical abuse respectively^[23].

The current literature review had observed prevalence rates of elder abuse range from 0.22 per 1,000 to 62 percent estimated across Asia. The reports of older persons or their caregivers as informants have been taken into account to estimate the psychological abuse. The cases reported in the clinical settings of governmental or nongovernmental organizations commonly observed to identified and estimate physical violence. ^[24]

The other study conducted on older Chinese in Hubei reported similar prevalence rates of 36.2 percent with psychological abuse found to be most common than that of demonstrated percentages of mistreatment 27.3, caregiver neglect 15.8, physical abuse 4.9 and financial exploitation 2 percent. ^[21]

To the tiniest one abusive behavior on elderly by the family members or caregivers found to be actualized fact. In the study on older Chinese, it had indicated that 27.5 percent of the older respondents reported having experienced at least one abusive behavior by their family caregiver during the surveyed year. ^[25]

In the reviews analyzed the most common form of abuse found with percentage’s in one of the Chinese survey that were 26.8 verbal abuse, 5.1violation of personal rights and 2.5 physical abuse observed as comparatively rare. These researchers also recruited 122 family caregivers of older persons with dementia from local community centers and found with 62 and 18 percent of the caregivers reported of verbally or physically abused in one month (Yan E, Kwok T., 2010)^[26]. Prevailing rate of elder abuse results in burdening the family ranging from increased health care costs of caring for elders, lesser productivity of family members. ^[27]

Study analysis on Singaporeans done by Cham and Seow (2000) reviewed facts depicted that all cases of non-accidental injuries in older persons presenting to the emergency department of a major hospital had found that 62,826 older patients received care between 1994 and 1997. Seventeen cases of elder abuse were identified yielding a prevalence rate was found to be 0.3 percent. ^[28]

Analyzed facts on reviewed previous literature found that the kind of abuse may vary in rates or its form but it has an impact on both physical and mental health. This fact signifies that this issue is a part of public health concern. As it has been depicted in one of the study findings that elder abuse victims are often more depressed. ^[29]

Observed fact in this review study had attempted have to investigate caregiver reports of abusive behaviors. In a survey of 412 family caregivers of older Japanese who used the visiting nursing services, 34.9 percent reported having engaged in potentially harmful behavior against the older care recipient in the duration of a year (Sasaki et al., 2007). ^[30]

Current literature review actualized that psychological abuse is known to be the most common among the types of elder abuse reported with the incidence rate of 54.1%. It lacks clear evidence since detecting this abuse is difficult. It needs an assessment that is suitable for each of the case^[31].

In one of the reviewed literature observed that most frequently reported behaviors were verbal aggression with 16.8 percent and ignoring was 13.6 percent. In another survey of 123 Japanese caregivers of older persons referred to a memory clinic reported abuse showed 15.4 percent (Kishimoto et al., 2013). ^[32]

Psychological abuse was reported in all cases and two cases involved both physical and psychological abuse. Thefact evidenced in the Japanese study on 4,391, elder abuse revealed that more than half older people personally knew an elder abuse victim (Tsukada et al., 2001). ^[33]

Another observation had revealed that despite the relatively high rates of elder abuse reported in the community, official records of elder abuse depicts lower rate of abuse in Japan. In the reviewed cases by municipal officials 489 elder abused were identified in 2008 basing on the community responses of 917 abused (Nakanishi and colleagues, 2010). ^[34]

Table 2: Shows findings of physical and Emotional abuse in various part of the globe

Universe and Agencies

No of Abuse Reported

EA/PA

Asia (Singapore)

64%

14%

Asia (Japan)

AVS

SSA

150

21%

35 %

50%

46%

Asia (Korea)

RSPS

960

126

11.9%

1.9%

4.2%

10%

US, SKI

100

24%

Asia Survey

(Hong Kong)

35%

28%

Asia (China)

48780

412

41%

5.8%

24%

11.4%

36.2%

US: United State

PA: Physical abuse

SS: Survey Shanghai

RS: Research Sample:

RC:Republic of China

ED: Emergency Department

SSA: Social Services Agencies

SKI: Survey Korean Immigrants

AVS: Agricultural Village Survey

EA/PA: Emotional/Psychological Abuse

RSPS: Representative Sample of Prevalence Study

In the year 2009 Nakanishi and other colleagues estimated elder abuse rate basing new reports of suspected cases over a 6-month period results depicted was 0.35 per 1,000 over the validated cases 0.22 per 1,000. ^[35] This study had analyzed elder abuse adults who had dementias and needed support from the carers.

One of the Korean studies interviewed 481 family caregivers those providing care to older Koreans with dementia. It was found that 16.4 percent were the victims of verbal abuse, 7.5 percent were confounding to the room, 4 percent were unattended, 2.9 percent found with not providing meal and 14.9 percent were hitting by care givers^[36]. Observed findings in the literature in the reported cases of Hubei the prevalence rates in older Chinese study among sample population found with 36 percent psychological abuse and 5 percent is physical abuse^[37].

Findings on Multiple Forms of Abuse:

Elder abuse is a public health issue that needs to be attended holistically having an understanding of multiple forms of abuse and its types, association with each other, consequences and so on. Current study had reviewed the literature and tried to learn multiple forms of abuse in different perspective.

The evidences in the previous literature analyzed among the elder abused, half of them were found to have multiple forms of abuse with a prevalence rate of 14.1 percent in a sample of 400 older Indians. It also prevailed chronic verbal abuse with 10.8 percent, followed by financial and physical abuse that is 5 and 4.3 percent respectively. Further at the other end neglect was found to be least i.e. 4.3 percent^[38].

It has been observed in most of the under developed countries among the elder abuse; neglect and verbal are most common. Reviewed Literature shows the representative household survey of Indian elderly sample population of 300 found with 49 percent neglect from their family members in the surveyed year, neglect and verbal abuse is 39 percent followed by 13 percent of physical abuse^[39].

Observed fact in one of the large-scale studies indicated 24 percent of 5,400 respondents experiencing abuse on daily basis^[40]. Another observed study showed more than half respondents had been continuously abuse for more than 4 years. Among those 44 percent identified disrespect, 30 percent experienced neglect and 26 percent were verbally abused. ^[41]

Examining the observed facts in the Canadian study on multiple abuses in Canada reported the findings on 2,272 older Chinese immigrants residing in Canada were randomly selected in the survey. The report depicted that 2.5 percent experienced multiple types of mistreatment among this sample group. ^[42]

Elder Abuse Commonly Remains Undetected:

Most of the developing countries, elder abuse found to be undetected thus the authenticity of prevalence rate of elder abuse remains questionable. Current study revealed the evidence on survey done in Hong Kong where multiple abuses in elderly remained undetected since the majority unreported. Among the reported 500 respondents 18.6% were found verbally abused that was more than an 11.2% of medical abuse by their careers. ^[43] Indeed, actualizing this fact has its own significance in scheming interventional programme for social melancholy.

Examined studies on elderly abuse ratings remain inaccurate because many people with abuse remain back without reporting. In addition to survey on victimization, there are also efforts has been extended to get findings related to victimization malaise. Current study on literature review found victimization on carers’ proclivity to abuse their elderly family members. The authenticity of these surveys may not go with accuracy because of unreported victimization. However, current literature analysis revealed psychological abuse and physical abuse remained hidden; this study had indicated higher prevalence rate of elder abuse among 355 elderly people depicted verbal abuse 20.8%, physical abuse 2.0%, and social abuse3.9%.^[43]

Current study observations found Republic of China (PRC) had estimated 8,000 cases of elder abuse. These findings may not provide an accurate comparison with the prevalence rates of elder abuse found across Chinese societies due to lack of clarity in their method of data collections. Yet, it is clear that elder abuse in the family does exist in Chinese societies with cultural tolerance; the data on prevalence are less illustrative. In spite of these limitations the Chinese societies in the western countries showed higher prevalence of psychological abuse in elderly.^[44]

Impact of Elder Abuse:

Preventive measures in elder abuse are an important aspect that needs to be focused. In analyzed psychological elder abuse that commonly remains unreported has its own adverse effect on mental health among the victims. Indeed, actualizing this fact has its own significance in scheming interventional programme for this social melancholy. In reviewed analysis one of the studies had revealed that 68% of the interviewed carers admitted in stressful situations; they would engage in at least one of the abusive behaviors against their elderly family members. This study also suggested that carers are more likely to engage in psychological rather than that of physical abuse. (S. M. Chong and Jiang, 2000). The study conducted in Taiwan indicated about 2 million citizens age 60 and above older adults were in the rural centers for the Prevention of Familial Violence and Sexual Aggression. However, 85 cases of elder abuse were also identified in one of its urban cities. Results showed that 2.5% of the interviewed elderly people admitted that their adult children were disrespectful toward them, and 0.4% reported being abused. ^[44]

Current study on review analysis observed the prevalence rates on physical and emotional abuse on Britain were 1.5%.(Bennett and Kingston, 1993). ^[45] Further analysis of reviewed literature found prevalence regarding elder abuse showed 14.3% for physical abuse, 14% for verbal abuse, 20% for financial abuse and 14% for neglect (Pittaway and Westhues,1993). ^[46]

Observing past literature current study findings indicates that prevalence rates vary with different forms of elder abuse. Prevalence of elder abuse in Western countries range from1 to 20 percent. The higher rate of abuse has been identified among elderly people who are sick or require special care. ^[47] Multiple elder abuses observed in Canada findings of this study indicates the prevalence rates of abuse are 1.1 percent for verbal abuse, 0.5% for physical abuse, 2.5% for material abuse, and 0.4% for neglect.^[25]Current study finding indicates basing observed study report the respondents having experienced at least one abusive behavior by their family caregiver has been identified during the surveyed year. ^[48]

Though it has been learnt that multiple abuse is common; observation findings also indicates that verbal abuse has been observed higher rate i.e. 26.8 percent than that of violation of personal rights and physical abuse that is 5.1 and 2.5 percent respectively though it is rare. It has also been observed that sample of 122 family caregivers of older persons with dementia from the local community centers caregivers reported having verbally or physically abused the care recipients. ^[49]

It is a realized that impacts of elder abuse possible in physical as well as psychological dimensions of individuals. Findings on negative impacts of elder abuse obvious observed as bruises, cuts, injuries, malnutrition, rejection showed by family members and poor hygiene care. Populations with elder abuse are distressed; many of them undergo anxiety and depression; some also suffer from feeling of rejection in the family, insecurity and some also have suicidal tendencies. Psychological abusers of elderly found to be their own family members in many cases and incidences also found in elderly that abusers are the caretakers of them in nursing homes where they reside^[21]. One of the reviewed literatures had revealed that the family violence is found as serious and detrimental in the elderly population as abusers are often found to be their own adult offspring’s. (Korbin et al.,1991; Yan &Tang, 2001). ^[50]

Depression is quite common most specifically in population with elder abuse. The current review showed that psychological abuse in elderly commonly lead to depression. This conceptualized fact had evidenced in one of the reviewed study revealed that elder abuse victims were often more depressed than their intact counterparts even after controlling for health, age, gender, and marital status^[51].

The observed fact in the study by Chen et.al (1981) found that elderly people who have been abused by their carers suffered with physical symptoms such as obvious bruises, cuts, injuries, malnutrition, and poor hygiene care; they also revealed that elder abuse who are impacted psychologically indicate symptoms of fear and anxiety as well as feelings of isolation and neglect, insecurity, powerlessness, and unworthiness^[52].

Inspected facts basing past reviews reveled in this study that there are various types of negative impacts of elder abuse that includes physical, psychological, financial, social, hospitalizations and disability, medical, and others. Learned from the documented facts, the most commonly abuses in elderly are physical impacts observed as swellings and wounds. The psychological impacts included levels of psychological distress, emotional symptoms, and depression^[53]. Another actualize fact in the literature observed among study of older women found that verbal abuse only leading to deterioration in mental health. ^[54]

Economic related aspects impacted elder abuse persons. Financial exploitation caused economic losses in families of elder abuse can lead to cognitive incapacities. Observation on literature of previous research indicated sufferers 100% greater in economic losses^[55]. Another impacting aspect of elder abuse observed was social isolation demonstrated as self-withdrawal, decreased social resources, social identities and supports. ^[56]

Further analysis indicated that elder abuse is a disability that had paved a way to increased rates of medical emergency, risks for hospitalization and mortality. ^[57] The financial impact on elder abuse that had observed in review literature spelt that direct medical costs of injuries contribute more than nation’s annual health expenditures. ^[58]

Most Suitable Interventions for Elder Abuse:

Drawing suitability among the intervening aspect of elder abuse possible with extensively and continuously updating knowledge in the field is essential.Most suitable interventions for elder abuse analyzed based on literature reviewed are social support that can benefit older adults in building mental health resilience and learn better coping skills. ^[59]

Previous literature revealed that the community-based programmes had found to be fruitful. Risk factors of elder abuse decreased over the course of the intervention and nearly three-quarters of participants made progress on their treatment goal. Current study observed the fruitfulness of longer-term relationship-based intervention for entrenched elders who are disinclined to receive supportive services. ^[60]

Table 3: shows intervention programme

Intervention programme: Social support

Community based intervention program called assists suspected victims elder abuse

Enforcement of local law in favor of elder abuse and self-neglect

Program to build alliances with the elder and family members

Connecting the elder to supportive services that reduce risk of abuse

Motivational interviews to help elders overcome ambivalence regarding making difficult life changes

Treatment goal for risk reduction

The longer-term rapport for intervention for elders who are unwilling to receive services

Current review observed education programme on elder abuse is helpful in intervene social malaise at the community level through changing attitudes toward elder abuse and bring behavior changes toward older adults. Examined literature finding indicates an educational intervention promotes altering tolerance for and behavioral intentions of elder abuse^[61].

Professional Interventions In Elder Abuse:

Interventions commonly go well with holistic approach in elder abuse although going hand in hand with new researches and current trends signifies professionally restructuring the intervention according to day today need.In the current review analyzed the facts regarding professional interventions in elder abuse. Examined literature had given multidisciplinary approaches compatible to the nature of elder abuse are also referred to as multidisciplinary teams that can work under one umbrella consisting of physicians, social workers, law-enforcement personnel, psychologists and other community workers go together in a coordinately in the intervention with success. ^[62]

Current study had found in the review analysis that Adult Protective Services (APS) Guidelines had contributed in the interventions are useful in reporting and data collection of elder abuse incidents. Further analysis of revived facts on APS systems showed the efficacy in addressing the abuse, neglect, self-neglect, and financial abuse among older adults. Reviewed literature observed the fact historically there was neither federal home for APS; there weren’t any designated federal facilities though its need was significant. Reports had stated that there are more number of local agencies were involved in wide variety of APS practices. Further observation found with an effort to supporting APS Agencies and enhancing elder abuse response that had extended by Administration on Community Living (ACL). ACL had developed guidelines that had intended to assist states in developing efficient and effective APS systems. ^[63]

CONCLUSION:

This review study concluded with the set of informative facts on significance of increasing prevalence rates of physical and emotional abuse in elderly over the globe along the increased vulnerability. The study had actualized elder abuse remains under reported, which may lead to an increase in morbidity and mortality from a delay in intervention. The expected need found that the medical practitioners are ideally positioned to detect elder abuse.

The study also concluded the fact by expressing difficulties in distinguishing between accidental and non-accidental causes of injury in the elderly; mainly because changes that occur with aging such as osteoporosis and brain atrophy predispose to injury from relatively minor trauma such as falls.

The bulk of research on elder abuse had focused on determining the prevalence and incidence of elder abuse. Identifying risk factors observed in the researches that had carried out by social scientists. Thus it has limited practical application in medicine. Looking into the need current study suggests that integrated research programmes are well appreciated with this regard.

REFERENCES:

1. National Center on Elder Abuse (NCEA) at1-855-500-3537, ncea info@aoa.hhs.gov. Available from: URL: https://ncea.acl.gov.

2. Health in Aging.org Trusted Information Better Care. Preventing and Addressing Elder Abuse 2017.Available from: URL: http://www.healthinaging.org/files/documents/tipsheets/elder_abuse.pdf

3. Anetzberger, G. (2004). The Clinical Management of Elder Abuse. New York, NY: Hawthorne Press.

4. Vancouver Coastal Health, About Adult Abuse and Neglect. Available from: URL: http://www.vchreact.ca/read_psychological.htm

5. New York State Office of Children and Family Services, Definitions of Adult Abuse: Available from: URL: http://www.ocfs.state.ny.us/main/psa/adultabuse.asp

6. Help Guide.org, Domestic Violence and Abuse: Available from: URL: http://helpguide.org/mental/domestic_violence_abuse_types_signs_causes_effects.htm

7. Wang JJ, et al. Psychologically abusive behavior by those caring for the elderly in a domestic context. Geriatric Nursing. 2006; 27: 284–291. [PubMed]

8. Wang JJ. Psychological abuse behavior exhibited by caregivers in the care of the elderly and correlated factors in long-term care facilities in Taiwan. Journal of Nursing Research. 2005; 13(4): 271–280. [PubMed]

9. Randal J, German T. The ageing and development report: poverty, independence, and the world’s people. London. Help Age International; 1999.

10. Hudson MF. Elder mistreatment: taxonomy with definitions by Delphi. Journal of Elder Abuse and Neglect. 1991; 3: 1–20.

11. Help Age International. Global age watch 2013 insights report London, UK: Help Age International; 2013.

12. Elsie Y. Elder Abuse and Its Prevention: Workshop Summary. Forum on Global Violence Prevention; Board on Global Health; Institute of Medicine; National Research Council Washington (DC): National Academies Press (US); 2014 Mar 18.

13. Krug EG, et al. World Report on Violence and Health 2002; Chapter 5: Abuse of the elderly. Geneva: WHO Press. 2012. Available from: URL: http://www.who.int/ violence_injury_prevention/

14. Family Violence in Canada: A Statistical Profile. 2009; Section 3: Police Reported Violence Against Seniors. Accessed January 18, 2012. Available from: URL: http://www.statcan.gc.ca/ pub/85-224-x/85-224-x2010000-eng.pdf.

15. Phua DH, et al. Epidemiology of suspected elderly mistreatment in Singapore. Singapore Medical Journal. 2008; 49 (10): 765–773. [PubMed]

16. Anme T. A study of elder abuse and risk factors in Japanese families: Focused on the social affiliation model. Geriatrics and Gerontology International. 2004; 4: 62–63.

17. Yamada Y. A telephone counseling program for elder abuse in Japan. Journal of Elder Abuse & Neglect. 1999; 11: 105–112.

18. Oh J, Kim HS. A study of elder abuse in Korea. International Journal of Nursing Studies. 2006; 43: 203–214. [PubMed]

19. Kim O, et al. The relating factors of elder abuse among community-dwelling elderly with stroke. Korean Journal of Adult Nursing. 2012; 24: 466–476.

20. Chang J, Moon A. Korean American elderly's knowledge and perceptions of elder abuse: A qualitative analysis of cultural factors. Journal of Multicultural Social Work. 1997; 6: 139–155.

21. Yan E, Tang C. Prevalence and psychological impact of Chinese elder abuse. Journal of Interpersonal Violence. 2001; 16: 1158-1174.

22. Zhang, A. Y. (1987). Shanghai census. People’s Republic of China: China Populations Science.

23. Xin QD. Elder Abuse in Chinese Populations: A Global Review. Journal of Elder Abuse & Neglect. 2015; 27 (3): 196-232.

24. Dong X, Simon MA. Is greater social support a protective factor against elder mistreatment. Gerontology. 2008; 54 (6): 381–388. [PubMed]

25. Yan E, Tang CS. Elder abuse by caregivers: A study of prevalence and risk factors in Hong Kong Chinese families. Journal of Family Violence. 2004; 19 (5): 269–277.

26. Yan E, Kwok T. Abuse of older Chinese with dementia by their family caregivers: An inquiry into the role of caregiver burden. International Journal of Geriatric Psychiatry. 2010; 6: 527–535. [PubMed]

27. Yan E, Tang CS. Proclivity to elder abuse: A community study on Hong Kong Chinese. Journal of Interpersonal Violence. 2003; 18 (9): 999–1017. [PubMed]

28. Cham GW, Seow E. The pattern of elderly abuse presenting to an emergency department. Singapore Medical Journal. 2000; 41 (12): 571–574. [PubMed]

29. Pillemer K, Prescott D. Psychological effects of elder abuse: A research note. Journal of Elder Abuse and Neglect. 1989; 1: 65-73.

30. Sasaki M, et al. Factors related to potentially harmful behaviors towards disabled older people by family caregivers in Japan. International Journal of Geriatric Psychiatry. 2007; 22(3): 250–257. [PubMed]

31. Margie Eckroth-Bucher RN, Devious Damage: Elder Psychological Abuse PMHCNS-BC Aging Well Vol. 1 No. 4 P. 24

32. Kishimoto Y, et al. Abuse of people with cognitive impairment by family caregivers in Japan (a cross-sectional study). Psychiatry Research. 2013; S0165-S1781 (13): 46–52.

33. Nakanishi M, et al. Disparities in systems development for elder abuse prevention among municipalities in Japan: Implications for strategies to help municipalities develop community systems. Social Science & Medicine. 2010; 71 (2): 400–404

34. Nakanishi M, et al. Impact of the elder abuse prevention and caregiver support law on system development among municipal governments in Japan. Health Policy. 2009; 90(2-3): 254–261. [PubMed]

35. Lee M, Kolomer SR. Caregiver burden, dementia, and elder abuse in South Korea. Journal of Elder Abuse & Neglect. 2005; 17 (1): 61–74. [PubMed]

36. Christine AW, (2004) Elder Abuse: Ethno cultural Issues and Perspectives; Research Symposium. Prairie Metropolis Centre Calgary, Alberta

37. Chokkanathan S1, Lee AE. Elder mistreatment in urban India: a community based study. Journal of Elder Abuse Negl. 2005; 17 (2): 45-61.

38. Sebastian D, Sekher TV. Extent and nature of elder abuse in Indian families: A study in Kerala. Help Age India Research and Development Journal. 2011; 17: 20–28.

39. Help Age India. Elder abuse in India: Summary of research reports 2012. [September 10, 2013]. Available from: URL: http://www.helpageindia.org/pdf/Report_Elder-Abuse_India

40. Bambawale U. The abused elderly. Indian Journal of Medical Research. 1997; 106: 389–395. [PubMed]

41. Lai DW. Abuse and neglect experienced by aging Chinese in Canada. Journal of Elder Abuse & Neglect. 2011; 23(4): 326–347. [PubMed]

42. Yan E, Tang C. Prevalence and psychological impact of Chinese elder abuse. Journal of Interpersonal Violence. 2001; 16(11): 1158-1174.

43. Leung, W. Elderly abuse in Tuen Mun public housing estates. Hong Kong Journal of Gerontology. 1989; 3: 6-9.

44. Chong SM, Jiang KY. Exploring elder protection works form the phenomena of elder abuse. Social Development Quarterly. 2000; 91: 269-285.

45. Bennett G, et al. (1997) The Dimensions of Elder Abuse: Perspectives

46. Pittaway E, Westhues A. The prevalence of elder abuse and neglect of older adults who access health and social services in London, Ontario, Canada. Journal of Elder Abuse and Neglect. 1993; 5: 77-93.

47. Pillemer K, Finkelhor D. The prevalence of elder abuse: random sample survey. Gerontological Society of America. 1988; 28 (1): 51-57.

48. Podnieks, E. (1990). National survey on abuse of the elderly in Canada: The Ryerson Study. Toronto, Canada: Ryerson Polytechnic Institute.

49. Rajini S, Wan YC, Noran NH. A Review on the Prevalence and Measurement of Elder Abuse in the Community. Trauma Violence Abuse. 2013;14: 316. Available from URL: http://www.sagepublications.com

50. Korbin J, Anetzberger G, Thomasson R, Austin C. Abused elders who seek legal recourse against their adult offspring: Findings from an exploratory study. Journal of Elder Abuse and Neglect, 1991; 3: 1-18.

51. Pillemer K, Prescott D. Psychological effects of elder abuse: A research note. Journal of Elder Abuse and Neglect. 1989; 1: 65-73.

52. Chen P N, et al. Elderly abuse in domestic settings: A pilot study. Journal of Gerontological Social Work. 1981; 4: 3-17.

53. Comijs HC, et al. Psychological distress in victims of elder mistreatment: the effects of social support and coping (PDF). Journals of Gerontology Series B-Psychological Sciences and Social Sciences. 1999; 54 (4): 240–245.

54. Mouton CP, et al. Psychosocial effects of physical and mental abuse in post-menopausal women. Annals of Family Medicine. 2010; 8: 206–213.

55. Gunther, J. (2011). The 2011 Utah Economic Cost of Elder Financial Exploitation.

56. Lachs MS, et al. ED use by older victims of family violence. Annals of Emergency Medicine. 1997; 30 (4): 448–454. Available from: URL: http://dx.doi.org/10.1016/S0196-0644(97)70003-9

57. Jones JS. Geriatric abuse and neglect. In: Bosker G etal., eds. Geriatric emergency medicine. St Louis, MO, CV Mosby, 1990:533–542.

58. Dong XQ. Medical implications of elder abuse and neglect. Clinics in Geriatric Medicine. 2005; 21(2): 293–313. doi: http://dx.doi.org/10.1016/j.cger.2004.10.006

59. Brown AS. A survey on elder abuse in one Native American tribe. Journal of Elder Abuse and Neglect. 1989; 1: 17–37.

60. Booth BK, et al. Psychological therapy with abused and neglected patients. In: Baumhover LA, Beall SC, eds. Abuse, neglect, and exploitation of older persons: strategies for assessment and intervention. Baltimore, MD, Health Professions Press. 1996; 185–206.

61. Goldstein M. Elder mistreatment and PTSD. In: Ruskin PE, Talbott JA, eds. Aging and post-traumatic stress disorder. Washington, DC, American Psychiatric Association. 1996:126–135.

62. GAO, Elder Justice: National Strategy Needed to Effectively Combat Elder Financial Exploitation, GAO-13-110 (Washington, D.C.: November 15, 2012).

63. Jogerst GJ, et al. APS investigative systems associated with county reported domestic elder abuse. Journal of Elder Abuse & Neglect. 2004: 16 (3): 1-17.

Received on 12.08.2018 Modified on 27.09.2018

Research J. Pharm. and Tech 2018; 11(10): 4731-4738.

DOI: 10.5958/0974-360X.2018.00862.4