The findings suggest important characteristics of older adults with dementia and their CGs that have potential for use in a clinical screening tool for elder mistreatment. Potential screening questions to be asked of CGs of people with dementia are suggested.

OBJECTIVES: To describe bruising as a marker of physical elder abuse. DESIGN: Consenting older adults were examined to document location and size of bruises and assess whether they were inflicted during physical abuse. An expert panel confirmed physical abuse. Findings were compared with results of an earlier study of accidental bruising in older adults. SETTING: Residences of participants. PARTICIPANTS: Sixty‐seven adults aged 65 and older reported to Adult Protective Services (APS) for suspected physical elder abuse. MEASUREMENTS: Age, sex, ethnicity, race, functional status, medical conditions, cognitive status, history of falls, bruise size and location, recall of cause, and responses to Revised Conflicts Tactics Scale and Elder Abuse Inventory. RESULTS: Seventy‐two percent (n=48) of older adults who had been physically abused within 30 days before examination had bruises. The physically abused older adults had significantly larger bruises; more of them knew the cause of their bruises (43 (89.6%) vs 16 (23.5%) of the comparison group); and they were significantly more likely to have bruises on the face, lateral aspect of the right arm and the posterior torso (including back, chest, lumbar, and gluteal regions) than older adults from an earlier study who had not been abused (n=68). CONCLUSION: Bruises that occur as a result of physical elder mistreatment are often large (>5 cm) and on the face, lateral right arm, or posterior torso. Older adults with bruises should be asked about the cause of the bruises to help ascertain whether physical abuse occurred.

Behavioral perinatology is as an interdisciplinary area of research that involves conceptualization of theoretical models and conduct of empirical studies of the dynamic time-, place-, and context-dependent interplay between biological and behavioral processes in fetal, neonatal, and infant life using an epigenetic framework of development. The biobehavioral processes of particular interest to our research group relate to the effects of maternal pre- and perinatal stress and maternal-placental-fetal stress physiology. We propose that behavioral perinatology research may have important implications for a better understanding of the processes that underlie or contribute to the risk of three sets of outcomes: prematurity, adverse neurodevelopment, and chronic degenerative diseases in adulthood. Based on our understanding of the ontogeny of human fetal development and the physiology of pregnancy and fetal development, we have articulated a neurobiological model of pre- and perinatal stress. Our model proposes that chronic maternal stress may exert a significant influence on fetal developmental outcomes. Maternal stress may act via one or more of three major physiological pathways: neuroendocrine, immune/inflammatory, and vascular. We further suggest that placental corticotropin-releasing hormone (CRH) may play a central role in coordinating the effects of endocrine, immune/inflammatory, and vascular processes on fetal developmental outcomes. Finally, we hypothesize that the effects of maternal stress are modulated by the nature, duration, and timing of occurrence of stress during gestation. In this paper, we elaborate on the conceptual and empirical basis for this model, highlight some relevant issues and questions, and make recommendations for future research in this area.

The recognition of injury patterns can aid forensic nurses to identify victims of elder abuse. This study examined the mechanism of injury of bruises endured by physical elder abuse victims. A sample of 67 elders aged 65 years and older who reported to Adult Protective Services for physical elder abuse was included in the analysis. A research nurse conducted assessments and documented the presence and characteristics of all bruises. Data regarding the abusive incident were collected through victim descriptions and the Revised Conflicts Tactic Scales (CTS2) physical assault scale. The most common bruising locations were the lateral/anterior arms (n = 23, 34.3%), head and neck (n = 10, 14.9%), and posterior torso (n = 7, 10.4%). Victims' odds of having head and neck bruises were greater when reporting being choked (OR = 7.71, 95% CI [1.29, 45.90], p = 0.039), punched (OR = 13.53, 95% CI [2.55, 71.80], p = 0.001), and beaten up (OR = 5.60, 95% CI [3.26, 74.45], p = 0.001). The odds of having lateral/anterior arm bruises were eight times greater when the victim reported being grabbed (OR = 8.43, 95% CI [2.67, 26.65], p < 0.001). The findings suggest similarities between injuries experienced in elder abuse and those in intimate partner violence. Findings highlight injury patterns that elder abuse victims sustain and can be informative for forensic nurses.