A Description of Cases of Severe Physical Abuse in the Elderly and 1-Year Mortality

Friedman, Lee S.; Avila, Susan; Shah, Manoj; Tanouye, Kathy; Joseph, Kimberly

doi:10.1080/08946566.2013.780944

Cited by 19 publications

(26 citation statements)

References 16 publications

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“…33-35 Reliance on the larger literature of intimate partner violence is relevant to improve understanding of injuries in physical elder abuse because some elder abuse is “domestic violence grown old,” family violence that began earlier in life and persists into old age. 16,36 …”

Section: Discussionmentioning

confidence: 99%

Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse

Rosen

Bloemen

LoFaso

et al. 2016

The Journal of Emergency Medicine

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Background Elder abuse is under-recognized by Emergency Department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. Objective To describe patterns and circumstances surrounding elder abuse-related and potentially abuse-related injuries in ED patients independently known to be physical elder abuse victims. Methods ED utilization of community-dwelling victims of physical elder abuse in New Haven, CT from 1981-1994 was analyzed previously. Cases were identified using Elderly Protective Services data matched to ED records. 66 ED visits were judged to have high probability of being related to elder abuse and 244 of indeterminate probability. We re-examined these visits to assess whether they occurred due to injury. We identified and analyzed in detail 31 injury-associated ED visits from 26 patients with high probability of being related to elder abuse and 108 visits from 57 patients with intermediate probability and accidental injury. Results Abuse-related injuries were most common on upper extremities (45% of visits) and lower extremities (32%), with injuries on head or neck noted in 13 visits (42%). Bruising was observed in 39% of visits, most commonly on upper extremities. 42% of purportedly accidental injuries had suspicious characteristics, with the most common suspicious circumstance being injury occurring >1 day prior to presentation and the most common suspicious injury pattern being maxillofacial injuries. Conclusion Victims of physical elder abuse commonly have injuries on upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries.

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Section: Discussionmentioning

confidence: 99%

Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse

Rosen

Bloemen

LoFaso

et al. 2016

The Journal of Emergency Medicine

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…20 This is likely due to a poor understanding of elder abuse among trauma service clinical staff and inadequate training regarding the proper procedures for reporting suspected incidents. 20 Very little research has examined severe traumatic injuries in victims of physical elder abuse. Friedman and colleagues, in a case-control study comparing victims of severe physical elder abuse to other trauma victims, found that elder abuse victims had more severe injuries, were more commonly female, were more likely to abuse drugs or alcohol, and more frequently had dementia.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, Friedman et al found, in a 1-year follow-up to a case-control study of severe physical elder abuse, that 3.3% of their control subjects, initially believed to be victims of accidental injury, had been substantiated by Adult Protective Services as victims of abuse. 20 As NTDB does not track the identity of the perpetrator, their relationship to the victim, or the dynamics that precipitated the violence, we were unable to distinguish between physical elder abuse and assault by a stranger, phenomena which may have important differences. When describing body regions injured, we did not distinguish between major and minor injuries.…”

Section: Limitationsmentioning

confidence: 99%

“…Little is known about the injury patterns, treatment, and outcomes for these severely-injured patients. 10, 20 . In addition, no national description of injury patterns in severe geriatric assault injury exists.…”

Section: Introductionmentioning

confidence: 99%

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Geriatric assault victims treated at U.S. trauma centers: Five-year analysis of the national trauma data bank

Rosen

Clark

Bloemen

et al. 2016

Injury

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Introduction While geriatric trauma patients have begun to receive increased attention, little research has investigated assault-related injuries among older adults. Our goal was to describe characteristics, treatment, and outcomes of geriatric assault victims and compare them to geriatric victims of and younger accidental injury assault victims. Patients and Methods We conducted a retrospective analysis of the 2008–2012 National Trauma Data Bank. We identified cases of assault-related injury admitted to trauma centers in patients aged ≥60 using the variable “intent of injury.” Results 3,564 victims of assault-related injury in patients aged ≥60 were identified and compared to 200,194 geriatric accident victims and 94,511 assault victims aged 18–59. Geriatric assault victims were more likely than geriatric accidental injury victims to be male (81% vs. 47%) and were younger than accidental injury victims (67±7 vs. 74±9 years). More geriatric assault victims tested positive for alcohol or drugs than geriatric accident victims (30% vs. 9%). Injuries for geriatric assault victims were more commonly on the face (30%) and head (27%) than for either comparison group. Traumatic brain injury (34%) and penetrating injury (32%) occurred commonly. The median injury severity score (ISS) for geriatric assault victims was 9, with 34% having severe trauma (ISS≥16). Median length of stay was 3 days, 39% required ICU care, and in-hospital mortality was 8%. Injury severity was greater in geriatric than younger adult assault victims, and, even when controlling for injury severity, in-hospital mortality, length of hospitalization, and need for ICU-level care were significantly higher in older adults. Conclusions Geriatric assault victims have characteristics and injury patterns that differ significantly from geriatric accidental injury victims. These victims also have more severe injuries, higher mortality, and poorer outcomes than younger victims. Additional research is necessary to improve identification of these victims and inform treatment strategies for this unique population.

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Elder Abuse and Mistreatment

Stripling

Dautovich

Tighe

et al. 2017

Handbook of Behavioral Criminology

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A Description of Cases of Severe Physical Abuse in the Elderly and 1-Year Mortality

Cited by 19 publications

References 16 publications

Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse

Emergency Department Presentations for Injuries in Older Adults Independently Known to be Victims of Elder Abuse

Geriatric assault victims treated at U.S. trauma centers: Five-year analysis of the national trauma data bank

Elder Abuse and Mistreatment

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