Do interventions to prevent or stop abuse and neglect among older adults work? A systematic review of reviews

Marshall, Khiya J.; Herbst, Jeffrey H.; Girod, Candace; Annor, Francis

doi:10.1080/08946566.2020.1819926

Cited by 20 publications

(21 citation statements)

References 36 publications

(103 reference statements)

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“…Also, the quantitative analysis showed that fewer respondents regarded their own lack of awareness as a barrier to asking questions about abuse at follow-up. Higher awareness after education about elder abuse is unsurprising and has also previously been reported [30,39]. Some mediators of the increased awareness were articulated in the interviews, e.g.…”

Section: Propensity To Ask Older Patients Questions About Abusementioning

confidence: 61%

Testing an educational intervention to improve health care providers’ preparedness to care for victims of elder abuse: a mixed method pilot study

et al. 2022

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Aabstract Background Elder abuse is prevalent and associated with ill-health. However, health care providers often lack education about elder abuse and older patients’ victimization often remains unknown to them. In this pilot study we performed initial testing of an educational model aiming at improving health care providers’ preparedness to care for older adults subjected to abuse, or more specifically their self-reported propensity to ask older patients questions about abuse and perceived ability to manage the response. Methods The educational model consisted of a full training day about elder abuse, including theory, group discussions and forum theatre. Forum theatre is an interactive form of drama in which participants are not only observers, but rather spect-actors, urged to participate in the scene. They are thereby given the opportunity to discuss and practise difficult health care encounters. Medical interns (intervention group n = 16, control group n = 14) in Sweden participated in the study and a mixed method convergent parallel design was used. Quantitative data was collected at baseline and 6 months post-intervention using a questionnaire (the REAGERA-P). Qualitative interviews were conducted with four of the participants in the intervention group and data was analysed using qualitative content analysis. Results The reported frequency of asking older patients questions about abuse increased in the intervention group (p = 0.047), but not the control group (p = 0.38) post-intervention. Potential mediators for the improvement were an increased awareness of elder abuse and higher self-efficacy for asking questions about elder abuse. Participants also reported a higher perceived ability to manage cases of elder abuse, even though uncertainties concerning how to provide the best possible care remained. The qualitative interviews indicated that learning from each other in group discussions and forum theatre likely was an important contributor to the positive results. Conclusion This pilot test indicated that the educational model may be effective in improving health care providers’ preparedness to care for older adults subjected to abuse. However, uncertainties about how to handle elder abuse cases remained post-intervention. In a future full-scale test of the model more focus needs to be put on how to manage cases of elder abuse.

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Section: Propensity To Ask Older Patients Questions About Abusementioning

confidence: 61%

Testing an educational intervention to improve health care providers’ preparedness to care for victims of elder abuse: a mixed method pilot study

et al. 2022

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“…Our results clearly reveal that system-wide associated factors of staff-to-resident abuse deserve particular attention. Future research can build on existing knowledge and initiatives on the community level, thereby focusing on the specifics of the nurse-resident-dyad [ 89 ]. To develop shared values and to facilitate authentic engagement, interventions may include public awareness campaigns, educational programs, supervision, as well as culture and practice development [ 12 , 90 ].…”

Section: Discussionmentioning

confidence: 99%

Staff-to-resident abuse in nursing homes: a scoping review

et al. 2022

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Background Elder abuse in long-term care is an important public health concern with social, health-related, and economic implications. Staff-to-resident abuse is of particular interest since institutions should protect residents’ rights and prevent harm. To provide an up-to date comprehensive overview of staff-to-resident abuse in nursing homes, we performed a scoping review considering types of abuse, their prevalence and associated factors, descriptions, experiences, and preventive interventions. Methods We performed a scoping review following the framework provided by Arksey and O’Malley. We searched MEDLINE (via PubMed), CINAHL, PsycINFO via Ovid, and Cochrane Library. Additionally, we performed free web searching using Google Scholar and checked relevant reviews. Two reviewers independently selected studies. We narratively synthesised the results. Results Out of 3876 references retrieved by our search, we included 46 studies in 47 reports. The prevalence rates of abuse varied widely, ranging from 0 to 93% depending on the type of abuse. Associated factors of abuse at the staff, resident, and nursing home level were evaluated inconsistently. Abuse was perceived ambiguous: even though it was considered unacceptable, it was underreported. We found only four studies addressing preventive interventions. Of these, four made recommendations for intervention development. Only one study with an experimental design examined a multi-component intervention including education and mutual support. Conclusions The review yielded heterogenous evidence not allowing a concrete conclusion on prevalence and associated factors. However, the results show the significance of the problem and indicate that there are associate factors of abuse that can be influenced by appropriate interventions. These are amongst other staff education, organisational culture, and conditions. Further research should investigate the composition and content of preventive interventions and their potential to reduce abusive behaviours.

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“…Frequent and substantial emphasis by various authors studying EA have repeatedly urged healthcare professionals to develop, evaluate, and scale potentially effective prevention intervention strategies for EA [ 38 , 39 ]. Educational interventions for caregivers in healthcare settings that include family-based interventions have been reported on elders suffering from various abuses [ 40 ]. Most studies, however, are primarily directed at preventing or reducing abuse through population education.…”

Section: Discussionmentioning

confidence: 99%

Sensitizing Family Caregivers to Influence Treatment Compliance among Elderly Neglected Patients—A 2-Year Longitudinal Study Outcome in Completely Edentulous Patients

et al. 2021

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Healthcare workers have reported a certain segment of geriatric patients that are suffering from abuse/neglect, which in turn has been associated with anxiety, depression, and helplessness in the individual. Family caregivers (blood relations), being the most common perpetrators of elder abuse and neglect (EAN), have also been shown to respond to sensitization if the type of EAN and the interventions are appropriate. This study was aimed to comparatively analyze the influence of intervention (psychotherapeutic sensitization of FCG) upon long-term (24 months) treatment maintenance and satisfaction in elderly neglected patients. One hundred and fifty patients (aged 41–80 years) suffering from elder neglect (EN) (self-confession) and their respective FCGs, fulfilling the study criteria, participated in this longitudinal 2-year study. The patients were randomly distributed (simple random, convenient) in two equal groups (75 each), namely Group (GP) A (control) and GP B (test). A standardized, complete denture treatment was initiated for all the participants. Both the FCGs and the patients of GP B were sensitized (psychotherapeutic education) for EN, while there was no such intervention in GP A. The influence of such intervention was measured for denture maintenance [denture plaque index (DPI) scores] and treatment satisfaction (10-point visual analog scale). Absolute/relative frequencies and means were major calculations during data analysis. Differences between the groups for any treatment compliance parameter was done through the unpaired t-test, while Karl Pearson’s test determined the level of relationship between variables (p-value < 0.05). Decrease in mean DPI scores (suggesting improvement) was seen among patients in GP A from 1 month (m = 2.92) to 24 months (m = 2.77). A negligible increase in DPI scores was observed among patients of GP B from 1 month (m = 1.38) to 24 months (m = 1.44). Differences in mean values between the two groups were statistically significant at 24-month intervals, while the relationship between the variables was nonsignificant. FCG sensitization through psychotherapeutic education shows a long-term positive influence on the treatment compliance (maintenance and satisfaction). Identifying the existence of EAN among geriatric patients, followed by psychotherapeutic education of FCGs is recommended for routine medical and dental long-duration treatment procedures.

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Do interventions to prevent or stop abuse and neglect among older adults work? A systematic review of reviews

Cited by 20 publications

References 36 publications

Testing an educational intervention to improve health care providers’ preparedness to care for victims of elder abuse: a mixed method pilot study

Testing an educational intervention to improve health care providers’ preparedness to care for victims of elder abuse: a mixed method pilot study

Staff-to-resident abuse in nursing homes: a scoping review

Sensitizing Family Caregivers to Influence Treatment Compliance among Elderly Neglected Patients—A 2-Year Longitudinal Study Outcome in Completely Edentulous Patients

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