Types, characteristics and anatomic location of physical signs in elder abuse: a systematic review

Abstract

Purpose Elder abuse is a worldwide problem with serious consequences for individuals and society. The recognition of elder abuse is complex due to a lack of awareness and knowledge. In this systematic review, types, characteristics and anatomic location of physical signs in elder abuse were identified. Methods Databases of MEDLINE, COCHRANE, EMBASE and CINAHL were searched. The publication dates ranged from March 2005 to July 2020. In addition to the electronic searches, the reference lists and citing of included articles were hand-searched to identify additional relevant studies. The quality of descriptive and mixed-methods studies was assessed. Results The most commonly described physical signs in elder abuse were bruises. The characteristics of physical signs can be categorized into size, shape and distribution. Physical signs were anatomically predominantly located on the head, face/maxillofacial area (including eyes, ears and dental area), neck, upper extremities and torso (especially posterior). Physical signs related to sexual elder abuse were mostly located in the genital and perianal area and often accompanied by a significant amount of injury to non-genital parts of the body, especially the area of the head, arms and medial aspect of the thigh. Conclusions Most common types, characteristics and anatomic location of physical signs in elder abuse were identified. To enhance (early) detection of physical signs in elder abuse, it is necessary to invest in (more) in-depth education and to include expertise from a forensic physician or forensic nurse in multidisciplinary team consultations.

Forensic Characteristics of Physical Elder Abuse and Current Status and Issues of Collaboration between Forensic Medicine Departments and Related Institutions in Japan

“…Another study stresses the need for forensic pathologists to recognize elder abuse and neglect in cases where physical abuse and neglect was a significant cause of death [29]. For early detection of elder abuse, it is important to include the specialized knowledge of forensic doctors and nurses in multidisciplinary team consultations [30,31]. In our study, there were a variety of opinions about the number of cases handled to be able to determine trends in elder abuse; however, many respondents discussed assessing from both clinical and forensic perspectives, considering both the results of the forensic examination and the various information known to the municipality when deciding whether abuse has occurred or not and the need for the involvement of forensic medicine in the detection and prevention of elder abuse.…”

Awareness and knowledge of elder abuse and neglect among dental practitioners in Southwestern England.

“…Another systematic review revealed that the most common injury pattern was in the maxillofacial region (nasal bone fractures) (11). Likewise, a systematic review to identify types, characteristics and anatomic locations of elder abuse reported that most physical signs were predominantly located on the head, face and maxillofacial area (12). The recognition of elder abuse is complex.…”

Sociodemographic aspects and functional capacity associated with physical violence in hospitalized elderly people

“…A Violência Contra a Pessoa Idosa (VCPI) caracteriza uma violação de direitos e se associa a um fenômeno multiaxial com consequências nos âmbitos social, econômico, político e de saúde (1) . Dentre algumas definições para esse evento, a mais utilizada corresponde a que foi emitida na Declaração de Toronto, pela Organização Mundial da Saúde (OMS), que estabelece a VCPI como "qualquer ação, única ou repetida, ou ainda, a omissão de providência apropriada, ocorrida numa relação em que haja expectativa de confiança, que acarrete prejuízo ou aflição a uma pessoa idosa" (2:332) .…”