What prompts elder abuse? Researcher find common triggers
4th January 2016 · 0 Comments
By Emily Gurnon
Contributing Writer
ORLANDO, Fla. (PBS Next Avenue/New America Media) – Tony Rosen, MD, has seen his share of cuts, bruises and broken bones. In his job as an emergency room physician at New York-Presbyterian Hospital, he witnesses the painful end result of accidents and attacks involving aging adults.
“I see lots and lots of older adults who either report that they fell or the caregiver or whoever’s standing next to them says, ‘They fell,’” Rosen said in a recent interview. “And we assume that some of those falls are, in fact, not falls but physical abuse.”
As of yet, there aren’t good ways to distinguish one from the other. But after working with professionals in other areas, including law enforcement, a prosecutor’s office and social workers, Rosen was able to figure out what happens before the violence descends.
Digging Down
In a recent study with researchers Karl Pillemer, PhD, Mark Lachs, MD, of the Weill Cornell Medical College in New York, and others, Rosen qualitatively analyzed the criminal files from 87 cases of physical elder abuse in Kings County (Brooklyn, N.Y.) from 2003 to 2014. In all of the cases, the perpetrator either pleaded guilty or was convicted at trial.
The case files included the criminal complaints, or charging documents, that the district attorney filed. Those include some initial evidence the prosecution puts forward for the case. The researchers also looked at police reports and victim statements, when available.
“What we found when we looked at these legal records was, wow, there was a lot of information,” Rosen said. “Looking at the qualitative stories, understanding the narrative of what happened,” and seeing the case from multiple perspectives, even, at times, the abuser’s — all was helpful.
As part of the findings of what Rosen called their “preliminary research,” the group assembled a list of what they termed acute triggers of physical elder abuse, he said during a presentation on the study at the annual Gerontological Society of America meeting in Orlando, Fla., last month.
The abuser in the greatest proportion of cases (41 percent) was the victim’s son. The second largest group were spouses (18 percent). The median age of the mostly female (72 percent) victims was 68, and 18 percent of abusers were “acutely intoxicated with alcohol or illicit substances” when the abuse occurred, Rosen said.
Resemblance to Domestic Abuse
Advocates for domestic abuse victims may be thinking the list sounds familiar, since some of the triggers — such as attempting to leave a relationship — have been identified as particularly dangerous for intimate partner victims.
Rosen said that he had, in fact, studied domestic violence and acknowledged the similarities in the abuse triggers. Some types of abuse no doubt fall into both categories, such as when a spouse is involved.
He said the study did not look at whether the perpetrator provided some care for the victim, and if so, how much care. He hoped to be able to explore that more in future research, he said.
Laura Mosqueda, MD, associate dean of primary care at Keck School of Medicine at the University of Southern California and director of the National Center on Elder Abuse praised Rosen’s research.
“It’s great because it’s rigorous,” she said. One particular element Mosqueda found notable: the high percentage of abusers who were under the influence of alcohol or drugs. “Is alcohol abuse a risk factor for violence behavior? It certainly seems like it is,” she said.
Mosqueda, one of Next Avenue’s 2015 Influencers in Aging, offered a caveat to the research, however: it was looking at a specific population — that is, cases in which the police got involved and there were a charge and conviction on elder abuse. The results may or may not apply to cases that never saw the light of day.
The Real Triggers?
In addition, Mosqueda questioned whether the “triggers” could really reflect the larger context of what was going on. For instance, in one case, a 62-year-old woman was arguing with her 29-year-old son because “the abuser believed his soap was missing.” He then picked up his mother’s wooden cane and repeatedly struck her with it.
In many of these situations, Mosqueda said, “It’s hard to know what the actual trigger is.”
Rosen said he and his team have submitted the study for possible publication in the Journal of Interpersonal Violence. He said he hoped it would make a difference.
“Research into acute precipitants will help us to know when older adults who are at high risk for elder abuse are most vulnerable and what we can do to protect them and help them protect themselves,” Rosen noted.
Emily Gurnon wrote this article for PBS Next Avenue, where she is Health and Caregiving Editor. She wrote the article with support from the Journalists in Aging Fellows Program of New America Media and the Gerontological Society of America, sponsored by the Retirement Research Foundation.
This article originally published in the January 4, 2016 print edition of The Louisiana Weekly newspaper.
