The best way to intervene in the problem of elder abuse is to prevent it from happening in the first place or to intervene as early as possible so as to mitigate its consequences. Despite the known negative impacts of adult maltreatment on older adults and adults with disabilities, adult maltreatment appears to be quite underreported.
Screening and assessments for maltreatment should occur on the broadest level possible to facilitate early detection and intervention.
Education and formal training in the signs of abuse are also generally poorly developed, as are reporting procedures which would lead to further investigation. Design: Systematic review. Screening of articles resulted in 11 included. Conclusions: The fundamental function of any assessment instrument is to guide through a standardised screening process and to ensure that signs of abuse are not missed.
Several tools have been tested; some have demonstrated a moderate to good internal consistency and some have been validated to allow an early identification.
When direct evidence is limited, absent, or restricted to select populations or clinical scenarios, the USPSTF may place conceptual upper or lower bounds on the magnitude of benefit or harms. The USPSTF found inadequate evidence on the harms of screening or interventions for elder abuse or abuse of vulnerable adults.
This recommendation applies to women of reproductive age and older or vulnerable adults without recognized signs and symptoms of abuse.
The studies reviewed for IPV included adolescents to women in their 40s. The term elder abuse refers to acts whereby a trusted person e. Although all women of reproductive age are at potential risk for IPV and should be screened, a variety of factors increase risk of IPV, such as exposure to violence as a child, young age, unemployment, substance abuse, marital difficulties, and economic hardships. Several screening instruments can be used to screen women for IPV.
PVS includes 3 items that assess physical abuse and safety. Most studies included only women who could be separated from their partners during screening, during the intervention, or both so that screening and the intervention could be delivered in private.
State and local reporting requirements vary from one jurisdiction to another, with differences in definitions, who and what should be reported, who should report, and to whom. Some states require clinicians including primary care providers to report abuse to legal authorities, and most require reporting of injuries resulting from guns, knives, or other weapons. No studies definitively identified which intervention components resulted in positive outcomes.
However, based on the evidence from 3 studies, 18 — 20 effective interventions generally included ongoing support services that focused on counseling and home visits, addressed multiple risk factors not just IPV , or included parenting support for new mothers.
These studies were conducted in pregnant or postpartum women. Prevalence estimates of elder abuse and abuse of vulnerable adults vary. Potential Preventable Burden: Men. Some potential harms of screening in older or vulnerable adults, women not of reproductive age, and men are shame, guilt, self-blame, retaliation or abandonment by perpetrators, partner violence, and the repercussions of false-positive results e.
Older or Vulnerable Adults. While not specific to age, evidence suggests that screening for IPV is not commonly occurring in practice. The National Hotline on Domestic Violence has information about local programs and resources across the country. The USPSTF has made recommendations on primary care interventions for child maltreatment 34 ; screening for depression in adolescents, 35 adults, and pregnant women 36 ; screening for alcohol misuse 37 ; and screening for drug misuse.
Already a member or subscriber? Log in. Interested in AAFP membership? Learn more. This recommendation statement was first published in JAMA.
Department of Health and Human Services, or the U. Public Health Service. Accessed March 4, Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. Accessed March 18, Centers for Disease Control and Prevention. Intimate partner violence: consequences.
Updated October 23, Accessed September 6, Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. Maternal exposure to domestic violence and pregnancy and birth outcomes: a systematic review and meta-analyses. J Womens Health Larchmt. Intimate partner abuse before and during pregnancy as risk factors for postpartum mental health problems.
BMC Pregnancy Childbirth. Intimate partner violence increases adverse outcomes at birth and in early infancy. J Pediatr. Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community. J Elder Abuse Negl. Adult protective service use and nursing home placement. Elder abuse and psychological well-being: a systematic review and implications for research and policy—a mini review. Elder abuse surveillance: uniform definitions and recommended core data elements: version 1.
A systematic review of risk factors for intimate partner violence.
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