Identifying older people at risk of abuse during routine screening practices.
OBJECTIVE
To examine the association between various characteristics of community-based older people and a constructed measure of potential elder abuse.


METHODS
Cross-sectional design.


METHODS
Public community-based long-term care programs in Michigan.


METHODS
Individuals aged 60 and older seeking home and community-based services in Michigan between November 1996 and October 1997 (N = 701).


METHODS
Data were collected using the Minimum Data Set for Home Care (MDS-HC) assessment. The dependent variable is a constructed measure of potential elder abuse reflecting physical and emotional abuse and neglect. Independent variables include demographic characteristics; diagnoses; behavioral measures; and cognitive, physical, and social functioning.


RESULTS
Several measures of social support and social function were strongly associated with the signs of a potentially abusive environment: brittle support (odds ratio (OR) = 3.5, 90% confidence interval (CI) = 1.5-8.1), older person feels lonely (OR = 2.4, 90% CI = 1.3-4.5), and older person expresses conflict with family/friends (OR = 2.3, 90% CI = 1.2-4.3). Home care participants' alcohol abuse, psychiatric illness, lack of ease interacting with others, and short-term memory problems were also significantly associated with the signs of potential elder abuse.


CONCLUSIONS
The results of this study suggest that the signs of potential elder abuse are associated with a diminishing social network and poor social functioning, although some characteristics of the older person's health are contributing factors. Improved understanding of the link between those characteristics and potential abuse will help healthcare providers, case managers, and others identify older people at high risk of abuse.
Shugarman
Lisa R
LR
RAND Corporation, Santa Monica, California 90407, USA. Lisa_Sugarman@rand.org
Fries
Brant E
BE
Wolf
Rosalie S
RS
Morris
John N
JN
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004552:Elder Abuse / Q000175:diagnosis / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008824:Michigan; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D012931:Social Environment