Fulmer Terry, Paveza Gregory, VandeWeerd Carla, Fairchild Susan, Guadagno Lisa, Bolton-Blatt Marguarette, Norman Robert
Steinhardt School of Education, Division of Nursing, New York University, 246 Greene Street, New York, NY 10003-6677, USA.
Gerontologist. 2005 Aug;45(4):525-34. doi: 10.1093/geront/45.4.525.
Neglect of older adults accounts for 60% to 70% of all elder-mistreatment reports made to adult protective services. The purpose of this article is to report data from research, using a risk-and-vulnerability model, that captures the independent contributions of both the elder and the caregiver as they relate to the outcome of neglect.
Between February 2001 and September 2003, older adults were screened and recruited through four emergency departments in New York and Tampa. The diagnosis of neglect was made by an expert neglect-assessment team. Elders and their caregivers were then scheduled for separate face-to-face interviews after discharge.
Constructs within the risk-and-vulnerability model were examined for scale-score significance based on the outcome diagnosis of neglect. In the risk domain, caregivers' functional status, childhood trauma, and personality were statistically significant. In the vulnerability domain, the elders' cognitive status, functional status, depression, social support, childhood trauma, and personality were significant.
Findings from this study underscore the value of interdisciplinary assessment teams in emergency departments for screening elder neglect, with attention given to risk factors related to the caregiver and elder vulnerability factors, including reports of childhood trauma. The risk-and-vulnerability model may provide a link between the caregiving and neglect research. Data should be collected independently from both members of the elder-caregiver dyad in order for clinicians to understand factors related to elders who receive the diagnosis of neglect from interdisciplinary teams.
向成人保护服务机构报告的所有虐待老年人事件中，对老年人的忽视占60%至70%。本文旨在报告一项研究的数据，该研究使用风险-脆弱性模型，捕捉老年人和照顾者与忽视结果相关的独立影响因素。
2001年2月至2003年9月期间，通过纽约和坦帕的四个急诊科对老年人进行筛查和招募。忽视的诊断由一个专家忽视评估小组做出。老年人及其照顾者在出院后分别安排进行面对面访谈。
根据忽视的结果诊断，对风险-脆弱性模型中的构成因素进行量表得分显著性检验。在风险领域，照顾者的功能状态、童年创伤和性格具有统计学意义。在脆弱性领域，老年人的认知状态、功能状态、抑郁、社会支持、童年创伤和性格具有显著性。
本研究结果强调了急诊科跨学科评估小组在筛查老年人忽视方面的价值，应关注与照顾者相关的风险因素以及老年人的脆弱性因素，包括童年创伤报告。风险-脆弱性模型可能为照顾与忽视研究之间提供联系。临床医生要了解跨学科团队诊断为被忽视的老年人相关因素，就应独立收集老年-照顾者二元组双方的数据。
