Cammer Paris B E
Geriatrics and Medicine, Mount Sinai School of Medicine, New York, City University of New York, USA.
Mt Sinai J Med. 1996 Mar;63(2):97-100.
Every year, more than one million older Americans are injured physically, debilitated psychologically, or exploited financially by a family member. Elderly men and women, who are from all socioeconomic, ethnic, and religious backgrounds and who have varying functional abilities are vulnerable to abuse and neglect. Health care professionals need to develop the skills to detect both patients at risk and those actively being abused. Barriers to detection of abuse and neglect are complex and include victims' resistance to disclosure due to their own ageist attitudes or feelings of shame and guilt; isolation of victims by their abusers; and the health care professional's discomfort with the situation and hesitancy to intervene, often as a result of inadequate knowledge and training in this area. Researchers have identified specific risk factors for abuse and neglect by family members, including psychopathology among family members, a family history of transgenerational violence, the elder's dependency, the elders and the caregivers' isolation, the caregivers' stress, and living arrangements. Thorough assessment of patients at risk by a multidisciplinary team including a physician, a nurse, and a social worker and the team's subsequent development of individualized intervention strategies can have a positive impact on this devastating problem.
每年，超过100万美国老年人在身体上受到伤害、心理上变得虚弱，或在经济上被家庭成员剥削。来自各种社会经济、种族和宗教背景且功能能力各异的老年男性和女性都容易受到虐待和忽视。医疗保健专业人员需要培养技能，以识别有风险的患者以及正在遭受虐待的患者。发现虐待和忽视行为存在诸多复杂障碍，包括受害者因自身的年龄歧视态度或羞耻感和内疚感而不愿披露情况；施虐者将受害者孤立起来；以及医疗保健专业人员对这种情况感到不适且不愿干预，这通常是由于在该领域知识和培训不足所致。研究人员已经确定了家庭成员虐待和忽视行为的特定风险因素，包括家庭成员的精神病理学问题、跨代暴力的家族史、老年人的依赖性、老年人与照顾者的孤立状态、照顾者的压力以及生活安排。由医生、护士和社会工作者组成的多学科团队对有风险的患者进行全面评估，以及该团队随后制定个性化的干预策略，可能会对这个毁灭性的问题产生积极影响。
