Violence against elderly people.

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.