Best-Practice Guideline on the Prevention of Abuse and Neglect of Older Adults.

A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000-April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed.

Developing a Research Agenda on Resident-to-Resident Aggression: Recommendations From a Consensus Conference.

This article provides an overview of the development of a research agenda on resident-to-resident aggression (RRA) in long-term care facilities by an expert panel of researchers and practitioners. A 1-day consensus-building workshop using a modified Delphi approach was held to gain consensus on nomenclature and an operational definition for RRA, to identify RRA research priorities, and to develop a roadmap for future research on these priorities. Among the six identified terms in the literature, RRA was selected. The top five priorities were: (a) developing/assessing RRA environmental interventions; (b) identification of the environmental factors triggering RRA; (c) incidence/prevalence of RRA; (d) developing/assessing staff RRA education interventions; and (e) identification of RRA perpetrator and victim characteristics. Given the significant harm RRA poses for long-term care residents, this meeting is an important milestone, as it is the first organized effort to mobilize knowledge on this under-studied topic at the research, clinical, and policy levels.

Institutional abuse of older adults: what we know, what we need to know.

Although Canadian policies support "aging in place," there still will be a number of older adults who will require institutional care in the future. Most research on elder abuse, however, has focused on domestic abuse and has paid less attention to institutional abuse. The purpose of this article is to comprehensively review current research to identify gaps in knowledge and methodological issues in the study of institutional abuse. Overall, 49 studies in English and 20 studies in French were reviewed, and 11 key-informant interviews were conducted with methodological experts. Methodological challenges are addressed in light of the review and interviews.

Elder mistreatment: an international narrative.

This eclectic overview of global reports on elder mistreatment reflects both the diversity of the work of the authors and the situations in the countries described. Some nations frame elder mistreatment as a human rights issue; others trace the development of emerging programs and practices as they articulate strategies designed to identify, prevent, and reduce the problem, while recognizing the shifting context in which elder mistreatment takes place. This article sheds light on the way different countries share their stories, policies, and initiatives, which stimulate discussions and debates of various aspects and cultural nuances of elder mistreatment. The data presented provide a platform for increased action toward preventing elder mistreatment and celebrate successes while looking for new ways to address challenges.

WorldView Environmental Scan on Elder Abuse.

In response to a growing and worldwide recognition of elder abuse, the WorldView Environmental Scan on Elder Abuse was undertaken. It represented an attempt to collect both information on the nature of the problem of elder abuse and responses to it from a global perspective. The first of its kind, the Scan gathered information about elder abuse as well as on related legislation and policy, services and programs, educational resources and needs, training, and past and ongoing research. A total of 53 countries responded to the survey questionnaire, with 362 respondents representing the six world regions designated by the World Health Organization. Findings revealed that factors contributing to elder abuse include changing social and economic structures, isolation of victims, inadequate knowledge of laws and services, intergenerational conflict, and poverty. Barriers to seeking resources to intervene and protect older adults include the culture of the country, language issues, literacy, stigma, lack of mobility, lack of funding, and insufficient familiarity with and access to the internet. The data serve as a catalyst to take action, both globally and nationally, while emphasizing the changes necessary to protect the rights and dignity of older adults.

Elder abuse: the Canadian experience.

Abuse and neglect of older adults occurs in all Canadian communities and solutions require the coordinated efforts of society at large. Amelioration entails more than a legislative approach. Prevention of this growing problem is a social responsibility that requires networking and collaboration between different disciplines in all sectors of the community. This article will discuss elder abuse in Canada from a historical perspective, as well as current legislation, model programs, and research initiatives. It is intended to allow for comparison from the various countries presented in this volume. Hopefully, readers will find some models, or ideas, they may wish to explore or even replicate within their own jurisdictions.

Social inclusion: an interplay of the determinants of health - new insights into elder abuse.

Social and economic exclusion and inclusion are receiving growing attention and study in North America for their usefulness as a conceptual framework that addresses the many dimensions of poverty and inequality in our society. A discussion of social and economic exclusion/ inclusion flows naturally out of the population health field in which the social determinants of health have become well-established over the last twenty years or more. The determinants of health provide a broad and inclusive outline within which to situate prevention, early detection and effective intervention of the abuse of older persons. A Social Inclusion Lens offers exciting possibilities for addressing the issue of elder abuse and neglect.