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Elder neglect and the pathophysiology of aging.

Kim A Collins1, S Erin Presnell

  • 1Department of Pathology, Forensic Section, Medical University of South Carolina, Charleston, South Carolina 29425, USA. collinsk@musc.edu

The American Journal of Forensic Medicine and Pathology
|May 26, 2007
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Summary

Fatal elder neglect is challenging to diagnose, often underreported, and can mimic natural aging. This study analyzed 8 forensic cases, finding deaths due to sepsis from decubitus ulcers and dehydration.

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Area of Science:

  • Forensic Pathology
  • Gerontology
  • Public Health

Background:

  • Elder neglect is a critical form of elder maltreatment, yet it is underreported and difficult to diagnose.
  • Distinguishing fatal neglect from age-related conditions or concurrent organic diseases presents significant challenges in forensic investigations.
  • Existing scientific literature and law enforcement data show underreporting of elder neglect cases.

Purpose of the Study:

  • To analyze characteristics of fatal elder neglect cases through a retrospective review of forensic autopsies.
  • To identify common causes of death, locations, and perpetrator relationships in cases of fatal elder neglect.
  • To review the pathophysiology of aging in the context of elder maltreatment.

Main Methods:

  • Retrospective review of forensic autopsy cases for individuals aged 65 years and older.
  • Analysis of identified fatal neglect cases based on demographics, cause of death, incident location, and perpetrator details.
  • Examination of autopsy and ancillary findings in relation to elder neglect.

Main Results:

  • Eight cases of fatal elder neglect were identified and analyzed.
  • The primary causes of death were sepsis resulting from severe decubitus ulcers and severe dehydration.
  • Cases involved victims aged 74-94, with 7 females and 1 male; 5 occurred in homes, 3 in institutions; family members were perpetrators in 5 instances.

Conclusions:

  • Fatal elder neglect, particularly when complicated by aging-related conditions, requires careful forensic evaluation.
  • Sepsis from decubitus ulcers and dehydration are significant causes of death in elder neglect.
  • Understanding the dynamics of neglect, including perpetrator relationships and locations, is crucial for prevention and intervention efforts.