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Physical abuse against elderly persons in institutional settings
Sofia Lalanda Frazão1, Ana Margarida Correia2, Pedro Norton3
1Department of Legal Medicine and Forensic Sciences, Faculty of Medicine of Porto University, Portugal; North Branch of the National Institute of Legal Medicine and Forensic Sciences, Porto, Portugal; Abel Salazar Biomedical Science Institute, Porto, Portugal; Forensic Science Center - CENCIFOR, Coimbra, Portugal.
Journal of Forensic and Legal Medicine
|September 24, 2015
Summary
Institutional physical abuse against the elderly is underdetected and underreported. Many cases lack clear injuries, and victims
Area of Science:
- Gerontology
- Forensic Medicine
- Social Sciences
Background:
- The population aged 65 and over is a growing demographic increasingly vulnerable to elder abuse.
- While intrafamilial elder abuse is well-researched, institutional abuse, its characteristics, and determinants remain poorly understood.
Purpose of the Study:
- To enhance understanding of physical abuse against elderly individuals in institutional settings.
- To aid in the early detection, accurate forensic diagnosis, and prevention of institutional elder abuse.
Main Methods:
- Retrospective analysis of forensic medical examinations conducted between 2004 and 2013.
- Study focused on elderly individuals (n=59) in institutional settings allegedly subjected to physical abuse by caregivers.
- Data sourced from the North Forensic Medical Services of Portugal.
Main Results:
- All alleged incidents occurred in nursing homes, with charges typically against the institution (93.2%).
- Victims were predominantly female (79.7%), aged 75+ (75.9%), severely disabled (55.9%), and often unable to communicate (47.2%).
- Physical abuse was supported by forensic findings in only 6.8% of cases; neglect was identified in 69.1%, with a significant association between disability and neglect (p=0.003).
Conclusions:
- Underestimation of sample size is likely due to detection and reporting challenges.
- Victims' disabilities, communication barriers, and fear of reprisal impede abuse detection and diagnosis, especially when injuries are not evident.
- Urgent analysis and understanding are needed to develop protective social policies and improve professional training amid a rapidly aging population.