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Improving forensics: Characterizing injuries among community‐dwelling physically abused older adults
Author(s) -
YonashiroCho Jeanine M. F.,
Gassoumis Zachary D.,
Wilber Kathleen H.,
Homeier Diana C.
Publication year - 2021
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.17192
Subject(s) - medicine , injury prevention , poison control , suicide prevention , occupational safety and health , elder abuse , accidental , incidence (geometry) , physical abuse , trauma center , human factors and ergonomics , child abuse , psychiatry , medical emergency , retrospective cohort study , surgery , physics , pathology , acoustics , optics
Background Physical elder abuse affects a substantial number of older adults, leaving victims at increased risk for negative health outcomes. Improved detection of abuse‐related injuries may increase victim access to professional support, but providers report difficulties distinguishing between accidental and abuse‐related injuries, due in part to victims' pre‐existing health conditions and medication use. Objectives To describe the spectrum and characteristics of injuries among physically abused older adults and identify injury characteristics associated with abuse. Design Case–control study. Setting Physically abused adult protective services clients were interviewed in their home; non‐abused comparison group participants were interviewed in an outpatient geriatrics clinic. Participants Sample included 156 community‐dwelling adults aged 65 and older, including 57 physically abused and 99 non‐abused individuals. Self‐reported abuse history was confirmed through independent case assessment by a LEAD (Longitudinal, Expert All‐Data) panel of clinicians with family violence expertise. Measurements Full‐body assessments were conducted, documenting injury incidence, diagnosis, and location. We also collected sociodemographic characteristics, level of social support, functional ability, medical history, and medication use. Results Physically abused older adults were more likely to be injured upon assessment (79.0% vs 63.6%; p < 0.05) and have a greater number of injuries ( x ¯ = 2.9 vs x ¯ = 2.0 , p < 0.05). Injuries seen more often among abused individuals included: upper extremity ecchymoses (42.1% vs 26.3%; p < 0.05), abrasions (31.6% vs 11.1%; p < 0.01), and areas of tenderness (8.8% vs 0.0%; p < 0.01); and head/neck/maxillofacial ecchymoses (15.8% vs 2.0%; p < 0.01) and tenderness (15.8% vs 0.0%; p < 0.001). Lower extremity abrasions (12.3%) were common but unrelated to abuse status. Conclusion While physical abuse does not always result in physical injury, victims more commonly display head/neck/maxillofacial ecchymoses or tenderness and upper extremity abrasions, ecchymoses, or tenderness. Detection of these injuries among older adults warrants further interview and examination.