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Dyadic Vulnerability and Risk Profiling for Elder Neglect

Correspondence: Address correspondence to Terry Fulmer, Division of Nursing, New York University, 246 Greene Street, New York, NY 10003-6677. E-mail: terryfulmer.don{at}nyu.edu

Purpose: Neglect of older adults accounts for 60% to 70% of all elder-mistreatment reports made to adult protective services. The purpose of this article is to report data from research, using a risk-and-vulnerability model, that captures the independent contributions of both the elder and the caregiver as they relate to the outcome of neglect. Methods: Between February 2001 and September 2003, older adults were screened and recruited through four emergency departments in New York and Tampa. The diagnosis of neglect was made by an expert neglect-assessment team. Elders and their caregivers were then scheduled for separate face-to-face interviews after discharge. Results: Constructs within the risk-and-vulnerability model were examined for scale-score significance based on the outcome diagnosis of neglect. In the risk domain, caregivers' functional status, childhood trauma, and personality were statistically significant. In the vulnerability domain, the elders' cognitive status, functional status, depression, social support, childhood trauma, and personality were significant. Implications: Findings from this study underscore the value of interdisciplinary assessment teams in emergency departments for screening elder neglect, with attention given to risk factors related to the caregiver and elder vulnerability factors, including reports of childhood trauma. The risk-and-vulnerability model may provide a link between the caregiving and neglect research. Data should be collected independently from both members of the elder–caregiver dyad in order for clinicians to understand factors related to elders who receive the diagnosis of neglect from interdisciplinary teams.

Key Words: Elder mistreatment • Assessment • Caregiver burden • Childhood trauma

This article has been cited by other articles:

				M. W. Baker Elder Mistreatment: Risk, Vulnerability, and Early Mortality Journal of the American Psychiatric Nurses Association, January 1, 2007; 12(6): 313 - 321. [Abstract] [PDF]

				S. M. Strasser and T. Fulmer The Clinical Presentation of Elder Neglect: What We Know and What We Can Do Journal of the American Psychiatric Nurses Association, January 1, 2007; 12(6): 340 - 349. [Abstract] [PDF]