This issue of Clinics in Geriatric Medicine, devoted to Medical Implications of Elder Abuse and Neglect, is edited by Drs. Lisa Gibbs and Laura Mosqueda. Articles in this issue include: Physiology of Aging; Understanding the Medical Markers of Elder Abuse and Neglect: Physical Exam Findings; Medical Markers of Elder Abuse and Neglect: Laboratory Findings; Common Presentations of Elder Abuse in Healthcare Settings; Physical Abuse; Elder Abuse and Neglect by Others; Geriatric Sexual Abuse; Emotional Abuse in Geriatrics; Self- Neglect in Geriatrics; Capacity Assessment in Elder Abuse and Neglect; Geriatric Dementia and Abuse; Mental Health/ Psychiatric Issues in Elder Abuse and Neglect; Care of the Victim in Elder Abuse and Neglect; Prevention and Early Identification of Elder Abuse and Neglect; and Doctors Roles and Relationships with other Agencies in Elder Abuse and Neglect.

Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine's Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims' needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings. Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.

This book provides a global comprehensive and systematic state-of-the review of this field that fills the gaps between research, practice, and policy. The book addresses the epidemiology of the issue and the global prevalence of elder abuse in both developed and developing countries, which synthesizes the most up-to-date data about risk factors and protective factors associated with elder abuse and consequences of elder abuse; clinical assessment and management of elder abuse, including screening, detection, management of elder abuse, and the role of decision making capacity and forensic approaches; practice and services that describe adult protective services, legal justice, elder court systems, and guardianship system; elder abuse and culture, which provides more in-depth anthropological and ethnographic experiences; policy issues, which highlights the elder justice movement, GAO reports, elder justice act, older American act and elder justice coordinating council; and future directions, which explores translational research, practice, education/training and policy issues surrounding elder abuse. Elder Abuse: Research, Practice and Policy is a useful resource for aging researchers, social services, general internists, family medicine physicians, social workers, nurses, and legal professionals interested in the issues of elder abuse.

Elder Abuse and Neglect remains an important topic in Geriatric Medicine not only because of our nation's large number of nursing homes (approx. 17,000), but also because of basic short term care that may fall into the defined categories of physical abuse, verbal/emotional abuse, and physical, medical and emotional neglect. This issue, guest edited by Martin Gorbien of Rush University Medical Center, serves to clearly define elder abuse and neglect. Topics ranging from cultural issues in elder abuse to the legal system's response and public policy initiatives are addressed by experts in this issue.

Since the late 1970s when Congressman Claude Pepper held widely publicized hearings on the mistreatment of the elderly, policy makers and practitioners have sought ways to protect older Americans from physical, psychological, and financial abuse. Yet, during the last 20 years fewer than 50 articles have addressed the shameful problem that abusersâ€"and sometimes the abused themselvesâ€"want to conceal. Elder Mistreatment in an Aging America takes a giant step toward broadening our understanding of the mistreatment of the elderly and recommends specific research and funding strategies that can be used to deepen it. The book includes a discussion of the conceptual, methodological, and logistical issues needed to create a solid research base as well as the ethical concerns that must be considered when working with older subjects. It also looks at problems in determination of a report's reliability and the role of physicians, EMTs, and others who are among the first to recognize situations of mistreatment. Elder Mistreatment in an Aging America will be of interest to anyone concerned about the elderly and ways to intervene when abuse is suspected, including family members, caregivers, and advocates for the elderly. It will also be of interest to researchers, research sponsors, and policy makers who need to know how to advance our knowledge of this problem.

Understand the complex ethical, legal, medical, and psychological issues of the most common form of elder abuse! Self-Neglect examines the social, ethical, medical, and practical implications of the most prevalent form of elder abuse. It can be difficult to diagnose and treat, and it poses ethical questions that cannot be answered simply. Yet it is so common and so destructive that anyone who works with geriatric patients must come to terms with it. Everyone is familiar with the image of the wild-haired elderly recluse hoarding junk in a dilapidated house, but to their neighbors, friends, and family--as well as to the health care professionals, social workers, and clergy who deal with them--these recluses are a special burden. They often refuse care despite such obvious problems as open sores. They tend to be intelligent and independent. Do they have the right to choose to live in squalor, or are their choices dictated by depression or other diseases? Do health care professionals have a responsibility to treat them against their will or a duty to respect their stated preferences? Self-Neglect examines the topics of passive suicide and indirect life-threatening behavior to help medical practitioners working with the elderly understand why patients do not follow doctor's orders or take care of themselves. Through case studies, this informative book explores the ways in which patients practice self-neglect by ignoring their doctors’advice, extreme lack of self-care, refusal to eat, failure to take their prescribed medication, and alcohol abuse. Self-Neglect offers insight into many facets of this condition, including: choosing among the many definitions of self-neglect what kinds of people become self-neglecting managing self-neglecting patients when and how to intervene the patient's autonomy and personal rights versus the rights of the community self-neglect as a way to gain control of a negative life situation when other tactics have failed Discussing the sometimes tragic outcome of misdiagnosing self-neglect or leaving it untreated, this intelligent book will help you identify and understand this dangerous behavior and offer your patients better care for this condition.