RESUMO
The demographic ageing of the population is accompanied by the gradual increase in the number of the people of the advanced age both in Russia and in other countries all over the world. This situation enhances the probability of violence and the improper care of the elderly subjects both in their families and in the specialized socio-medical facilities. The objective of the present work was to study the experience of the foreign specialists dealing with the problem of the improper care for the elderly subjects with a view to the identification of the diagnostic criteria for the application in the forensic medical practice. The improper care of the elderly subjects is one of the most widespread forms of violence because the associated inadequate actions or the absence of thereof are likely to be a cause of high morbidity and mortality among the persons of this age group as a result of infectious diseases. In the case of the lethal outcomes, the measures of investigation have the purpose not only to elucidate the cause of death but also to establish the relationship between the fact of death and the form of violence including the improper care. The latter can be manifested as the poor hygienic conditions, untidiness of attire, marked dehydration, nutritional dystrophy, injuries and skin burns, persistent and/or refractory cutaneous eruption in the anogenital and inguinal regions, inadequately treated decubital sore of atypical localization. The most dangerous complication of decubital ulcers in the elderly subjects is the systemic infection making up the commonest case of death. Such lethal outcomes are considered to be accidents and sometimes are qualified as murder. The report of the careful forensic medical examination is indispensable for the reliable evaluation of the circumstances of death and the quality of the medical treatment provided for the elderly subjects. Not infrequently it is of crucial importance in the civil and criminal procedures.