Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community.

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.

Prevention and early identification of elder abuse.

Elder abuse is a public health problem growing more pervasive despite being grossly underreported and underdetected. Annually, many vulnerable older adults suffer various forms of abuse threatening their overall health, quality of life, and survival. To better protect our aging population, we must overcome obstacles such as ageism, lack of geriatric health professional training, and low screening practices in clinical settings. Addressing these challenges is not sufficient for eliminating the abuse of older adults, but it is necessary for diminishing the potential for abuse and the associated negative health outcomes.

Anticipatory stress response in PTSD: extreme stress in children.

TOPIC: Anticipatory stress chronically activates the stress response in children with post-traumatic stress disorder (PTSD). Effects of the allostatic load may begin even before birth in a stressful environment. PURPOSE: The purpose of this paper is to discuss the anticipatory stress response in children with PTSD. The paper discusses the etiology, the impact of the disorder on long-term health, cognitive and behavioral manifestations, and clinical management and treatment options. SOURCES USED: A review on current literature is presented and includes several key studies. CONCLUSIONS: Anticipatory stress in PTSD has acute and long-term health implications for the child. The psychiatric nurse plays a key role in preventing the long-term effects of PTSD.