Financial-patrimonial elder abuse: an integrative review

integrative review of articles indexed in the databases CINAHL, Scopus, Web of Science, LILACS and MEDLINE, from 2007 to 2017. The combination of controlled and uncontrolled descriptors was used in Portuguese, English and Spanish.

Results:

15 studies developed in seven countries were included. In the thematic analysis, three categories emerged: epidemiological data, risk factors and institutions providing services to the elderly. The occurrence of this type of violence concomitantly to the other subtypes was highlighted among the most frequent.

Final considerations:

the literature points to important epidemiological data, risk factors and characteristics of this type of violence, including within institutions providing services to the elderly, in different countries, essential aspects for structuring and rethinking public policies for protection and appreciation of the elderly.

Descriptors:
Aged; Violence; Elder Abuse; Review; Geriatric Nursing

MEDLINE via Pubmed
P	MESH	Aged; Aging; Aged, 80 and over;
P	Und	Elderly; Senescence; Oldest Old
V	MESH	Elder Abuse; Violence
V	Und	Financial exploitation; Elder financial abuse; Elder mistreatment; Economic abuse
O	MESH	Nursing care; nursing
Search history		Search ((((((((aged) OR aging) OR ("aged, 80 and over")) OR elderly) OR senescence) OR "oldest old")) AND (((((("elder abuse") OR violence) OR "financial exploitation") OR "elder financial abuse") OR "elder mistreatment") OR "economic abuse")) AND (("nursing care") OR nursing)
CINAHL
P	Titles	Aged; Aging; Aged, 80 and over
P	Und	Elderly; Senescence; Oldest Old
V	Titles	Elder Abuse; Violence
V	Und	Financial exploitation; Elder financial abuse; Elder mistreatment; Economic abuse
O	Titles	Nursing care
O	Und	Nursing
Search history		(TX aged OR TX aging OR TX ("aged, 80 and over") OR TX elderly OR TX senescence OR TX "oldest old") AND (TX "nursing care" OR TX nursing) AND (TX "elder abuse" OR TX violence OR TX "financial exploitation" OR TX "elder financial abuse" OR TX "elder mistreatment" OR TX "economic abuse")
LILACS via VHL
P	DECS	Aged; Aging; Aged, 80 and over
P	Und	Elderly; Senescence; Oldest Old
V	DECS	Elder Abuse; Violence
O	DECS	Financial exploitation; Elder financial abuse; Elder mistreatment; Economic abuse
O	Und	Nursing care; Nursing
Search history		(tw:((tw:((tw:(aged)) OR (tw:(aging)) OR (tw:("aged, 80 and over")) OR (tw:(elderly)) OR (tw:(senescence)) OR (tw:("oldest old")))) AND (tw:((tw:(violence)) OR (tw:("elder abuse")) OR (tw:("financial exploitation")) OR (tw:("elder financial abuse")) OR (tw:("economic abuse")) OR (tw:("elder mistreatment")))) AND (tw:((tw:(nursing)) OR (tw:("nursing care"))))))
Scopus
P		Aged; Aging; Aged, 80 and over; Elderly; Senescence; Oldest Old
V		Elder Abuse; Violence; Financial exploitation; Elder financial abuse; Elder mistreatment; Economic abuse
O		Nursing care; Nursing
Search history		((TITLE-ABS-KEY ("aged") OR TITLE-ABS-KEY ("aging") OR TITLE-ABS-KEY ("aged, 80 and over") OR TITLE-ABS-KEY ("senescence") OR TITLE-ABS-KEY ("elderly") OR TITLE-ABS-KEY ("oldest old"))) AND ((TITLE-ABS-KEY ("elder abuse") OR TITLE-ABS-KEY ("violence") OR TITLE-ABS-KEY ("financial exploitation") OR TITLE-ABS-KEY ("elder financial abuse") OR TITLE-ABS-KEY ("elder mistreatment") OR TITLE-ABS-KEY ("economic abuse"))) AND ((TITLE-ABS-KEY ("nursing care") OR TITLE-ABS-KEY ("nursing")))
Web of Science
P		Aged; Aging; Aged, 80 and over; Elderly; Senescence; Oldest Old
V		Elder Abuse; Violence; Financial exploitation; Elder financial abuse; Elder mistreatment; Economic abuse
O		Nursing care; Nursing
Search history		(Topic: ("nursing care") OR Topic: (nursing)) AND (Topic: ("elder abuse") OR Topic: (violence) OR Topic: ("financial exploitation") OR Topic: ("elder financial abuse") OR Topic: ("elder mistreatment") OR Topic: ("economic abuse")) AND (Topic: (aged) OR Topic: (aging) OR Topic: ("aged, 80 and over") OR Topic: (elderly) OR Topic: (senescence) OR Topic: ("oldest old"))

Year/Country/Database	Outlining	Objectives	Sample	Conclusion
2009 Czech Republic VHL⁽⁹9 Buzgová R, Ivanová K. Elder abuse and mistreatment in residential settings. Nurs Ethics. 2009;16(1):110-26. doi: 10.1177/0969733008097996 https://doi.org/10.1177/0969733008097996... ⁾	Qualitative	To describe the experiences of elder abuse experienced by residents and employees of institutions for the elderly practiced by the nursing team and family members.	20 elderly, 20 institution employees and 2 municipal authority managers.	The financial abuse suffered by the elderly was practiced especially by family members, influenced by internal (personal) and external (professional) factors. Preventive programs should address these factors.
2010 USA CINAHL⁽¹⁰10 Acierno R, Hernandez MA, Amstadter AB, Resnick HS, Steve K, Muzzy W, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health. 2010;100(2):292-7. doi: 10.2105/AJPH.2009.163089 https://doi.org/10.2105/AJPH.2009.163089... ⁾	Cross-sectional	To estimate the prevalence and correlations between emotional, physical, sexual and financial abuse among the elderly.	5,777 elderly.	The correlated factor found for all types investigated was low social support.
2011 Turkey PubMed⁽¹¹11 Kissal A, Beser A. Elder abuse and neglect in a population offering care by a primary health care center in Izmir, Turkey. Soc Work Health Care. 2011;50(2):158-75. doi: 10.1080/00981389.2010.527570 https://doi.org/10.1080/00981389.2010.52... ⁾	Qualitative	To investigate the prevalence of abuse and neglect of elderly living with their relative and related factors.	331 elderly.	Abuse and neglect were prevalent in 13.3% of the elderly. The related factors were female gender, low schooling, living with spouses and children, having few family relationships.
2012 Ireland PubMed⁽¹²12 Naughton C, Drennan J, Lyons I, Lafferty A, Treacy M, Phelan A, et al. Elder abuse and neglect in Ireland: results from a national prevalence survey. Age Ageing. 2012;41(1):98-103. doi: 10.1093/ageing/afr107 https://doi.org/10.1093/ageing/afr107... ⁾	Cross-sectional	To measure the prevalence of elder abuse and neglect for 12 months and examine the profile of victims and offenders.	2,021 elderly.	The prevalence of abuse and overall neglect was 2.2%. The victims were women, with cognitive impairment and low social protection. The offenders were unemployed, with some addiction (alcoholism), a physical or mental health problem.
2012 Slovenia PubMed⁽¹³13 Habjanic A, Lahe D. Are frail older people less exposed to abuse in nursing homes as compared to community-based settings? Statistical analysis of Slovenian data. Arch Gerontol Geriatr. 2012;54(3):e261-70. doi: 10.1016/j.archger.2011.07.006 https://doi.org/10.1016/j.archger.2011.0... ⁾		To statistically analyze whether elderly care institutions protect frail elderly individuals from mental, physical and financial abuse.	Elderly: 300 (172 living in the home and 128 in shelters for the elderly).	Elderly people may find better protection from physical and financial abuse in institutional custody.
2012 USA VHL⁽¹⁴14 Payne BK, Strasser SM. Financial exploitation of older persons in adult care settings: comparisons to physical abuse and the justice system's response. J Elder Abuse Negl. 2012;24(3):231-50. doi: 10.1080/08946566.2011.653315 https://doi.org/10.1080/08946566.2011.65... ⁾	Cross-sectional	To compare cases of financial abuse with cases of elder physical abuse and the dynamics of the judicial processes of each case.	Elderly who have suffered financial abuse: 242. Elderly who suffered physical abuse: 314.	Most cases of financial abuse received fines as a penalty, while physical abuse cases received arrests and detentions.
2013 USA PubMed⁽¹⁵15 Dong X, Simon MA. Association between reported elder abuse and rates of admission to skilled nursing facilities: findings from a longitudinal population-based cohort study. Gerontology. 2013;59(5):464-72. doi: 10.1159/000351338 https://doi.org/10.1159/000351338... ⁾	Population-based cohort	To quantify the relationship between elder abuse and the specific subtypes of elder abuse and the rate of admission in specialized nursing practices.	6,674 participants in the Chicago Aging and Health Project.	Elder abuse is independently associated with increased admission rates and stays longer than 30 days in the health service.
2013 Ireland PubMed⁽¹⁶16 Naughton C, Drennan J, Lyons I, Lafferty A. The relationship between older people's awareness of the term elder abuse and actual experiences of elder abuse. Int Psychogeriatr. 2013;25(8):1257-66. doi: 10.1017/S1041610213000513 https://doi.org/10.1017/S104161021300051... ⁾	Cohort	To describe the prevalence of five types of elder abuse, compare levels of consciousness, examine the relationship between elder abuse experiences and the characterization of the term, and the relationship between knowing the term and asking for help.		Knowing the term elder abuse and/or having had some experience with abusive behavior has not made the person capable of recognizing all kinds of abuse present in their lives. Knowing abuse in general did not influence the behavior of asking for help.
2013 Australia CINAHL⁽¹⁷17 Bagshaw D, Wendt S, Zannettino L, Adams V. Financial abuse of older people by family members: views and experiences of older Australians and their family members. Aust Soc Work. 2013;66(1):86-103. doi: 10.1080/0312407X.2012.708762 https://doi.org/10.1080/0312407X.2012.70... ⁾	Mixed	To analyze data from two Brazilian online surveys, which examined elder abuse.	Health services providers: 214Elderly and family members: 113.	All elderly and family members identified the sense of entitlement held by a relative and diminished ability as risk factors for financial abuse. Many elderly were unaware of the potential risks to their financial well-being. Service providers have difficulties in involving the elderly in preventive interventions.
2013 USA VHL⁽¹⁸18 Mukherjee D. Financial exploitation of older adults in rural settings: a family perspective. J Elder Abuse Negl. 2013;25(5):425-37. doi: 10.1080/08946566.2012.751828 https://doi.org/10.1080/08946566.2012.75... ⁾	Qualitative	To explore perceptions of children who migrated from the urban area due to lack of employment opportunities and provide care to parents.	Elderly Caregivers of Southern Illinois: 6.	The financial exploitation of the elderly in rural environments is a hidden problem.
2013 Canada PubMed⁽¹⁹19 Ploeg J, Lohfeld L, Walsh CA. What is "elder abuse"? voices from the margin: the views of underrepresented Canadian older adults. J Elder Abuse Negl. 2013;25(5):396-424. doi: 10.1080/08946566.2013.780956 https://doi.org/10.1080/08946566.2013.78... ⁾	Qualitative	To explore perceptions of elder abuse from older people representing less-either-or less-marginalized groups in Canada.	Elderly people from less - or marginalized groups: 87.	The elderly are a heterogeneous group with diverse origins, concerns and vulnerabilities, so it is important to consider the cultural and ethnic differences and the various perspectives of elder abuse.
2013 USA PubMed⁽²⁰20 Castle N, Beach S. Elder abuse in assisted living. J Appl Gerontol. 2013;32(2):248-67. doi: 10.1177/0733464811418094 https://doi.org/10.1177/0733464811418094... ⁾	Cross-sectional	To identify elder abuse perpetrated by Nursing aides in Assisted Livings (AL).	Nurse aides who worked at AL: 832.	Complaints at places like Assisted Livings are not uncommon. It is necessary to extend the institutional focus to the AL to better investigate elder abuse
2014 USA VHL⁽²¹21 Friedman B, Santos EJ, Liebel DV, Russ AJ, Conwell Y. Longitudinal prevalence and correlates of elder mistreatment among older adults receiving home visiting nursing. J Elder Abuse Negl. 2014;27(1):34-64. doi: 10.1080/08946566.2014.946193 https://doi.org/10.1080/08946566.2014.94... ⁾	Cohort	To identify the prevalence of ill-treatment to the elderly who received a Home Visit of nurses and to determine the types of elder abuse and the factors associated with such maltreatment.	Elderly: 724.	The prevalence of abuse was 7.4%, and the types of were psychological, financial, physical, sexual and negligence. Associated factors were: social and family, mental and physical health and the inability to perform ADL and IADLs.
2014 Australia VHL⁽²²22 Adams VM, Bagshaw D, Wendt S, Zannettino L. Financial abuse of older people by a family member: a difficult terrain for service providers in Australia. J Elder Abuse Negl. 2014;26(3):270-90. doi: 10.1080/08946566.2013.824844 https://doi.org/10.1080/08946566.2013.82... ⁾	Mixed	To report findings from a research project funded by the Australian Research Council that focused on financial abuse by family members.	Executive heads of care organizations for the elderly: 228. Assistance professionals of these institutions: 214.	Assistance professionals and executive heads could benefit from whistleblower legislation to prevent prosecution in cases where they initiated research that did not produce sufficient evidence for financial abuse.
2016 Turkey Scopus⁽²³23 Özcan NK, Boyacioglu NE, Sertçelik E. Reciprocal abuse: elder neglect and abuse by primary caregivers and caregiver burden and abuse in Turkey. Arch Psychiatr Nurs. 2016;31(2):177-82. doi: 10.1016/j.apnu.2016.09.011 https://doi.org/10.1016/j.apnu.2016.09.0... ⁾	Cross-sectional	To determine the relationship between neglect and abuse suffered by the elderly and primary caregivers and the experiences of overloading and abuse of caregivers.	Elderly: 186; Caregivers: 136.	Abuse is a mutual relationship between the elderly and caregivers, it is necessary to study the burden on perpetrators of abuse.

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[1] Corresponding Author: Ana Maria Ribeiro dos Santos. E-mail: ana.mrsantos@gmail.com