Abuse and Neglect: A Ten-Year Review of Mortality and Morbidity in Our Elders in a Large Metropolitan Area

• NCJ Number: 203998
• Journal: Journal of Forensic Sciences Volume: 49 Issue: 1 Dated: January 2004 Pages: 122-127
• Author(s): Lisa B. E. Shields M.D.; Donna M. Hunsaker M.D.; John C. Hunsaker M.D.
• Date Published: January 2004
• Length: 6 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This paper draws lessons for the investigation of cases that involve elderly victims, based on a 10-year (1992-2001) retrospective study of individuals 60 years old and older whose manner of death included homicide and signs of neglect at the completion of background investigation and postmortem examination performed at the Office of the Chief Medical Examiner in Louisville, KY.

Abstract

The neglect cases included those in which either bronchopneumonia, sepsis, or dehydration were the underlying causes of death, or various combinations of findings were diagnosed, such as decubitus ulcers, necrotizing fascitis/gangrene, and cachexia unrelated to carcinoma. A total of 1,099 autopsy cases were classified as homicide over the study period. Medicolegal investigators determined that 52 individuals were victims of homicidal acts, and 22 subjects died as a result of neglect. The various causes of death of the homicide victims included gunshot, beating, stabbing, and asphyxia, or combinations of these. Twenty-two individuals yielded findings at post mortem examination regarded as suspicious for neglect. Two of the 52 homicide victims sustained a sexual battery, as confirmed at autopsy. A total of 2,250 living individuals 60 years old and older were evaluated by the staff of the Clinical Forensic Medicine Program between 1992 and 2001. The staff concluded that 19 of the subjects were the victims of physical and/or sexual assault. Three subjects had experienced neglect. This report summarizes the characteristic features of elder abuse in both postmortem and living cases and emphasizes the necessity of multiagency collaboration in cases of suspected abuse and neglect that involve elderly victims. Policies established by an elderly abuse task force promote the collaborative interaction required to formulate criteria for the prevention and investigation of abuse and death within this vulnerable population. 3 figures, 7 tables, and 18 references