News and Commentary Archive

Explore recent scientific discoveries and news as well as CLBB events, commentary, and press.

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Elder Abuse

This comprehensive review article published by The New England Journal of Medicine highlights the scope and management of elder abuse, drawing from research and clinical evidence. Perhaps most strikingly, they estimate that the prevalence of elder abuse (physical, psychological, verbal, and sexual abuse, financial exploitation, and neglect) is around 10%.

By Mark S. Lachs and Karl A. Pillemer | The New England Journal of Medicine | November 12, 2015

Although it has probably existed since antiquity, elder abuse was first described in the medical literature in the 1970s.1 Many initial attempts to define the clinical spectrum of the phenomenon and to formulate effective intervention strategies were limited by their anecdotal nature or were epidemiologically flawed. The past decade, however, has seen improvements in the quality of research on elder abuse that should be of interest to clinicians who care for older adults and their families. Financial exploitation of older adults, which was explored only minimally in the initial studies, has recently been identified as a virtual epidemic and as a problem that may be detected or suspected by an alert physician.

In the field of long-term care, studies have uncovered high rates of interpersonal violence and aggression toward older adults; in particular, abuse of older residents by other residents in long-term care facilities is now recognized as a problem that is more common than physical abuse by staff.2,3 The use of interdisciplinary or interprofessional teams, also referred to as multidisciplinary teams in the context of elder abuse, has emerged as one of the intervention strategies to address the complex and multidimensional needs and problems of victims of elder abuse, and such teams are an important resource for physicians.4,5 These new developments suggest an expanded role for physicians in assessing and treating victims of elder abuse and in referring them for further care.

In this review, we summarize research and clinical evidence on the extent, assessment, and management of elder abuse, derived from our analysis of high-quality studies and recent systematic studies and reviews of the literature on elder abuse.6-10

DEFINITIONS AND ESTIMATES OF PREVALENCE

Debates about how to define elder abuse and which types of behavior to include in the definition greatly inhibited progress during the early period of research on this topic. Initial formulations were overly broad and included types of behavior that are not typically part of definitions of domestic abuse, such as crime by strangers, age discrimination, and failure to care for oneself (referred to as “self-neglect”). Over the past decade, however, consensus has arisen about the inclusion of five major types of elder abuse11-13: physical abuse, or acts carried out with the intention to cause physical pain or injury; psychological or verbal abuse, defined as acts carried out with the aim of causing emotional pain or injury; sexual abuse, defined as nonconsensual sexual contact of any kind; financial exploitation, involving the misappropriation of an older person’s money or property; and neglect, or the failure of a designated caregiver to meet the needs of a dependent older person (Table 1).

When these types of abuse have been considered together, epidemiologic surveys have shown generally similar prevalences of elder abuse over a period of 12 months, as indicated by three high-quality epidemiologic studies of community-dwelling older people (60 years of age or older). In a survey of more than 4000 older people in New York State, the rate of elder abuse was found to be 7.6%16,17; in a national survey by Laumann et al., the rate was 9%,12 and in a national telephone survey by Acierno et al.,18 the rate was 10%. It is likely that these figures are underestimates; the reliance on self-reported information from persons who are able to participate in a survey excludes patients with dementia, and studies have shown that dementia places older persons at greater risk for mistreatment.19 When the available evidence is taken into consideration, an estimated overall prevalence of elder abuse of approximately 10% appears reasonable. Thus, a busy physician caring for older adults will encounter a victim of such abuse on a frequent basis, regardless of whether the physician recognizes the abuse.

Continue reading the full journal article here.

Pair allegedly swindled $450,000 meant for cat

John R. Ellement | The Boston Globe | April 17, 2014

Two Brighton roommates allegedly concocted a brazen scheme to bilk an ailing, elderly neighbor of $450,000 by agreeing to use the money to care for the woman’s beloved cat as long as it lived.

But instead of safeguarding the assets for the pet, a tabby named Puddy Cat, the two women are accused of going on a spending spree, buying a $28,000 Mini Cooper car, an iPad, a Vitamix blender, and a Netflix subscription — all while the 74-year-old woman, who suffers from dementia, was in a nursing home. They also siphoned off tens of thousands of dollars in cash, Suffolk Assistant District Attorney Michele Granda said in Suffolk Superior Court Thursday.

Protecting our Parents: Can Science Help?

High-profile schemes to defraud the elderly of their lifetime savings have headlined top newspapers and tabloids alike. There was Brooke Astor, whose son and attorney were convicted of criminal fraud, Anna Nicole Smith and the fight over J. Edgar Marshall’s inheritance, and Huguette Clark, a multi-billionaire who lived for years in a hospital and whose death prompted a criminal investigation into her donations and inheritance. Unfortunately, these notorious cases are merely the tip of a vast and growing iceberg of financial fraud against the elderly. In 2011, Metlife Mature Market Institute estimated an annual loss of $2.9 billion in fraud against elders. Recent surveys indicate that more than 7.3 million Americans over 65 have been victims of financial fraud. As crime rates — and vulnerable populations — increase, the scientific and legal communities must pool our ever-increasing knowledge and resources to protect elderly family members.

Read the full article on the Huffington Post, published February 21, 2014. By Bruce H. Price, MD and Ekaterina Pivovarova, PhD. Written with Judith G. Edersheim, JD, MD.

For further resources on elder fraud and decision making, see the reference materials from our December 2013 event Capacity, Decision-Making and the Elderly: Brain Science Meets the Law, and follow-up article in the Boston Globe “Scammers take aim at aging population,” by event moderator and Globe reporter Kay Lazar.