Identifying forensic markers for determining elder mistreatment as cause of death
Clark, Colleen Marie
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Elders, people over the age of 64, comprise the fastest growing segment of the population, and it is expected that the incidence of elder mistreatment will increase just as rapidly. Elder mistreatment is a serious issue that has only recently gained public awareness. Elder mistreatment is one of the least understood, researched or reported social issues and studies estimate that only 1 of every 14 cases is ever discovered. When an elder dies, it is usually the responsibility of the local medical examiner or coroner to conduct a full investigation to determine the cause and manner of death. However, there are currently no guidelines in existence to help distinguish between mistreatment and the ravages of advanced age or disease. Without effective tools to aid detection of elder mistreatment, the problem cannot be properly addressed, making reporting, intervention and prosecution impossible. This paper evaluates several potential markers of elder mistreatment along with physiologic changes of age and disease, to ascertain the merit of each finding asan indicator of abuse or neglect and develop an investigative protocol. A table and figure summarize and categorize the findings discussed throughout this paper. To ensure more accurate certification of elder deaths, research was reviewed and compiled in order to compare natural aspects of aging or accidental injury to inflicted injuries. In addition to characterizing elder's injuries, this research also describes the typical victim, the usual perpetrator, the victimperpetrator relationship and risk factors of elder mistreatment as part of the investigative protocol development. Enhanced knowledge of the signs and typical features of abuse and neglect will help medical professionals, law enforcement officials, and social service providers, more readily detect, report, and intervene in cases of elder mistreatment when they occur.
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