Elder abuse at end of life

Context: Advances in health care and changing demographics have led to an aging population whose care at the end of life has become complex. Patients at the end of life, by the nature of their clinical and social circumstances, are at high risk for elder abuse. Underreporting of elder abuse is a growing concern. The clinical presentation of abuse may overlap with the natural dying process, further compounding the problem. Evidence acquisition: Articles were obtained through a PubMed search using the terms "elder abuse" and "elder mistreatment" and from the University of California, Irvine's Elder Abuse Forensic Center library. Additional references were followed through these first set of articles and also from colleagues expert in this field. Evidence synthesis: Multidisciplinary teams have been shown to be the most effective intervention for the assessment and prevention of abuse. Most abuse occurs at home by family members; the hospice team may be the only outside professionals coming into the home. Caregiver stress and victim dependency increase the risk for abuse. Although physical abuse is the most commonly envisioned, neglect is the most common form of abuse. Financial abuse is often the underlying motivation for other forms of abuse. Conclusions: Health professionals have an ethical and legal responsibility to both report and work to prevent suspected abuse. The interdisciplinary team can make a significant impact on elder abuse, a major detriment on quality of life.