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Bruising as a Forensic Marker of Physical Elder Abuse

Award Information

Award #
Funding Category
Congressional District
Funding First Awarded
Total funding (to date)

Description of original award (Fiscal Year 2005, $375,655)

The existence of the nation's only Elder Abuse Forensic Center gives physicians and gerontologists from the University of California, Irvine School of Medicine a unique and unprecedented opportunity to systematically document bruising known to have occurred in elders who have been physically abused. The goals of this project are to: (1) provide practical information to medical, forensic, and law enforcement personnel; and (2) advance the science on the forensic markers of physical elder abuse.

The research questions guiding the project are: (1) In cases of confirmed physical elder abuse, what percentage of the victims are bruised? (2) What are the location, initial color, number of bruises, and victim-stated cause of bruises; (3) Are there systematic differences between bruises in older adults who have not been abused as compared to older adults who have been physically abused?

In order to answer these three questions, the project will:
(1) Identify cases of suspected physical elder abuse from Adult Protective Services, Law Enforcement, and the Emergency Department;
(2) Determine the likelihood that the physical abuse occurred in the reported case;
(3) Conduct skin examinations of older adults who have reportedly been the victims of physical elder abuse;
(4) Document bruising, victim demographics, medications, and functional status in a format parallel to the data collected in the prior NIJ study on accidental bruising.
(5) Compare the pattern of bruises in people who have been physically abused with the pattern in those who have not been abused.


This project will develop a theoretical framework for understanding why elder abuse occurs. In order to develop this framework, an extensive literature review of the elder abuse, domestic violence, child abuse, criminal justice, psychology, medical anthropology, sociology, palliative care, gerontology, forensics, and public health literature will be conducted. This review will uncover all published and referenced theoretical models pertinent to elder abuse. Systematic, comprehensive searches will be guided by elder abuse and theoretical modeling experts aided by the librarians of the Grunigen Medical, the Jack Langson and the Science Libraries of the University of California Irvine. A search strategy will be outlined through library consultations attended by Laura Mosqueda, M.D., Kerry Burnight, Ph.D., and the Co-Investigator (TBN), and reviewed for completeness by UCI researchers including Aileen Wiglesworth, Ph.D. (gerontologist and elder abuse expert) and Dara Sorkin, Ph.D. (social ecologist and modeling expert). Additionally, domestic violence experts Carol Tryon, M.S.W., (a geriatric social worker specializing in family violence and elder abuse) and Ronald A. Chez, M.D. (a retired obstetrician-gynecologist who is active with the American College of Obstetricians and Gynecologists' initiative in domestic violence and elder abuse) will contribute to the research strategy as paid consultants.

The librarian will provide literature source and search technology expertise. A plan of all the activities required will result, and provide a template for tracking and completing this phase of the project. As pertinent literature is identified, a trained Research Assistant will download or enter reference information into a software tool for managing bibliographies (EndNote), and write a brief review of relevant information for inclusion in the notes section. Each model will be scanned, annotated and maintained online as well. In addition, as interesting models are identified, the research team will attempt to locate their authors for brief telephone interviews to determine whether a structured interview will provide new information to guide and inform the project.
Drs. Mosqueda, Burnight and the Co-Investigator will develop a structured, in-depth interview based on the literature review. Through their current network of experts, the consultants and the literature review, the Co-Investigator will identify 20 or more subject matter experts, both practitioners and researchers, to participate in structured interviews. The goal of the interviews will be to capture unpublished, up-to-date work and ideas on theoretical models for elder abuse and the related topics. The recorded interviews will be conducted either onsite, via teleconference, or via videoconference. The Co-Investigator, with the help of the Research Assistant will transcribe notes from the interviews to be included in the study data.
For the final report, the Co-Investigator, advised by Drs. Mosqueda and Burnight and the domestic violence consultants, will synthesize the literature and interview materials based on emergent categories of theoretical models. Samples of theoretical models for elder mistreatment will also be produced, as 'straw men' for further discussion.


Date Created: September 19, 2005