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The problem with this approach is that caregivers, Adult Protective Services agencies, and doctors are often not trained to distinguish between injuries caused by mistreatment and those that are the result of accident, illness, or aging.Compounding the difficulty in diagnosis is the fact that many elderly individuals suffer from diseases or conditions that produce symptoms mirroring those resulting from abuse.

Responses ranging from cynical disbelief to perverse amusement were observed.

NIJ-funded researchers are also examining data on the deaths of elderly residents in long-term care facilities to identify potential markers of abuse. D., of the University of Missouri-Columbia, the study examined coroners’ reports of elderly nursing home residents in Arkansas over a 1-year period.[6] Amassing data collected pursuant to an Arkansas law[7] requiring nursing homes to report all deaths to local coroners, researchers studied the medical examiner’s investigative process to gather impressions about markers that might indicate mistreatment and identify barriers to accurate assessments of abuse.

Although a majority of the coroner investigations did not raise suspicions of mistreatment, researchers identified four categories of markers that often led to referral to the Arkansas Attorney General for further investigation: Lindbloom’s multidisciplinary research team also conducted focus group interviews with medical examiners, coroners, and geriatricians across the United States to assess the state of forensic investigation of nursing home deaths and to determine ways to identify how abuse and neglect leading to mistreatment deaths might be identified.

Researchers also identified a propensity for medical examiners and coroners to exhibit ageism—a belief that focusing on nursing home deaths was “a waste of their time and resources…because of the poor health status of most nursing home residents…

[who] would die anyway.”[8]These beliefs are major impediments to improvements in the forensic identification of elder deaths. D., of the Baylor College of Medicine, is leading a team of researchers who are examining the deaths of elders who reside in the community to isolate risk factors and identify potential markers of abuse.

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