Case control study of factor analysis of elder abuse and intervention program for dependent persons at home

[方法]采用访谈法对老年虐待案例和同龄非虐待老年人群体进行对比调查。[结果]主要因素有痴呆、严重依赖、压力、部分人格、精神障碍、经济困难、家庭和亲属的理解和帮助差等，其中最相关的因素是老年人与照顾者的人际关系。2.干预方案[方法]个案研究和对照调查[结果]干预应在遵循以下四项原则的基础上进行；(1)自由(2)安全(3)生活方式的最小改变和(4)对护理选择的最小限制。如有必要，需要逐一进行个别研究。干预赋权的概念对老年人是有效的。至于施虐者，应仔细研究个别个案，包括精神病治疗、慰问、职业训练/介绍等，但事实上，现有资料并不完整，不足以作出准确的评估，在目前的情况下，甚至连评估的地方也没有。有几个因素被认为是阻碍及时进行紧急保护的因素。(一)不保证预算拨款或委托合同。(2)所需床位不能经常预留用于应急保护。(3)员工有义务在强烈的负面形象下工作。(4)老年人不能自己做决定，应该针对这种进退两难的局面做出决定

1.Factor analysis of eldery abuse cases at home by contrast investigation[Method] Contrast investigation of eldery abuse cases and group of eldery persons of similar age without abuse by way of visiting and interview[Findings] Significant factors included dementia, severy dependent cases, stress, partial personal character, mental disorder, economical difficulty, poor understanding and help by family and relatives, etc.The most relevant factor was the human relations between eldery persons and caregivers.2.Intervention program[Method] Case study and contrast investigation[Findings] Intervention should be made on the basis of observing the following four principles ; (1) freedom (2) security (3) minimum change in life style and (4) the least possible limit to the choice of care. If necessary, individual study is required case by case. Intervention with the concept of empowerment is effective for eldery persons. As for the abusers, individual case should be carefully worked out, including medical treatment for mental diseases, couseling, vocational training/introduction.In reality, however, available information is fragmentary and inadequate to make a precise assessment, and there is not even a place for assessment under the present conditions. Several factors are considered to be obstacles to a timely emergency protection. (1) Budget allocation or trust contract is not ensured. (2) Required beds can not be constantly saved for emergency protection. (3) Staff are obliged to work under strong negative image. (4) Decision should be made against the dilemma as the eldery persons are not able to make their self decision