Mistreatment and self-neglect in community dwelling older adults: Studies of construct validity, measurement invariance and latent classes

Mistreatment and self-neglect significantly increase the risk of dying in older adults. It is estimated that 1 to 2 million older adults experience elder mistreatment and self-neglect every year in the United States. Currently, there are no elder mistreatment and self-neglect assessment tools with construct validity and measurement invariance testing and no studies have sought to identify underlying latent classes of elder self-neglect that may have differential mortality rates. Using data from 11,280 adults with Texas APS substantiated elder mistreatment and self-neglect 3 studies were conducted to: (1) test the construct validity and (2) the measurement invariance across gender and ethnicity of the Texas Adult Protective Services (APS) Client Assessment and Risk Evaluation (CARE) tool and (3) identify latent classes associated with elder self-neglect. Study 1 confirmed the construct validity of the CARE tool following adjustments to the initial hypothesized CARE tool. This resulted in the deletion of 14 assessment items and a final assessment with 5 original factors and 43 items. Cross-validation for this model was achieved. Study 2 provided empirical evidence for factor loading and item-threshold invariance of the CARE tool across gender and between African-Americans and Caucasians. The financial status domain of the CARE tool did not function properly for Hispanics and thus, had to be deleted. Subsequent analyses showed factor loading and item-threshold invariance across all 3 ethnic groups with the exception of some residual errors. Study 3 identified 4-latent classes associated with elder self-neglect behaviors which included individuals with evidence of problems in the areas of (1) their environment, (2) physical and medical status, (3) multiple domains and (4) finances. Overall, these studies provide evidence supporting the use of APS CARE tool for providing unbiased and valid investigations of mistreatment and neglect in older adults with different demographic characteristics. Furthermore, the findings support the underlying notion that elder self-neglect may not only occur along a continuum, but that differential types may exist. All of which, have very important potential implications for social and health services distributed to vulnerable mistreated and neglected older adults.^

Questões sobre Classes, Dominação e Conflitos Sociais na Alta Idade Média

Except for a History that is mobilized, nowadays, much more by the supposedly continuities than the changes, the periods of major transitions continue to demand interpretative effort from specialists. It is long the list of those who have been dedicated to the transitional problem between the Antiquity and the Middle Ages, focused on a period of poor and unequally distributed sources, trying to shed light and establish various interpretative means for this phenomenon. Albeit having overcome some of the catastrophic perspectives hindering the pioneer analyses within this context, the current approaches have also eliminated the recognition of both the contradictory manifestations and the social struggles acting as central and fundamental engines of the social transformations within the discussed context. When supported by an adequate theoretical background, documents from the period lead us to a process resulting from contradictions and a scenario of actions and reactions that eventually materialized the conflicts and moved History forward. The transition from the Antiquity to the Middle Ages was encompassed by diverse social antagonist manifestations, which allows us to consider that the arena of disputes were, therefore, that of the society itself.

Questões sobre Classes, Dominação e Conflitos Sociais na Alta Idade Média

Except for a History that is mobilized, nowadays, much more by the supposedly continuities than the changes, the periods of major transitions continue to demand interpretative effort from specialists. It is long the list of those who have been dedicated to the transitional problem between the Antiquity and the Middle Ages, focused on a period of poor and unequally distributed sources, trying to shed light and establish various interpretative means for this phenomenon. Albeit having overcome some of the catastrophic perspectives hindering the pioneer analyses within this context, the current approaches have also eliminated the recognition of both the contradictory manifestations and the social struggles acting as central and fundamental engines of the social transformations within the discussed context. When supported by an adequate theoretical background, documents from the period lead us to a process resulting from contradictions and a scenario of actions and reactions that eventually materialized the conflicts and moved History forward. The transition from the Antiquity to the Middle Ages was encompassed by diverse social antagonist manifestations, which allows us to consider that the arena of disputes were, therefore, that of the society itself.

Questões sobre Classes, Dominação e Conflitos Sociais na Alta Idade Média

Except for a History that is mobilized, nowadays, much more by the supposedly continuities than the changes, the periods of major transitions continue to demand interpretative effort from specialists. It is long the list of those who have been dedicated to the transitional problem between the Antiquity and the Middle Ages, focused on a period of poor and unequally distributed sources, trying to shed light and establish various interpretative means for this phenomenon. Albeit having overcome some of the catastrophic perspectives hindering the pioneer analyses within this context, the current approaches have also eliminated the recognition of both the contradictory manifestations and the social struggles acting as central and fundamental engines of the social transformations within the discussed context. When supported by an adequate theoretical background, documents from the period lead us to a process resulting from contradictions and a scenario of actions and reactions that eventually materialized the conflicts and moved History forward. The transition from the Antiquity to the Middle Ages was encompassed by diverse social antagonist manifestations, which allows us to consider that the arena of disputes were, therefore, that of the society itself.