Elder abuse in Finland, France, Spain and United Kingdom

The subject of abuse and the related issues of dignity, poor quality of care and human rights are the most important issue facing health and social services today. Elder abuse has been defined as a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. It includes physical, psychological or emotional, sexual, and financial abuse, and can also be the result of intentional or unintentional neglect. The prevalence of elder abuse is high but widely variable, a fact that may be due both to the use of different definitions or to real societal differences in different countries. Wide differences are reported in the different subtypes of abuse and neglect. Geriatricians and other professionals involved in care of older people seem to be aware and active in detecting and managing abuse, but this awareness has not so clearly been transferred to other specialists or other health care professionals. An increasing number of organizations are being developed in different countries to tackle this problem. Some local guidelines on how to act when abuse is suspected are also available, but the degree of follow-up is highly variable. The lack of valid and widely available screening instruments may leave many cases of abuse and neglect unnoticed. Legal approaches to abuse are again different, but most countries do not have specific legal regulations similar to those usually available for child abuse. Awareness by laypersons is increasing rapidly, with growing attention being paid by the media to relevant cases.