Elder abuse: a retrospective analysis of autopsy cases from the department of legal medicine in Genoa from 2006 to 2017

Elder abuse is a form of violence that is often misunderstood and still underestimated. This kind of abuse is classified in physical abuse, psychological abuse, financial abuse, sexual abuse, neglect and self-neglect. In this study, 784 cases of dead people over 65 years of age were retrospectively analyzed: in all cases, the cause of death was determined by the autopsy. Ten cases have been classified as victims of elder abuse: 7 females and 3 males aged between 67 and 91 (average age of 78.9 years). The types of abuse were as follows: neglect: 8 cases; physical abuse: 2 cases; psychological abuse: 2 cases; financial abuse: 2 cases; self neglect: 2 cases. In three cases, the victims had been subjected to two or more types of abuse. In 5 cases the victims had a neuro-psychic decay. In cases of neglect the cause of death was due to sepsis or dehydration. In a case of physical abuse, death was traumatic and related to physical violence. In cases of self neglect, death occurred due to cardiac causes. In cases of domestic abuse, the perpetrator was in most cases the elder's son and in one case the paid caregiver. In three cases, however, the abuses were committed against elderly guests in Nursing Homes. In three cases the perpetrator was affected by psychiatric disorders. Recognizing the elder abuse is often difficult and the understanding of the phenomenon in the case of death requires an integrated analysis of the autopsy data and the anamnesis of the victim.