Studies in dating bruising in elderly
Researchers are also examining how psychological conditions place elders at risk for abuse—in particular, sexual abuse. Researchers noted a disturbing propensity of nursing home staff to diminish the gravity of assaults on residents.
Responses ranging from cynical disbelief to perverse amusement were observed.
Researchers found that accidental bruising occurred in predictable locations in older adults: 90 percent of all bruises were on the extremities; no accidental bruises were observed on the ears, neck, genitals, buttocks, or soles of the feet.
Contrary to a popularly held belief that one can estimate the age of a bruise by its color, this research found that the color of a bruise at the time of its initial appearance is unpredictable.
Some medical examiners and coroners felt that decedents’ families might resist such investigations, particularly if a family member’s complaint had not initiated the investigation.Because most of Cullen’s early victims were elderly and seriously ill, and because toxicology and other tests were not done to detect whether there had been wrongdoing, medical examiners did not classify the deaths as homicides. As a result, no criminal investigations were initiated for several years, which resulted in the loss of valuable forensic evidence.Cullen’s case is an extreme example of what happens when professionals fail to recognize the signs of elder abuse.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.”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.
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.