Elder abuse in New Mexico, 2000-2011: The medical examiner perspective

Background/Purpose:Given the rapidly increasing population of people age 60 and over, elder abuse is of increasing concern. Methods: We reviewed 313 records of homicides and undetermined deaths in people age 60 and older from the statewide medical examiner's office in New Mexico to identify confirmed and suspected cases of elder abuse from 2000-2011. Results/Outcomes: White non-Hispanics (57%) and American Indians (19%) were over-represented in the 67 identified elder abuse cases, compared to NM's population. The 29 female decedents were older (78.1 years) than the 38 male decedents (73.6 years) (p=0.10). Two-thirds of the cases were ruled homicides, with homicide victims more likely to be male and younger (p=0.03) than decedents whose deaths were undetermined in manner. In 49% of deaths, the perpetrator was a family member and in 12% of cases the perpetrator was a non-family member caregiver. Blunt force injuries were the most common cause of death (31%), followed by sepsis (12%). Physical evidence of neglect and abuse was found in over a third of the cases, including bed sores (34%), malnutrition (16%), dehydration (12%) and evidence of sexual abuse (8%). A history of physical, emotional or financial abuse was reported in 68% of the investigations. Conclusions: The 4-11 cases of elder abuse per year identified by the NM medical examiner were most likely an under-reporting, given the difficulty of investigating these cases. Family members were the most common perpetrators, similar to previous studies. Implementing an Elder Death Review Team would expedite identification of cases and inform prevention policies.