Curated Research: Forensics

Curated Research: Forensics

The forensic aspects of elder abuse and neglect are beginning to be explored and documented. In this section we present some recent research about several potential forensic markers.


 
Hair sample and test tube

 

Hair samples reveal starvation to help document elder abuse and neglect

Baković, M., Vreča, P., & Mayer, D. (2017). Case of fatal starvation: Can stable isotope analysis serve to support morphological diagnosis and approximate the length of starvation? Journal of Forensic Science, 62(1), 258-264. doi:10.1111/1556-4029.13244

The authors conducted analysis of stable carbon and nitrogen isotope ratios in hair samples to investigate whether or not this type of analysis could support more traditional forms of starvation diagnosis based on anthropological measurements, visual, microscopic analysis, laboratory testing, and exclusion of other causes of death.  They conclude that because hair growth rate of malnourished individuals has never been measured accurately, it is still not possible to determine the time frame of isotope change reliably.  But future investigations of stable isotope changes in people deceased due to starvation, as well as comparisons of these with autopsy findings, could lead to advances in forensic medicine that would be useful for forensic medicine experts testifying in cases of suspected starvation.

 
Patient being rushed into ER

 

Emergency room protocol to photograph injuries and evaluate abuse

Bloemen, E.M., Rosen, T., Schiroo, J.A.C., Clark, S., Mulcare M.R., Stern, M.E., Mysliwiec, R., Flomenbaum, N.E., Lachs, M.S., &Hargarten, S. (2016). Photographing injuries in the acute care setting:  Development and evaluation of a standardized protocol for research, forensics, and clinical practice.  Academic Emergency Medicine, 23(5), 653-659.  doi:  10.1111/acem.12955

The authors created and validated a standardized protocol for photographing and documenting injuries to elders in acute care Emergency Department settings. The protocol requires a simple ruler, color guide and a standard point-and-shoot digital camera.  The protocol was accurate and reliable for different types of injuries to 33 different parts of the body when used by non-professional photographers with minimal training.  The process took less than two minutes when photographing a single injury and less than five minutes for multiple injuries.  The photos can be used in future legal/forensic processes as defensible evidence. 

 
Elderly person's arm in cast

 

Fracture repair healing continuum applied to elder abuse investigations

Boyd, D. C. (2017). The anatomical basis for fracture repair: Recognition of the healing continuum and its forensic applications to investigations of pediatric and elderly abuse. In C. C. Boyd & D. C. Boyd (Eds.), Forensic anthropology: Theoretical framework and scientific basis (pp. 151-200). Hoboken, NJ: John Wiley & Sons.

The author reviews the theoretical basis for fracture healing in pediatric and elderly populations, including bone growth and healing processes.  She then presents a model, developed with the aid of digital light microscopy, that incorporates the healing continuum and allows for more accurate observation of the healing process.  She thinks that this model could be developed further to refine time since injury estimates in pediatric and elderly non-accidental death investigations. 

 
Illustration of trees in spring, late summer, fall

 

Forensic markers of elder abuse and capacity assessment

Heisler, C.J. (2017). Elder abuse forensics:  The intersection of law and science.  In X. Dong (Ed.), Elder Abuse.  Research, Practice and Policy (pp. 387-416).  Cham, Switzerland:  Springer International Publishing AG.  doi:  10.1007/978-3-319-47504-2_18

 

This chapter is an excellent overview of the complexities involved in identifying elder abuse and forensic markers used for this purpose. Forensic markers for various types of elder abuse are presented along with alternative explanations for the etiology of the indicator.  Careful consideration of the legal distinction between self-neglect and neglect by a caregiver is made so as to distinguish situations likely worthy of filing a criminal case.  Various categories of capacity and competency are discussed along with the professional qualifications of individuals able to assess these neuropsychological characteristics.  The chapter concludes with a discussion of the necessity and characteristics of successful collaborative teams and a review of training sites useful for various professionals dealing with elder abuse. 

 

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