From the Guidelines
The protocol for suspected elderly abuse involves immediate reporting to Adult Protective Services (APS) or local law enforcement if the elder is in immediate danger, as stated in the guidelines for geriatric emergency departments 1. When encountering potential abuse, first ensure the elder's safety, then document all observations thoroughly, including physical injuries, behavioral changes, and environmental conditions. The assessment should evaluate physical signs (unexplained injuries, poor hygiene), behavioral indicators (withdrawal, fear), and financial irregularities. Different types of elder abuse include physical, emotional, sexual, financial exploitation, and neglect. Some key points to consider in the assessment and management of suspected elder abuse include:
- Ensuring the elder's safety and well-being
- Documenting all observations and findings thoroughly
- Evaluating physical signs, behavioral indicators, and financial irregularities
- Considering the different types of elder abuse
- Reporting suspected abuse to APS or local law enforcement
- Providing follow-up care, including safety planning, medical treatment, and connecting the elder with support services, as recommended by the US Preventive Services Task Force 1. Healthcare providers, social workers, and other mandated reporters are legally obligated to report suspected abuse, and should be aware of the laws and regulations in their state regarding reporting requirements 1. Early intervention can prevent serious harm and potentially save lives, making it essential to prioritize the safety and well-being of the elder in all aspects of care.
From the Research
Protocol for Suspected Elderly Abuse
The protocol for suspected elderly abuse involves several steps, including:
- Screening or systematic inquiry to detect abuse 2
- A detailed medical evaluation of patients suspected of being abused, as medical and psychiatric conditions can mimic abuse 2
- Interviewing patients and caregivers separately to gather more information 2
- Assessment of cognitive function, using tools such as the Elder Abuse Suspicion Index for cognitively intact patients 2
- A more detailed two-step process for screening patients with cognitive impairment 2
Signs of Abuse
Signs of abuse may include:
- Specific patterns of injury 2
- Emotional abuse, neglect, economic abuse, physical abuse, and sexual abuse 3
- Depression, which can be detected using the Geriatric Depression Scale 3
Reporting and Intervention
If elder abuse is suspected, the following steps should be taken:
- Documenting findings in detail 4
- Reporting to the authorities 4
- Ensuring patient safety 4
- Treatment of acute medical, traumatic, and psychological issues 4
- Creating a safety plan for at-risk elders, using a multidisciplinary team or recruiting available resources in the hospital and the community 5
Risk Factors
Certain individuals may be more susceptible to elder abuse, including:
- Those in the advanced age group (75-95 years) 3
- Women, single persons, those with low education levels, those without income of their own, and those who cannot perform their self-care 3
- Those with cognitive impairment 2
Assessment Tools
Several assessment tools are available to detect elder abuse, including: