Elder Abuse

How to Screen

The healthcare setting provides a vitally important opportunity to screen for elder/dependent adult abuse. Office or ED visits may be the only time the patient can have safe, confidential contact with someone other than the abuser. If the patient is able to understand questions and respond to them, interview in a quiet, private location with a professional interpreter as needed. Always see the patient alone for at least part of the visit.

Interviewing can be difficult if the patient is mentally challenged, or if you suspect the caregiver is the abuser.  This is best handled by someone with expertise in geriatrics, and/or a social worker or other mental health professional.

See Ethics & Privacy

Asking indirectly:

  • Do you feel safe where you live?
  • Who prepares your food?
  • Does someone help you with your medication?
  • Who takes care of your checkbook?

Asking directly:

  • Does anyone at home hurt you?
  • Do they scold or threaten you?
  • Touch you without your consent?
  • Make you do things you don’t want to do?
  • Take anything that’s yours without asking?
  • Had you sign documents that you did not understand?
  • Are you afraid of anyone at home?
  • Are you alone a lot?
  • Has anyone ever failed to help you take care of yourself when you needed help?

Adapted from Ansell, P. & Breckman, R. (1988). Elder mistreatment guidelines for health care professionals: Detection, assessment, and intervention. New York: Mount Sinai/Victim Services Agency.

Follow-up questions:

  • Explore mistreatment – what, how, when, how often?
  • Who is the perpetrator?
  • How does the patient cope?
  • Assess safety
  • What are alternative living options; who are alternative caregivers?
  • What can be done to prevent future abuse?

 

Stanford Medicine Resources:

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