Elder Abuse Continues to Fall Under the Radar in Emergency Departments


Study finds a lack of formal diagnoses of elder abuse by emergency room providers.

Elder abuse affects approximately 1 in 10 older individuals in the United States. Despite this, a new analysis estimated that 1 in every 7700 visits results in emergency providers making a formal diagnosis of elder abuse.

Researchers used a nationally-representative dataset for the study published in theJournal of the American Geriatrics Society.

“These findings indicate that the vast majority of victims or federal abuse pass through the emergency department without the problem being identified,” said senior study author Timothy Platts-Mills, MD. “Emergency physicians strive to make sure that for each patients who comes through the door, all serious and life-threatening conditions are identified and addressed. For elder abuse, EDs across the country are falling short.”

In fact, more than 23 million annual emergency department visits by older adults give medical professionals the opportunity to diagnose cases of abuse. The study authors acknowledged that identifying elder abuse can be a challenge, since withold agecomes an array of issues, such as poor mobility and strength.

“It can be very difficult distinguishing whether a bruise is from a fall or physical abuse, or whether poor hygiene is a result of a patient asking to be left alone or the result of overt neglect on the part of a care provider,” Platts-Mills said. “But those difficulties don’t change the reality that elder abuse is common, takes a tremendous toll on its victims, and is frequently missed.”

The current practice in emergency departments to identify elder abuse is to ask one question about the safety at home at that time. Now, the study authors hope that they can develop this practice by developing and validating a screening tool that will use several questions to inquire about different aspects of elder abuse, including mental abuse and neglect. Furthermore, it will include a physical exam for patients who have significant cognitive impairment.

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