Emergency department provider perspectives on elder abuse and development of a novel ED-based multidisciplinary intervention team

Tony Rosen · Mary R. Mulcare · Alyssa Elman · Thomas J. McCarthy · Veronica M. LoFaso · Elizabeth M. Bloemen +3 more

36 citations0/0 files storedEmergency Medicine Journal

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Elder Abuse and Neglect Emergency and Acute Care Studies Child Abuse and Related Trauma

Abstract

BACKGROUND: An ED visit provides a unique opportunity to identify elder abuse, which is common and has serious medical consequences. Despite this, emergency providers rarely recognise or report it. We have begun the design of an ED-based multidisciplinary consultation service to improve identification and provide comprehensive medical and forensic assessment and treatment for potential victims. METHODS: We qualitatively explored provider perspectives to inform intervention development. We conducted 15 semistructured focus groups with 101 providers, including emergency physicians, social workers, nurses, technologists, security, radiologists and psychiatrists at a large, urban academic medical centre. Focus groups were transcribed, and data were analysed to identify themes. RESULTS: Providers reported not routinely assessing for elder mistreatment and believed that they commonly missed it. They reported 10 reasons for this, including lack of knowledge or training, no time to conduct an evaluation, concern that identifying elder abuse would lead to additional work, and absence of a standardised response. Providers believed an ED-based consultation service would be frequently used and would increase identification, improve care and help ensure safety. They made 21 recommendations for a multidisciplinary team, including the importance of 24/7 availability, the value of a positive attitude in a consulting service and the importance of feedback to referring ED providers. Participants also highlighted that geriatric nurse practitioners may have ideal clinical and personal care training to contribute to the team. CONCLUSIONS: An ED-based multidisciplinary consultation service has potential to impact care for elder abuse victims. Insights from providers will inform intervention development.

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References

2007Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups 1995Qualitative Research: Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research 2017Elder abuse prevalence in community settings: a systematic review and meta-analysis 1993Elder Abuse 1998Qualitative research and evidence based medicine 2015Elder Abuse 2004Progress in Elder Abuse Screening and Assessment Instruments 2008Development and Validation of a Tool to Improve Physician Identification of Elder Abuse: The Elder Abuse Suspicion Index (EASI)©

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2019Nonfatal Assaults and Homicides Among Adults Aged ≥60 Years — United States, 2002–2016 2020Screening for elder mistreatment in emergency departments: current progress and recommendations for next steps 2019Disclosure among victims of elder abuse in healthcare settings: a missing piece in the overall effort toward detection 2022Vulnerable Elder Protection Team: Initial experience of an emergency d epartment‐based interdisciplinary elder abuse program

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