Screening for elder mistreatment in emergency departments: current progress and recommendations for next steps

ABSTRACT

Emergency Department (ED) visits provide an important but seldom realized opportunity to identify elder mistreatment. Many screening tools exist, including several that are brief and may be effective, but few have been specifically designed for or tested in EDs. In addition to the absence of validated tools, other challenges with implementing ED elder mistreatment screening include difficulty integrating anything longer than a few questions into a busy clinical encounter and resources required to respond to positive screens. The Electronic Health Record (EHR) offers a critical tool to facilitate elder mistreatment screening through required data entry and real-time monitoring of compliance and results. We describe current work in the field and recommend next steps including design and testing of a two-step screening process, implementation research to accelerate adoption, development of ED-based interventions and referral protocols for positive cases, and consideration of the important role of pre-hospital providers in case identification.

KEYWORDS:

• Elder abuse
• screening
• emergency department
• geriatrics
• family violence

Additional information

Funding

All authors are members of the National Collaboratory to Address Elder Mistreatment, a group funded by the John A. Hartford Foundation and the Gordon and Betty Moore Foundation to focus on improving identification, intervention, and prevention of elder mistreatment in health-care settings. Tony Rosen’s participation has also been supported by a Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76 AG054866) from the National Institute on Aging. Timothy F. Platts-Mills’ participation has also been supported by a grant (2015-IJ-CX-0022) from the National Institute of Justice. Terry Fulmer is the President of the John A. Hartford Foundation, a foundation dedicated to improving the care of older adults through research focused on age-friendly health systems, which has provided funding for the National Collaboratory to Address Elder Mistreatment.