Screening might catch more cases of elder abuse

NEW YORK (Reuters Health) - Screening elderly adults for signs of abuse may catch many more cases than otherwise would be, a new study suggests.

Israeli researchers found that while 6 percent of older adults in their study admitted to being abused by a family caregiver when asked directly, many more had evident signs of abuse or were at high risk of abuse.

The findings suggest that older adults should be routinely screened for signs of abuse, or risk factors for it, when they enter a hospital or a community service, the study's lead author told Reuters Health.

The study, which is published in the Journal of the American Geriatrics Society, involved 730 men and women age 70 and older who were hospitalized in two major Israeli medical centers. All were living at home, but relied on a family member for help with day-to-day living.

When asked directly, 5.9 percent acknowledged that they'd suffered some form of abuse from a family member. The types of abuse ranged from physical and verbal abuse to neglect to financial exploitation.

However, when the researchers used two additional methods of detecting potential abuse, the results were significantly different.

When nurses and social workers assessed the patients after they entered the hospital -- interviewing them and conducting physical exams -- they found evidence of abuse in 21 percent. These signs included suspicious bruises and burns; angry or indifferent behavior in the caregiver; and evidence that the patient was being neglected at home, such as poor hygiene or dehydration.

What's more, the third measure of abuse -- which looked at risk factors for abuse -- indicated that one-third of patients were at high risk. Risk factors for abuse included problems such as emotional instability and poor family relationships, in both caregivers and elderly patients.

The findings point to a need for routine screening of elderly adults to "rule out the possibility of abuse," said lead study author Dr. Miri Cohen, head of the department of gerontology at Haifa University.

Screening could be done at hospitals, Cohen noted, or at centers that provide social services to the elderly. Because few older adults may admit to abuse when questioned directly, it's "most important" to look for evident signs of abuse, as well as risk factors for it, according to Cohen.

Elderly adults judged to be at high risk could then be assessed further to see whether abuse is in fact taking place.

SOURCE: Journal of the American Geriatrics Society, August 2007.

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