Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly
Elder abuse is any abuse and neglect of persons age 60 and older by a caregiver or another person in a relationship involving an expectation of trust.
Elder Assessment Instrument
Screening tool for elder mistreatment
Forms of elder abuse include:
Physical Abuse occurs when an elder is injured (e.g., scratched, bitten, slapped, pushed, hit, burned, etc.), assaulted or threatened with a weapon (e.g., knife, gun, or other object), or inappropriately restrained.
Sexual Abuse or Abusive Sexual Contact is any sexual contact against an elder’s will. This includes acts in which the elder is unable to understand the act or is unable to communicate. Abusive sexual contact is defined as intentional touching (either directly or through the clothing), of the genitalia, anus, groin, breast, mouth, inner thigh, or buttocks.
Psychological or Emotional Abuse occurs when an elder experiences trauma after exposure to threatening acts or coercive tactics. Examples include humiliation or embarrassment; controlling behavior (e.g., prohibiting or limiting access to transportation, telephone, money or other resources); social isolation; disregarding or trivializing needs; or damaging or destroying property.
Neglect is the failure or refusal of a caregiver or other responsible person to provide for an elder’s basic physical, emotional, or social needs, or failure to protect them from harm. Examples include not providing adequate nutrition, hygiene, clothing, shelter, or access to necessary health care; or failure to prevent exposure to unsafe activities and environments.
Abandonment is the willful desertion of an elderly person by caregiver or other responsible person.
Financial Abuse or Exploitation is the unauthorized or improper use of the resources of an elder for monetary or personal benefit, profit, or gain. Examples include forgery, misuse or theft of money or possessions; use of coercion or deception to surrender finances or property; or improper use of guardianship or power of attorney.
The Elder Assessment Instrument (EAI) is a 41-item assessment instrument, (Fulmer T, 1984) and is comprised of seven sections that reviews signs, symptoms and subjective complaints of elder abuse, neglect, exploitation, and abandonment.
There is no “score”.
A patient should be referred to social services if the following exists:
1) if there is any evidence of mistreatment without sufficient clinical explanation
2) whenever there is a subjective complaint by the elder of EM
3) whenever the clinician believes there is high risk or probable abuse, neglect, exploitation, abandonment
The EAI is appropriate in all clinical settings and is completed in approximately 15 minutes by clinicians screening for elder mistreatment.
This is one of several topics presented in the Thorny Issues sector of this toolkit
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