Hidden in the Shadows: Detecting and Addressing Elder Abuse

Disorder

• Impaired memory
• Impaired judgment
• Loss of personhood

• Resisting care
• Difficult relationship with caregiver(s)
• Aggression/agitation

• Decreased motivation
• Decreased self-esteem

• Aggressive behavior·
• Disinhibition
• Depression

Domain

• Presence of psychological or physical disability
  Inability to participate in activities of daily living
• Reluctance of caregiver to give information about elder’s condition
• Delay in elder’s seeking/receiving professional assistance
• Inappropriate caregiver reaction to clinician’s concern

• History of abuse experienced by either the elder or the caregiver

• Unrealistic expectations of the elder
• Social isolation
• Conflict in the family system

• Pattern of accidents that do not make sense

• Healthcare “shopping” (ie, the elder does not have a regular physician)
• Infrequent visits to physicians

• Duration and nature of the relationship
• How much responsibility the caregiver has
• Potential control/power dynamics
• Financial resources
• Power of attorney/how decisions are made

Elder Abuse Screening Test (H-S/EAST)
Elder Abuse Suspicion Index (EASI)
Brief Abuse Screen for the Elderly (BASE)
Vulnerability to Abuse Screening Scale (VASS)

US Department of Health and Human Services: https://www.hhs.gov/answers/programs-for-families-and-children/how-do-i-report-elder-abuse/index.html
Eldercare Locator: https://eldercare.acl.gov/Public/Index.aspx
National Adult Protective Services Association (NAPSA): http://www.napsa-now.org/get-help/help-in-your-area/
National Center on Elder Abuse (NCEA): https://ncea.acl.gov/suspectabuse/gethelp-reportingabuse.html
National Long Term Care Ombudsman Resource Center: http://www.ltcombudsman.org
National Academy of Elder Law Attorneys, Inc.: http://www.naela.org
National Clearinghouse on Abuse in Later Life: http://www.ncall.us