Call for criteria for suspicion of elder abuse to be improved

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Call for criteria for suspicion of elder abuse to be improved

Media release from the University of Otago
1 minute to Read
Unfiltered May 2022

Despite one in six older adults being a victim of elder abuse, its prevalence is often undetected and under-reported, something University of Otago researchers want to change.

In a study just published in BMJ Open, they argue the criteria for suspicion of elder abuse needs to be changed in screening methods to include the category ‘unable to determine abuse’.

Co-author Associate Professor Yoram Barak, of the Department of Psychological Medicine, says this would substantially improve the identification of at-risk older adults, providing them with better protection.

“This simple change would have a significant impact on the lives of vulnerable older adults, enabling them to get the support they need,” he says.

“Elder abuse has been a major global health threat for decades, yet it remains a form of victimisation receiving limited attention, resources, and research. This is despite it having far-reaching and long-lasting impacts on older adults, their families, and communities.”

The aging population will only exacerbate the issue – by 2030, one in six people worldwide will be aged 60 or older, and approximately 16 per cent of them will experience at least one form of maltreatment.

“Better screening is a valuable first step towards improving elder abuse detection and response.”

For the study, the researchers used data from the interRAI Abuse-Clinical Assessment Protocol, a suite of clinical assessment instruments used in aged residential care, and home and community services in Aotearoa New Zealand to identify any risks to a person’s health.

In an extension of a previous pilot study, more than 186,000 assessments over nine years were analysed. They found by including those evaluated as being ‘unable to determine abuse’, capture rates of at-risk individuals more than doubled from 2.5 per cent to 5.9 per cent.

Those classed as being at high risk of abuse tended to be male, were 79.2 years old on average, 49.6 per cent lived alone, 39.4 per cent suffered from depression, and a majority were assessed as not having independent decision making.

In comparison, when related to the general sample, the unable to determine group were slightly younger with an average age of 80.1 years old, had higher rates of depression at 33.5 per cent compared to 14.8 per cent, and most were assessed as not having independent decision making.

“While the ‘unable to determine’ group is distinct from the general sample, they have similar, though less extreme, characteristics as the ‘high risk’ group.

“Unfortunately, in New Zealand, as in most countries, ageism is rife. However, combating elder abuse is not a lost battle – we urge policy makers to take this important step in improving the lives of vulnerable older adults.”

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References

Effects of Changing Criteria on Improving interRAI assessment for Elder Abuse. Analysis of a National Dataset from Aotearoa New Zealand.

Professor Robin Turner, Prof Paul Glue and Associate Professor Yoram Barak

BMJ Open

DOI: 10.1136/bmjopen-2023-081791