Title | Emergency department provider perspectives on elder abuse and development of a novel ED-based multidisciplinary intervention team. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Rosen T, Stern ME, Mulcare MR, Elman A, McCarthy TJ, LoFaso VM, Bloemen EM, Clark S, Sharma R, Breckman R, Lachs MS |
Journal | Emerg Med J |
Volume | 35 |
Issue | 10 |
Pagination | 600-607 |
Date Published | 2018 Oct |
ISSN | 1472-0213 |
Keywords | Aged, Aged, 80 and over, Attitude of Health Personnel, Elder Abuse, Emergency Medicine, Emergency Service, Hospital, Female, Focus Groups, Humans, Male, Physicians, Qualitative Research |
Abstract | BACKGROUND: An ED visit provides a unique opportunity to identify elder abuse, which is common and has serious medical consequences. Despite this, emergency providers rarely recognise or report it. We have begun the design of an ED-based multidisciplinary consultation service to improve identification and provide comprehensive medical and forensic assessment and treatment for potential victims. METHODS: We qualitatively explored provider perspectives to inform intervention development. We conducted 15 semistructured focus groups with 101 providers, including emergency physicians, social workers, nurses, technologists, security, radiologists and psychiatrists at a large, urban academic medical centre. Focus groups were transcribed, and data were analysed to identify themes. RESULTS: Providers reported not routinely assessing for elder mistreatment and believed that they commonly missed it. They reported 10 reasons for this, including lack of knowledge or training, no time to conduct an evaluation, concern that identifying elder abuse would lead to additional work, and absence of a standardised response. Providers believed an ED-based consultation service would be frequently used and would increase identification, improve care and help ensure safety. They made 21 recommendations for a multidisciplinary team, including the importance of 24/7 availability, the value of a positive attitude in a consulting service and the importance of feedback to referring ED providers. Participants also highlighted that geriatric nurse practitioners may have ideal clinical and personal care training to contribute to the team. CONCLUSIONS: An ED-based multidisciplinary consultation service has potential to impact care for elder abuse victims. Insights from providers will inform intervention development. |
DOI | 10.1136/emermed-2017-207303 |
Alternate Journal | Emerg Med J |
PubMed ID | 30093378 |
PubMed Central ID | PMC6589031 |
Grant List | K24 AG022399 / AG / NIA NIH HHS / United States K76 AG054866 / AG / NIA NIH HHS / United States R03 AG048109 / AG / NIA NIH HHS / United States |