Other suggestions for rephrasing the ques- tion were:
“Have you felt physically threatened by someone? Does this happen often?”
“Has anyone physically hurt you, for ex- ample hit you, pushed you or impeded your free movement?”
Questions 1, 2, 7, 9 and 10 were considered to be the least important questions.
e 12 questions considered together: e
general feeling was that the 12 questions were comprehensive and covered all of the key areas of elder abuse. Two people sug- gested that all items should be retained. However, the questions that should be asked depended on the doctor’s under- standing of the older person and the older person’s particular circumstances. It may be possible to combine some questions; for example, Question 4 (being prevented from having access to things essential to health and well-being) could well be related to Question 5 (feeling intimidated; someone making the person feel sad, anxious and fearful).
Some suggestions were made for reorder- ing the questions. It was stressed that psychological abuse and intimidation of older people are likely to be the most com- mon forms of abuse. erefore, Question 5 should go earlier in the list. It might then set the context for other forms of abuse.
It was emphasized in all groups that there was a need for “real conversations” between
general practitioners and their patients, and hence the way in which the questions are asked is very important.
e view was that time constraints and lack
of appropriate training would make it dif- ficult for many general practitioners to use the instrument effectively. Nevertheless, general practitioners are at the front line of health care, and there are strong arguments for any initiatives that increase their aware- ness and understanding of elder abuse. Initial training and ongoing professional development around elder abuse issues would be necessary.
Australia’s population is culturally and linguistically diverse. It would, therefore, be necessary to test out the effectiveness of the questions with different cultural groups, including the language used to refer to the various forms of elder abuse.
It is clear that participants favoured word- ing that was as simple and as straight- forward as possible. For this reason, they tended to think that long lists of examples, as in Question 4, should not be included, although they realized that examples were sometimes necessary for clarification. In refining the tool further, it is important to maintain a balance between clarity, simplicity and brevity. In reality, and used effectively, some of the examples in the existing questionnaire could be included as follow-up questions. Moreover, participants also thought that questions that contained more than one idea should be separated.
It was stressed that questions referring to sexual and physical abuse would be con- frontational for many older people and, as reported, should not be asked of all people.