Some of the doctors thought that starting with a time frame such as “Over the past few years” would be helpful in eliminating episodes that occurred decades ago. After a “yes” answer, PHC practitioners would then need to follow up with questions about the duration and severity of any reported sexual abuse.
e doctors did not feel the second part of
the question was necessary (“Was this an isolated event or not?”). e fact that any such abuse had taken place would trigger a more extended interview with the patient.
Participants wanted to drop the phrase “to the degree that it upsets you”. is was redundant given the term “unwanted”. Also, the word “advances” was considered more Australian than “approaches”. Nurses also recommended clarifying “touched you” by adding “touched parts of your body”, as this would make the sexual context more implicit.
e following alternative was suggested for
the Australian context:
“Has anyone touched parts of your body in ways that upset you, or made unwanted sexual advances to you?”
Although sexual abuse is a real and serious issue for older Australians, several of these PHC professional cautioned about un- trained people asking such sensitive ques- tions. us, both training and appropriate referral services must be available when administering Questions 11 and 12.
e 12 questions considered together:
Overall, the key areas of elder abuse were covered, but most questions needed re- wording or simplification and some could be excluded.
ere were a few issues that were consid-
ered to have been missed. ese were:
Risk factors associated with a relative’s
or caregiver’s illicit drug-taking.
reatened physical violence – which could be added to Question 11.
Chemical restraint – giving older people inappropriate medication or too much medication, which ties into Questions 6 and 11.
Not facilitating the older persons needs (i.e. neglect), as in Question 4.
Social participation and involvement in decision making via control of au- tonomy – this could be picked up in Questions 3, 4, 6, 8 and 11.
A number of general issues were raised:
Several nurses felt that administration of the 12 questions by general practitio- ners would take longer than the stan- dard consultation time (10–15 minutes). Community assessments and care plans are staffed by trained nurses and social workers rather than general practitioners. However, the extra costs to patients and time pres- sures on doctors were not considered to be impediments by the doctors.