Entry of an older person into the system is almost always through a physician. is makes it more difficult to detect elder abuse due to a lack of awareness among PHC professionals.
should be asked about living conditions, family dynamics, addictions of any family members, degree of physical and economic dependence of the older person, and social and emotional isolation.
Many of the participating social workers see elder abuse as a cultural and social factor, due to the predominant culture of disregard and disrespect towards older people, expressed by flaws in public policies relating to health care, social issues and financial issues.
Culturally specific risk factors for elder abuse in a Brazilian urban area are family members who work in drug dealing. Also, living in a favela increases the level of vul- nerability due to the violent environment, caused mainly by drug trafficking. Together with the impediment of free movement, these factors contribute to a higher isola- tion of older people and prevent action and intervention when there is a suspicion of abuse.
e SWEF was not considered useful for
the Brazilian context due to its length. Most of the consultations in the respec- tive facilities and institutions have an established duration. A social work con- sultation takes a maximum of 30 minutes. Questions 54, 57, 58, 61, 62, 63, 64, 65 and 66 are considered to be important. In order to assess elder abuse, the older person
e social workers also commented on
the bank of 12 questions and considered Questions 4, 5, 6 and 8 to be the most im- portant.37
Workshop with social workers and PHC professionals
e participants considered abuse as a
health and social issue, as the two were in- terconnected. Psychological abuse, neglect and abandonment occur more frequently than physical abuse. Several participants mentioned a connection between culture, education and elder abuse: “One must learn to respect elders.”
Although Brazil has adopted the Elderly Act, a law that makes reporting of suspi- cions or proven cases of elder abuse man- datory, the lack of training and guidelines becomes evident trough the statements of the health professionals. Some stated that they were able to identify physical elder abuse but often did not know how to follow up a suspicion. Although the social work- ers emphasized the implication of this law (mandating), the physicians were concerned about their own safety.
These results are not included in the findings in section 3.2, as the questions were discussed with social workers only in the Brazilian groups.