For screening, there should be two pre- requisites. One is privacy and the other is reporting of the questions. All these questions should be asked in a more conversational way rather than like a questionnaire or checklist. General practitioners could become very famil- iar with these questions and it would be then easier to include this as part of their consultation.
As general practitioners spend on aver- age only 15–20 minutes with a patient, 12 questions are more than enough. General practitioners can also pick up those questions that are relevant to the condition of the older person.
Asking these questions would also require physical examination as part of the screening.
Nurses rather than physicians could ask all of these questions.
General practitioners can ask these questions only after the older person has visited the clinic a few times.
ere might be a need to reorder the questions in order to get a better re- sponse. For example, asking Question 1 first might not elicit any response at all, whereas asking Questions 2 and 3 first might elicit a response.
Older men are more reluctant than women to answer the questions.
Generally, it was difficult to translate these questions into either Chinese and its dialects or Bahasa Melayu.
Instead of the phrase “sign documents”, the term “thumb print” could be used, as most older people in Singapore have little or no education. Relatives can also be included when one asks an older person about people they would trust.
Some suggestions to rephrase this question included the following:
“Have you been cheated financially by someone you trust?”
“Has anyone asked you to sign away your money and/or your house?”
“Has anyone you trust misused or tried to misuse your money, possessions or prop- erty, or forced you to sign documents that you did not understand or did not want to sign?”
Question 11: All general practitioners found this question relevant and important in detecting elder abuse, as it is direct and easy to ask.
A suggestion to rephrase this question was as follows:
“Has anyone physically hurt you, for ex- ample hit you, pushed you or locked/tied you up?”
Questions 7, 9, and 11 were considered the least relevant.
By looking at all the questions together, some final comments were made: