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A Global Response to Elder Abuse - page 19 / 149

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Perceptions are changing, reflecting results from studies in many countries. 7 Elder abuse is starting to be recognized as a seri- ous social and (public) health issue. e occurrence and severity of elder mistreat- ment are likely to increase markedly over the coming decades, as the population ages, as caregiving responsibilities and relation- ships change and as increasing numbers of older people require long-term care.

  • e United States National Research

Council (National Research Council, 2003) recognized that substantial research is needed in order to improve and develop new methods of screening for possible elder mistreatment in a range of clinical settings. Moreover, it strongly recommends system- atic studies of reporting practices and the effects of reporting.

Although a comprehensive health-care re- sponse is the key to a coordinated commu- nity-wide approach to family violence, phy- sicians report only 2% of all reported cases of elder abuse, compared with reports from family members (20%), hospitals (17.3%) and home health aids (9.6%) (Rosenblatt et al., 1996). Even though the detection of el- der abuse is an issue in some hospitals, only a few hospitals have appropriate protocols and follow-up guidelines for dealing with the problem (Ahmad & Lachs, 2002; Lachs, 2004).

It is central to understand the nature and value of increased and more refined medi- cal and social surveillance and screening practices and their effect on geographically based elder mistreatment rates. ere is no doubt that health-care settings are particu- larly important. For instance, in the United States, each year approximately 85% of people aged 65 years and older use formal ambulatory care services and 16–20% are hospitalized (National Research Council, 2003). erefore, physicians need to be able to recognize risk factors and to apply the diagnostic techniques specifically involved in the detection of elder abuse. Many physi- cians and other PHC professionals, howev- er, are not yet familiar with the definitions, epidemiology, diagnosis and intervention strategies associated with elder abuse, since it is usually not a problem that can be as- sessed quickly. Nevertheless, emergency rooms, walk-in clinics and family doctors practices are commonly used by victims of elder abuse. Similarly, the busy primary care office, although hardly the ideal setting for a time-consuming examination, may be the victim’s only hope of detection and protection. In each of these settings, an un- derstanding of good assessment practices is necessary for the physician in touch with the potential victim.

  • e medical profession is only now be-

ginning to turn its attention to research, detection and prevention of elder abuse. Since physicians are in a unique position to detect elder abuse and neglect first- hand, they have a special responsibility to promote greater awareness and effective

7.

For example, PubMed delivered 1111 hits for “elder abuse” in February 2006.

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