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interventions for this problem. Physicians cannot tackle elder abuse alone, however.

  • e cooperation between existing public

health, social, medical and legal activities and systems needs to be improved, as each depends on the others for detection, for as- sessment techniques and for the reduction of the occurrence of mistreatment. is is particularly true since a substantial propor- tion of elder mistreatment episodes appear to occur in frail elder people, who are often least likely to participate in household surveys and who may be difficult to reach due to social isolation. Consultation at the medical practice is sometimes the only regular interaction that older people have outside their home.

A GLOBAL RESPONSE TO ELDER ABUSE AND NEGLECT

1.4 Detecting elder abuse in a PHC setting

Many aspects of elder abuse would appear to make it a condition ideally amenable to traditional public health screening: it is prevalent, it causes morbidity and mortal- ity, and traditionally it would appear that it is often hidden during consultation. But compared with other diseases and condi- tions, screening for elder abuse is problem- atic, since some patients are probably not eager to be detected as a potential victim of abuse. Also “true positives” are not well defined by blood tests or consensus criteria used to screen for other conditions and diseases.

Several screening and detection tools for elder abuse have been developed and tested.

  • ey have rarely been validated properly for

wider use, however. e multiplicity of the tools available reveals the need to develop, through collaborative research, a reliable and simple tool that can be adapted and used in different geographical and cultural settings. is will help to maximize the full understanding and multiple dimensions of the problem.

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