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PAGE 8

ensuring that a tool would be used by PHC professionals. A useful comparison was made to screening for alcohol dependence (e.g. the CAGE8 tool with four questions; Ewing, 1984). e ultimate goal should be to sensitize medical professionals and raise their awareness about elder abuse and the possibility that it can occur.

General practices and PHC centres seem to be the best locations for the detection of elder abuse within this research proposal. Among PHC professionals, physicians are in the best position to detect abuse, since they are often the first port of call for older people. e difficulty arises from placing another burden on the physician’s already full agenda. Nurses may be a valuable alter- native, since they often have, depending on the setting, regular contact with patients.

  • us, it was decided that the best option

would be to adopt the EASI that had been developed and tested in Canada using focus group discussions to adjust it for cultural and linguistic factors in the eight partici- pating countries.

2.2 e Elder Abuse Suspicion Index

EASI is an instrument that was devel- oped and tested in Montreal by a research team from McGill University, St Mary’s Hospital Centre, CSSS René Cassin, and Sir Mortimer B. Davis Jewish General Hospital, with funding from the Canadian Institutes of Health Research. EASI con- sists of a few copyrighted, brief and direct questions (five questions for the patient and one for the physician) asked in the course of any office physician–patient encounter

and formulated in doctor-friendly language. It is readily applicable to cognitively intact seniors (people aged 65 years and older).

  • e EASI was designed not necessarily to

detect cases but to raise suspicion of the occurrence of elder abuse in order to justify referral to community experts in elder abuse such as social workers. A secondary aim was to help familiarize family doc- tors with elder abuse through the repeated use of a simple set of questions about elder abuse. Although EASI cannot guarantee detection of elder abuse or mistreatment, its application already indicates that the doctor is aware of elder abuse and may therefore refer potential cases to social and community services.

  • e style of the EASI questions and appli-

cation is along the lines of recommenda- tions found in the relevant literature. e use of explicit, behaviourally specific closed questions, contextually orienting preface statements, and simultaneous assessment of both assault by strangers and abuse by family members/caregivers is appropriate for older adults. Moreover, there are sev- eral advantages of in-person interviewing:

  • is permits visual assessment of both the

respondent’s physical presentation and the respondent’s reactions to the questions. Interviews also offer opportunities for non- verbal indications of support. Finally the validity of clinical diagnosis made on the basis of in-person interviews is higher than that of other methods, such as telephone

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