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Other questions cannot be asked in all cultural contexts. It was a general com- ment that the question about sexual abuse (Question 12) would be very con- frontational and should not be asked of all people. In Kenya, the issue of sex is consid- ered to be a topic that is too delicate to be discussed with a stranger or even a doctor known to the person. It was suggested that this question should be asked only if there is already some suspicion of sexual abuse.

Depending on the geographical setting, some questions were given more weight and emphasis. e question on alcohol dependence was considered much more relevant in Costa Rica and Kenya than in other countries. It was also suggested that drug abuse be included in this question. Question 7, relating to the risk of financial abuse, was considered as one of the most important questions by the Brazilian focus group participants. Also in Kenya, financial dependence was identified as a high-risk factor, since almost all households depend on older parent(s) for financial support for food, clothing, fees and medical care. e issue was regarded as less important in other countries, however. e burden of child care on older people appears to be an overwhelming concern in Kenya that was not addressed directly by the questions. e Brazilian group of older men and women felt that physicians should not be concerned with the concept of “being taken advantage of”, as this was considered a daily issue to which people in Brazil are used.

A GLOBAL RESPONSE TO ELDER ABUSE AND NEGLECT

3.2 Focus groups with PHC professionals

  • e organization of focus groups with phy-

sicians caused difficulties as only a limited number (Australia, Kenya, Singapore) or none (Chile) were willing to participate in the groups. In some countries they were re- placed (partly) by nurses (Australia, Chile) or dentists (Kenya).

Some general comments were made throughout the discussions:

  • • 

    e term “elder abuse” has a negative connotation and elicits such fear and anxiety, even among health-care pro- fessionals, that there may be a need to look for other terms that can be used to replace it.

  • It is essential to determine whether or not there is a cognitive deterioration in the older patient before asking such questions, as this questionnaire cannot be used when a patient is cognitively impaired.

  • ese questions should not be asked

in front of the potential perpetrator, e.g. a caregiver.

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