Although sexual abuse of older people is a category that needs to be included, it may be detrimental to the well-being of an older person if an untrained person asks about the issue. Furthermore, there were doubts about whether people would be willing to answer such a direct and delicate question (Costa Rica, Kenya, Spain). Also, the gender dimension was emphasized: It was pointed out that it would be difficult in some countries if a male GP asked an older woman about this issue (Singapore).
e concept of preventing somebody
from something needs further clarifica- tion (Question 4): At times the necessities of older parents cannot be met because of a lack of financial means and resources (Costa Rica, Singapore), and sometimes life events or health problems curtail the freedoms and choices of older people, such as advice from family or doctors to cease driving a car (Australia). e deprivation of something that is needed by an older per- son is therefore not necessarily an abuse, although this depends on the definition of need that is being used. Additionally, it should be further specified whether the question refers to a person or an abstract body, for example the community (Spain).
Question 11 was considered ambiguous as it is not clear whether this item refers to accidental harm (such as a fall or bruise when transferring someone into a wheel- chair or bath) or intentional harm (being intentionally rough or violent).
As in the groups with older people, some questions are considered important ac- cording to the geographical context they are asked in. Question 9 on alcohol de- pendence polarized participants. More significance was attached to the question in Australia, Chile and Costa Rica than in other countries. Also illicit drug-taking and gambling addictions by caregivers or family members could be added to this item (Australia). However, it was pointed out that drinking too much alcohol should not be considered automatically as a risk factor for elder abuse, but it may be impli- cated in the development and perpetuation of abusive situations and therefore should act to raise suspicions that abuse exists or has taken place.
Issues that were neglected in the ques- tions were chemical restraint (Australia), threatened physical violence (Australia), involvement in decision-making (Australia), abandonment (Costa Rica) and neglect (Singapore).
ere were only a few comments on the
order of the questions. In most cases it was suggested to leave the order as it is or to reverse the order of the first few questions.