Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

OBJECTIVES

To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting.

DESIGN

Cross-sectional analysis.

SETTING

Statewide EMS protocols in the United States.

PARTICIPANTS

Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website.

MEASUREMENTS

Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison.

RESULTS

Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse.

CONCLUSION

Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse.