The University of Texas Health Science Center, Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, Houston, TX, USA.
Education Development Center, Waltham, MA, USA.
Int J Psychiatry Med. 2024 Nov;59(6):633-643. doi: 10.1177/00912174231225765. Epub 2024 Jan 9.
Elder Mistreatment (EM) occurs in approximately 10% of older adults and is associated with trauma-related outcomes including depression, anxiety, posttraumatic stress disorder, and early mortality. Low screening and older adult self-reporting, especially within emergency departments, represent missed opportunities for identify and mitigate future EM occurrences and consequences. To date, no studies have obtained EM survivors' perspectives on EM screening and response practices in emergency departments.
Semi-structured interviews with 19 EM survivors of those with Adult Protective Services validated EM were completed in older adults' homes. The Elder Mistreatment Emergency Department Screening and Response Tool (EM-SART) was used to guide the interview questions. All interviews were recorded, transcribed, and analyzed using qualitative thematic analyses.
The participants were mostly female (63%) and white (58%) with an average age of 74 years. Physical abuse accounted for 67% of the EM incidents. Three themes emerged indicating the survivor preference for (1) building rapport and approaching the older adult with compassion and care, (2) setting the context before asking the EM questions, and (3) allowing mutuality, collaborative work, and shared decision-making during the response.
Older adults are agreeable and willing to self-report and actively engage in the EM screening and response practices in the emergency department if trauma-informed care principles are utilized.
老年人虐待（EM）在大约 10%的老年人中发生，与创伤相关的结局有关，包括抑郁、焦虑、创伤后应激障碍和早逝。低筛查率和老年人自我报告率，特别是在急诊科，代表着错过识别和减轻未来 EM 发生和后果的机会。迄今为止，尚无研究获得 EM 幸存者对急诊科 EM 筛查和反应实践的看法。
对有成人保护服务机构确认的 EM 的 19 名 EM 幸存者进行了半结构式访谈，访谈在老年人的家中进行。使用老年虐待急诊筛查和反应工具（EM-SART）来指导访谈问题。所有访谈均进行录音、转录和定性主题分析。
参与者主要为女性（63%）和白人（58%），平均年龄为 74 岁。身体虐待占 EM 事件的 67%。出现了三个主题，表明幸存者更喜欢（1）建立融洽关系，并以同情和关怀的态度接近老年人，（2）在询问 EM 问题之前设置背景，以及（3）在反应过程中允许相互尊重、协作和共同决策。
如果采用创伤知情护理原则，老年人愿意并愿意自我报告，并积极参与急诊科的 EM 筛查和反应实践。
