Pilot Study 1: Elder Abuse Interventions in Rural Communities
Elderly victims of abuse are frequently the victims of disparate health
care treatment. The abuse to which they are subject may deprive them
of the financial resources to seek medical care, may deprive them of
proper nutrition and hygiene, and may subject them to physical injuries
or other adverse health consequences. The elder who is trapped in an
abusive situation may well be subject to further disparity in health
care treatment because the perpetrator of the abuse seeks to hide the
consequences of the abuse from outsiders, and consequently impedes the
access of the abuse victim to health care services. The health care
consequences of such elder abuse are magnified if the health care and
law-enforcement personnel in the area lack the skills and resources
to detect elder abuse, so that elder abuse may persist unrecognized
for a prolonged period of time. Elder abuse is an issue which concerns
both the legal and the medical system. One strategy that has not been
sufficiently explored to make this unsupervised home environment somewhat
safer is to seek to remove from that environment the instruments of
the highest lethality. The two categories of items which pose a significant
risk of lethality not just to the impaired elder, but also to those
around him, are firearms and motor vehicles. Safe use of both these
kinds of items requires not merely motor skills but also good judgment.
There is accordingly a major public health benefit to be gained from
identifying those individuals who lack good judgment but who nevertheless
are in possession of either motor vehicles or firearms. In the present
pilot study it is proposed to develop and pilot test tools and training
methods for police and ambulance and emergency room personnel to use
to increase the recognition of elder abuse and to train health care
personnel to implement a standard protocol regarding use of the tools
in hospital emergency rooms to evaluate elders presenting with traumatic
injury. The study will permit the law enforcement and public health
communities to acquire epidemiologic data on elder abuse of elders who
do not reach the emergency room and develop countywide approaches to
reporting and making appropriate referrals regarding elder abuse that
can be disseminated to other counties. (Neil
Nusbaum MD JD, Principal Investigator)
