H.A.L.F.—a tool to assess elder abuse within the family

Elder abuse is a prevalent and growing social problem with significant consequences on victims' mental and physical health. Unfortunately, many cases of elder abuse go unreported. Elderly women are at increased risk for abuse and, as such, obstetrician-gynecologists (OB/GYNs) are in a unique position to screen for and report abuse. This study intended to determine OB/GYNs' knowledge, attitudes, and practice regarding elder abuse.

Two hundred Fellows and Junior Fellows of the American College of Obstetricians and Gynecologists (ACOG) received a survey. Analysis was completed with SPSS 20.0. In addition to descriptive statistics, χ² analyses were used to determine differences between groups.

In total, 122 fellows responded (61%). Abuse screening rates differed by abuse type. Few “always” screen for abuse, with half assessing only when it is suspected. Most (81%) had never reported a case of abuse. Younger males reported different clinical practice patterns than other groups. Generally, OB/GYNs were knowledgeable about risk factors and facts about elder abuse, but several knowledge gaps were identified. Most reported that elder abuse screening is within their professional purview. Half of the respondents cited time constraints as a barrier to screening.

Greater education about elder abuse screening is needed. Specifically, training regarding available valid and brief screening tools, local abuse reporting laws, and available community resources. This study identified the potential need to target younger male OB/GYNs for additional training.

L’abuso nell’anziano è oggi un problema di salute pubblica decisamente in crescita, la cui rilevanza è ormai segnalata sia nella letteratura scientifica sia dai media. Negli Stati Uniti si stima che, mediamente, 2 milioni di persone l’anno siano vittime di maltrattamento durante la senilità. L’abuso in questa fase della vita è un problema generalmente sottaciuto, in termini sia quantitativi sia qualitativi.

È stata condotta una ricerca bibliografica sulla letteratura riguardante il maltrattamento nella senilità, consultando i più noti database internazionali e integrando i dati attraverso le fonti bibliografiche di maggior rilevanza.

Le più comuni forme di maltrattamento nell’anziano includono la negligenza, l’abuso emozionale, psicologico, fisico e lo sfruttamento economico. La condotta violenta è associata agli aspetti della relazione tra il potenziale paziente e colui che l’assiste ed è fortemente condizionata dalla storia familiare, dai fattori di rischio ambientali e psicopatologici, nonché dall’entità del carico assistenziale.

Chi lavora nell’ambito dell’assistenza e della sanità deve essere oggi particolarmente vigile, prestare attenzione alle circostanze in cui è avvenuto il maltrattamento e non trascurare il riconoscimento dei segni d’allarme. Gli operatori sanitari hanno la responsabilità etica e professionale di segnalare il problema e di lavorare per prevenire i casi di sospetto abuso. Un intervento multidisciplinare può avere un significativo impatto sul maltrattamento e impedire un peggioramento della qualità di vita in età senile.

Abuse of the elderly is a growing problem in public health. The importance of this issue has been emphasized both by the scientific community and by the media. US literature reveals that nowadays, every year, about 2 million elderly people are victims of abuse. Mistreatment of the elderly is largely a hidden problem both from a quantitative and a qualitative standpoint.

We conducted a comprehensive literature search on the abuse of the elderly through international databases backed up by a search of the references of all the relevant articles.

Commonly mistreatment is attributed to the relationship with the caregiver, self-neglect, emotional, psychological and physical abuse as well as financial exploitation. Abuse is generally associated with aspects of the patient/caregiver relationship, frequently conditioned by family history, environmental and psychopathological risk factors and by the burden the caregiver sustains.

Healthcare workers need to be attentive and aware of the warning signs of the situations in which abuse occurs. Health professionals have an ethical and legal responsibility to report and work to prevent abuse even when only suspected. Interdisciplinary teams can have a significant impact on the issue of abuse in the elderly and prevent major detriment on the quality of their life.