Ability of Older Adults to Report Elder Abuse: An Emergency Department-Based Cross-Sectional Study.
cognitive dysfunction
dementia
elder abuse
emergency medicine
geriatrics
mental status
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
20
02
2019
revised:
30
08
2019
accepted:
07
09
2019
entrez:
10
1
2020
pubmed:
10
1
2020
medline:
15
8
2020
Statut:
ppublish
Résumé
To characterize assessments of a patient's ability to report elder abuse within the context of an emergency department (ED)-based screen for elder abuse. Cross-sectional study in which participants were screened for elder abuse and neglect. Academic ED in the United States. Patients, aged 65 years and older, presenting to an ED for acute care were assessed by trained research assistants or nurses. All patients completed the four-item Abbreviated Mental Test 4 (AMT4), then completed a safety interview (using the Emergency Department Senior Abuse Identification tool) designed to detect multiple domains of elder abuse and received a physical examination. Based on the cognitive assessment and safety interview, assessors ranked their confidence in the patient's ability to report abuse as absolutely confident, confident, somewhat confident, or not confident. To assess interrater reliability, two assessors independently rated confidence for a subset of patients. Assessors suspected elder abuse in 18 of 276 patients (6.5%). Assessors were absolutely confident in the patient's ability to report abuse for 95.7% of patients, confident for 2.5%, somewhat confident for 1.5%, and not confident for 0.3%. Among patients with an AMT4 of 4 (n = 249), assessors were confident or absolutely confident in 100% of patients. Among patients with an AMT4 of less than 4 (n = 27), they were confident or absolutely confident in the patient's ability to report abuse for 81% of patients, including 11 of 12 patients with mild cognitive impairment and 7 of 11 patients with severe cognitive impairment. For patients receiving paired evaluations (n = 131), agreement between assessors regarding patient ability to report abuse was 97% (κ = 0.5). In this sample of older adults receiving care in an ED, research assistants and nurses felt that the vast majority were able to report elder abuse, including many patients with cognitive impairment. J Am Geriatr Soc 68:170-175, 2019.
Identifiants
pubmed: 31917460
doi: 10.1111/jgs.16211
pmc: PMC7110415
mid: NIHMS1566016
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
170-175Subventions
Organisme : NIA NIH HHS
ID : T35 AG038047
Pays : United States
Informations de copyright
© 2020 The American Geriatrics Society.
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