Elder Abuse an Underreported Public Health Problem – Even in the Emergency Room, Says New Study

Elder Abuse an Underreported Public Health Problem – Even in the Emergency Room, Says New Study

Over the last decade, the population of Americans aged 65 and above has increased by 30 percent, to 47.8 million. By 2060, this demographic is expected to more than double.

Nursing and elder care homes across the country are expanding to accommodate vulnerable residents as the older generation grows at a dramatic rate. Also growing, unfortunately, is the already staggering volume of elder abuse – which currently affects 1 in 10 individuals in the U.S. and 1 in 6 worldwide.

In recent years, the U.S. government and various states have passed laws to help put the brakes on this nursing home epidemic. For example, the Older Americans Act Reauthorization Act of 2016 updated screening and prevention efforts of the 1965 Older Americans Act.

A new study, however, has revealed that prevention and screening leave a lot to be desired in a critical branch of care: hospital emergency rooms. Apparently, ER doctors are having trouble recognizing abuse in elderly patients.

Study Finds Lack of ER Intervention

This study, entitled “Diagnosis of Elder Abuse in U.S. Emergency Departments, examined the rate at which emergency departments diagnose patients over 60 with abuse.

Researchers looked at 2 datasets retrospectively: the 2012 Nationwide Emergency Department Sample (NEDS) and the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). Of the 6.7 million ER visits in 2012, they weighed the proportion of visits with common ER diagnoses related to elder abuse.

Shockingly, the study found fewer than 0.02 percent cases of elder abuse diagnosis. These mostly comprised physical abuse and neglect, and largely affected elderly women (74 percent), which is representative of usual elder abuse patterns. But considering the estimated national occurrence of elder abuse is around 5-10 percent, said researchers, ER incidences seem far from accurate.

“The current study findings expose, on a national level, the failure of U.S. EDs [emergency departments] to address a major public health problem,” said study authors. “Efforts to improve the identification of elder abuse among ED patients and to link these people to effective interventions are needed.”

It’s troubling to consider that the most important facilities for identifying urgent injuries – especially abuse – cannot make these crucial diagnoses. One could speculate whether this is due to a lack of expertise, or something much worse: ignorance.

Taking No Notice Will Solve Nothing

More than 2 million new cases of elderly abuse surface every year in the United States. That, of course, is completely unacceptable. Still, it’s thought by many that this national epidemic is grossly underestimated, misunderstood, and sometimes completely overlooked. Ignorance, in fact, is the primary reason that the issue is allowed to continue, putting millions of elders at risk of disability and death.

Nursing homes, of course, are found to be key instigators. Families do all they can to protect and address the needs of their elderly loved ones, but the power to protect them from hidden nursing home abuse is out of their hands. Oftentimes, residents are reluctant to report their experiences, and the staff themselves are all too eager to cover up their crimes.

While neglect and violent physical abuse are among the most common types of senior abuse in nursing homes, others include verbal abuse, humiliation, over- or under-medication, sexual abuse, and financial exploitation.

It’s almost unimaginable that these types of events occur – but pretending they don’t will not help. Going forward, the goal should be to prevent elder abuse before it starts. As friends, family, and concerned associates of elderly nursing home residents, we have a duty to look out for signs of abuse and to take care decisions seriously. Most of us would assume that this is a job for the experts. But clearly, as this study shows, we cannot even rely on healthcare providers to protect the vulnerable.

Sokolove Law Team

Contributing Authors

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Last modified: September 28, 2020