A Comparative Study of Elder Abuse Reporting at Two Large Veteran?s Affairs Medical Centers

Abstract

Purpose of the study: One to two million elderly Americans are injured, exploited, or otherwise mistreated by someone on whom they depend on for care or protection. Elder abuse (EA) is detrimental to the individual and has significant societal and health cost implications. Despite these profound consequences, research suggests that elder abuse is often underreported. We conducted a retrospective review of reported EA cases over a 7 year period at 2 large VA Medical Centers (VAMC) to assess the types of EA cases reported, the characteristics of those patients who were reported and the 1 year outcome. Design and methods: A retrospective review of all cases of elder abuse reported to Adult Protective Services at two large VA Medical Centers between 2006 and 2012 was conducted as part of an educational initiative to improve health care provider identification and triage of elder abuse. Results: Thirty cases of EA were reported at the Providence VAMC and 25 were reported at the Durham VAMC during the study period. A dementia diagnosis was common among EA cases, present in 50% of cases in Providence and 72% in Durham. The majority (41/55) of referrals were made by the medical team but cases were also reported by caregivers and patients themselves. In over half of the cases, the Veteran was able to remain in the home environment with support from additional community based services, such as home health aides, physical and occupational therapy. Implications: Based on the published prevalence of elder abuse in elderly populations, EA was likely underreported in the two large VAMCs. More research is necessary to help determine the prevalence of elder abuse among Veterans, to identify risk factors that might aid diagnosis, and to develop interventions that target this important problem.