Protecting Our Vulnerable Population: Screening for Mistreatment in Palliative Care (S776)

Abstract

•Discuss the impact of mistreatment among vulnerable palliative care patients.•Recognize the need to improve awareness and identification of mistreatment in palliative care populations. Palliative Care (PC) patients are a vulnerable population. While the incidence of mistreatment in other vulnerable populations has been defined, approaching 10% of the elderly and 50% of those suffering from dementia, the incidence of mistreatment in PC not well defined. To assess rate of PC patients who establish concern for mistreatment (ECM) and identify its risk factors Patients seen by the PC clinical service of a tertiary hospital (inpatient and outpatient) were screened for mistreatment over 30-day period using two mistreatment screening tools validated among elderly: Elder Abuse Suspicion Index (EASI) and Caregiver Abuse Screen (CASE). Patients able to participate in a survey were screened using EASI. Caregivers were screened with CASE if patient was unable to participate or reported relying on caregiver. EASI score ≥1 (max 6) and CASE ≥4 (max 8) ECM. N= 64 (47 inpatients, 17 outpatients, all with common PC diagnosis). 58% female; 11% elderly; 53% Hispanic; 63% with cancer diagnosis; 55% rely on caregiver. Forty-five completed EASI only, four CASE only, and 15 both. Eleven (17.19%) were ECM cases. A significant relationship was found between presence of PC diagnoses and ECM, [p = 0.01]. EASI question #2 (preventing access to resources/people/medical care, p=0.02), #3 (verbal shaming, p<0.001) and CASE question #2 (caregiver shameful of actions, p=0.005), #4 (caregiver acting rough, p=0.02), and #7 (caregiver exhaustion, p=0.006) were significant to ECM. The rate of PC patients who ECM is similar to other vulnerable populations. ECM risk factors included PC diagnoses; further risk factor identification was limited by small sample size and variable applicability of elderly-targeted, validated scales.