GENERATIONS – Journal of the American Society on Aging

The Power of Data Can Support Effective Response to Elder Mistreatment in Hospital Emergency Departments By Kim Dash,

The Elder Mistreatment Emergency Department Assessment Profile and the Geriatric Emergency Care Applied Research Network are effective approaches to mitigating elder mistreatment.

Tony Rosen, Kevin Biese, Timothy F. Platts-Mills, and Ula Hwang

E lder mistreatment is common, with as many as 10 percent of community-dwelling adults ages 60 and older (Connolly, Brandl, and Breckman, 2014; Lachs and Pillemer, 2015), and more than 20 percent of long-term-care residents (Lachs et al., 2016) being victimized each year. This mis- treatment includes physical abuse; sexual abuse; neglect; verbal, emotional, and psychological abuse; and fnancial exploitation. Elder mistreatment leads to dramatically increased mortality, as well as to the develop- ment of depression, dementia, and worsened chronic conditions (Dyer et al., 2000; Lachs et al., 1998). Annual medical and other costs asso- ciated with elder mistreatment are estimated in the many billions of dollars (Connolly, Brandl, and Breckman, 2014). The burden and cost of elder mistreatment is likely to grow substan-

tially with the anticipated growth of the older adult population. Identifcation of and intervention in elder mistreatment should be a major public health priority. Yet, elder mistreatment is infrequently detected. Research suggests that only one in twenty-four cases of mistreatment is identi- fed and reported to the authorities (Lifespan of Greater Rochester, Inc., Weill Cornell Medical Center, and New York City Department for the Aging, 2011). Inadequate detection increases the likelihood of poor outcomes. Hospital emergency department (ED) vis- its provide an important opportunity to identify older adults who are at risk of or are experienc- ing mistreatment, as well as to report and inter- vene when appropriate (Fulmer et al., 2005; Rosen et al., 2016; Rosen et al., 2018). Assess-

abstract Hospital emergency departments (ED) are in a unique position to advance best practices for identifying and responding to suspected cases of elder mistreatment. But implementing programs to improve ED clinical practice is challenging given competing priorities, systems barriers, and ED resource variation. Leaders in elder mistreatment prevention/identification/management, emergency medicine, and implementation science have developed approaches for using data to help EDs adopt such best practices. This article describes the Elder Mistreatment Emergency Department Assessment Profile and the Geriatric Emergency Care Applied Research Network. | key words : elder mistreatment, emergency department, implementation, data-driven decision-making, organizational assessment, patient outcomes

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38 | Spring 2020

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