When a “Fall” Isn’t a Fall: Screening for Elder Mistreatment

From EP Monthly:

Emergency physicians are at the front line to detect elder mistreatment, but they receive minimal training on this during residency. One in 10 older adults experiences abuse,1 and the majority of abuse/neglect cases are missed. In fact, victims of elder mistreatment visit the ED twice a year on average, and have over twice the relative risk of hospitalization.2,3 There are the obvious cases, such as Frank’s, where we know not to send someone back into a dangerous situation. But what about Mabel? Her humeral fracture does not require admission to the hospital. Does your hospital have a standardized medical work up for patients with concern for abuse or neglect? How would you and your ED social work team handle her situation? All too often in our busy EDs, Mabel would get an x-ray, a sling, and discharge paperwork without someone taking the extra time to discover her true situation. Once she reveals that her injury is not entirely accidental, are there other questions you should be asking?

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