Goodfellow Symposium 25 March 2012 Presentation  Elder abuse  Background  Research Project: –Question –Approach –Results  Questions

Goodfellow Symposium 25 March 2012 ELDER ABUSE DEFINITION “…a single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person” (Action on Elder Abuse, 2004; WHO/INPEA, 2002). Types: Psychological, Financial, Physical, Sexual, Neglect and Institutional

Goodfellow Symposium 25 March 2012 Background  Primary healthcare practitioners (PHC’s) are are in a unique position in many older peoples lives and are ideally positioned to engage in the early identification, support and referral of older adults experiencing elder abuse.  July 2009 – June 2010 –Only one G.P. or medical specialist referred to the Elder Abuse and Neglect Prevention Service based in Auckland. Why so low?

Goodfellow Symposium 25 March 2012 Research Project Research Question:  How do primary healthcare practitioners respond to elder abuse? Approach taken:  Qualitative approach (cross sectional, exploratory survey) Methods QL and QT (questionnaire and interview) in a suburb of Auckland during 2011  Participants were PHC practitioners (G.P.’s, Nurses and Pharmacists) employed through either a PHO or an A&M care centre; “junior” doctors, and key informants

Goodfellow Symposium 25 March 2012 Results Participants (N=63) questionnaire (n=55) PHC interview (n=3) Key informant interview (n=5) Participants (N=63) questionnaire (n=55) PHC interview (n=3) Key informant interview (n=5) Half (n=17) of RNZCGP 1 st Year Registrars and approx 75% of Pharmacists, G.P.’s and Nurses had encountered elder abuse in their practice.

Goodfellow Symposium 25 March 2012Results No participant reported having received any specific elder abuse training Top three identified barriers that may restrict detection of elder abuse: time, lack of elder abuse knowledge and fear of litigation Top five identified risk factors that were present when elder abuse encountered: patients living with family/caregiver; were isolated, fearful, or had experienced a recent change in living arrangements Of the 34 questionnaire participants who had encountered elder abuse within their practice, 70% (n=24) referred their concerns onto 18 varying contacts Of the remaining 30% 8 did not refer their concerns to anyone (1 did not respond and 1 stated not applicable)

Goodfellow Symposium 25 March 2012

MOH Family Intervention Guidelines: Elder Abuse and Neglect Approximately 85% of questionnaire participants (n=46) and 100% (n=3) of interview participants were NOT aware of the Guidelines and even if made aware 8 questionnaire participants would not consult it

Goodfellow Symposium 25 March 2012 CONCLUSION  PHC practitioners are encountering, recognising and initially managing elder abuse.  Given that –indicator based screening for elder abuse is recommended, and –the Crimes Amendment Act (No3) 2011 became effective on 19 th March 2011, and –the population is ageing Does this not make it imperative that: –elder abuse training is undertaken and –the MOH Guidelines be distributed to all PHC practitioners? PHC practitioners?