Elder Abuse and Neglect: Addressing unmet social needs in the Geriatric ED

Main Learning Points

This webinar shifts the focus away from purely physical abuse to the neglect suffered by older people.  It highlights that neglect is often an outcome of unmet social needs and that EDs have a role to play in both identifying and helping meet those social needs.

Dr. Tony Rosen 12:30

Tony, a physician, discusses how abuse differs from neglect and how neglect – often unintentional — is probably a more pressing issue in EDs as it can have a major serious, even lethal, impact on the life of older patients.

His main points:

Elder neglect is often an extreme case of unmet social needs.  It is more common than other types of abuse and has more associated morbidity/mortality.   The ED visit is an important opportunity to identify elder neglect and initiate intervention to address unmet social needs.  Recognizing neglect and effectively addressing it requires all members of ED team to work together

Ms. Alyssa Elman 21:30

Alyssa, a social worker, highlights that EDs are often a good place to identify neglect because this may be the one time that the older person leaves their home.  They can make direct contact with ambulance paramedics who may have a lot of information about the home situation.  She also makes direct contact with community agencies to develop relationships that will benefit subsequent patients.

Her main points:

Social workers play a critical role in the assessment of elder neglect and unmet social needs and in offering resources and developing a plan to ensure safety.  Consider holding older adults in the ED until morning for a social work evaluation and additional collateral.  For EDs without access to social work, consider developing a local resource guide that may be used to build connections with community partners.

Dr. Terry Fulmer 28:30

Terry, a nurse by training and advocate, reinforces the essential role of an interdisciplinary team in addressing elder neglect: one person can’t do it alone! She also considers the strategies for addressing this challenge in situations of lower resources: what a smaller ED can do once it commits to the challenge.

Her main points:

• It’s our job to orient ED teams to look for subtle signs of neglect
• Neglect is a lethal issue: people die because of neglect.
• Transitions of care are essential in managing neglect – know your community resources and link to them

We presented four complex cases and suggested possible ways that an ED can respond to intervene. at 36:30.

Dr. Kristin Lees Haggerty 46:00

Finally, Dr. Kristin Lees Haggerty, an educator, presented a series of educational resources to support EDs some of which are linked below.

Moderated By

Don Melady

MD

Bio

Dr. Don Melady is an emergency physician at Mount Sinai Hospital in Toronto, Canada and a founding member of the Geriatric Emergency Department Collaborative. He is the author of the website www.geri-EM.com – a CME accredited program for geriatric emergency medicine education – and the chair of the Geriatric EM committee of the International Federation of Emergency Medicine.

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