St Vincent’s strategy to detect and respond to elder abuse

Elder abuse in Australia is significantly under-reported but public hospitals can be a major part of a solution by offering a “window of opportunity” to detect and manage the problem, according to one of the country’s leading health and aged care providers.

St Vincent’s Health Australia (SVHA) – the Catholic not-for-profit organisation which operates 27 hospitals and aged care facilities around the country, including the St Vincent’s public hospitals in Sydney and Melbourne – said it had increased detection of elder abuse at its Melbourne hospital since introducing a new policy to protect the vulnerable elderly.

Because older people experiencing abuse have a higher hospitalisation rate than their peers, hospitals offer an ideal place to detect and manage the problem. But the challenge is healthcare staff often lack the training to recognise the symptoms of abuse and how to intervene.

At St Vincent’s Hospital Melbourne – when we started looking into the issue – we found that a significant number of staff were suspicious of elder abuse having taken place, but didn’t know how to explore the situation further or how to intervene. For example:

  • 38% of staff surveyed had suspected elder abuse among their patients within the last 12 months.
  • 44% of staff we surveyed said they would have acted differently on their suspicions of elder abuse if they’d been educated and confident on how to intervene.

Starting in 2009, we began an intensive process to develop an education package to improve the knowledge, competence and confidence of our staff in responding to suspicions of elder abuse.

This culminated in a hospital-wide policy being introduced in March 2013 which includes a new model of care for when elder abuse cases are detected, a training resource for staff (including literature and a DVD covering five elder abuse scenarios), and the establishment of a Vulnerable Older Persons Response Group.

We’ve since conducted an audit of the elder abuse cases notified to our response group. We found:

  • The type and nature of the abuse was quite diverse. Most common was financial (60%) followed by psychological (56%), neglect (34%) and physical (30%).
  • It was not uncommon to find people experiencing more than one type of abuse. In some cases, three types of abuse were suspected.
  • A number of other results stood out to us: in almost half the cases of abuse, it was the victim’s son who was responsible; in 70% of cases, the older person lived with their alleged perpetrator; and 60% came from culturally and linguistically diverse (CaLD) backgrounds with many needing interpreters.

All this information is extremely valuable, not just in detecting cases and for us to respond appropriately by putting together individual care plans and safety nets for the victims, but also for authorities to help them gain a better understanding of the problem, and its scale, so it can be addressed more effectively.

What our results tell us is that hospitals absolutely can play a role – and a very valuable role – at uncovering this hidden aspect of family violence.

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