Team approaches needed to curb elder abuse in LTC

Skilled nursing facilities face an unfortunate fact: Many older adults in long-term care have faced some type of elder abuse, often from other residents, according to a new study published in the New England Journal of Medicine.

Current consensus on the definition of elder abuse includes five main types: physical abuse, psychological or verbal abuse, sexual abuse, financial exploitation and neglect.

Within long-term care settings, incidents of physical elder abuse has often been viewed as violence toward residents by the staff. However, the new study reveals that other residents are often the instigators of physical abuse among elderly residents. “[The] abuse of older residents by other residents in long-term care facilities is now recognized as a problem that is more common than physical abuse by staff,” the study reports. “The use of interdisciplinary or interprofessional teams, also referred to as multidisciplinary teams in the context of elder abuse, has emerged as one of the intervention strategies to address the complex and multidimensional needs and problems of victims of elder abuse, and such teams are an important resource for physicians. These new developments suggest an expanded role for physicians in assessing and treating victims of elder abuse and in referring them for further care.”

In addition, financial exploitation, little studied in the past, has recently been identified as “a virtual epidemic,” the study authors note.

Interdisciplinary teams within skilled nursing can stem aggressive behaviors from other residents and can help physicians be aware of residents who have experienced elder abuse, the study’s authors advise. Team-based approaches, including multiple assessment strategies, also can assist in differentiating between abuse and the false findings that can surface among residents with chronic illnesses and/or dementia, the study adds.

“Advances in our understanding of the many manifestations of elder abuse and the emergence of interprofessional-team approaches also point to an important role for physicians in addressing this major public health problem,” the study states. “Both research and clinical experience suggest that cases of elder abuse can rarely, if ever, be successfully treated by the physician alone.”

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