Diagnosis and Management of Elder Abuse by Family Physician
ABSTRACT
The purpose of this study is to investigate the difficulties encountered by primary care physicians in diagnosing and handling elderly abuse. A survey of the practice of 266 family physicians in France was conducted by email using a questionnaire during the fall of 2012. Statistical analysis was performed using a Chi-2 test for the comparison of two qualitative variables, and the Kruskal-Wallis test was used to compare a qualitative variable with an ordinal one. 77 physicians responded to the questionnaire. They are often faced with the phenomenon of mistreatment, including psychological abuse, of elderly people. They describe the diagnosis correctly but express management difficulties. These difficulties are due to lack of knowledge of the law and a lack of practical tools usable on a daily basis. These physicians call for better training regarding the law and clearer reporting procedures. Education and training in the legislative field must be improved. This conclusion has been reached before in previous surveys in the USA and Europe since the 1970s, which leads to the question as to whether full comprehension of the magnitude of the issue exists. Perhaps the complexity of medical practice requires that an anthropological approach should be taken to identify all the facets involved.
The purpose of this study is to investigate the difficulties encountered by primary care physicians in diagnosing and handling elderly abuse. A survey of the practice of 266 family physicians in France was conducted by email using a questionnaire during the fall of 2012. Statistical analysis was performed using a Chi-2 test for the comparison of two qualitative variables, and the Kruskal-Wallis test was used to compare a qualitative variable with an ordinal one. 77 physicians responded to the questionnaire. They are often faced with the phenomenon of mistreatment, including psychological abuse, of elderly people. They describe the diagnosis correctly but express management difficulties. These difficulties are due to lack of knowledge of the law and a lack of practical tools usable on a daily basis. These physicians call for better training regarding the law and clearer reporting procedures. Education and training in the legislative field must be improved. This conclusion has been reached before in previous surveys in the USA and Europe since the 1970s, which leads to the question as to whether full comprehension of the magnitude of the issue exists. Perhaps the complexity of medical practice requires that an anthropological approach should be taken to identify all the facets involved.
Cite this paper
Dumortier, V. and de Freminville, H. (2014) Diagnosis and Management of Elder Abuse by Family Physician. Open Journal of Social Sciences, 2, 424-432. doi: 10.4236/jss.2014.26049.
Dumortier, V. and de Freminville, H. (2014) Diagnosis and Management of Elder Abuse by Family Physician. Open Journal of Social Sciences, 2, 424-432. doi: 10.4236/jss.2014.26049.
References
[1] Burston, G.R. (1975) Granny Battering. British Medical Journal, 3, 592.
http://dx.doi.org/10.1136/bmj.3.5983.592-a [2] Baker, A.A. (1977) Granny Battering. Nursing Mirror and Midwives Journal, 144, 65-66. [3] World Health Organization (2002) World Report on Violence and Health. Geneva. [4] The National Elder Abuse Incidence Study (NEAIS) (1998) Final Report. The National Center on Elder Abuse at the American Public Human Services Association. American Public Health Services Assocication, Washington DC. [5] Fulmer, T., Guadagno, L., Connolly, M.T., et al. (2004) Progress in Elder Abuse Screening and Assessment Instruments. Journal of the American Geriatrics Society, 52, 297-304.
http://dx.doi.org/10.1111/j.1532-5415.2004.52074.x [6] Wagenaar, D.B., Rosenbaum, R., Page, C. and Herman, S. (2010) Primary Care Physicians and Elder Abuse: Current Attitudes and Practices. The Journal of the American Osteopathic Association, 110, 703-711. [7] Pillemer, K. and Finkelhor, D. (1988) The Prevalence of Elder Abuse: A Random Sample Survey. Gerontologist, 28, 51-57.
http://dx.doi.org/10.1093/geront/28.1.51 [8] Garre-Olmo, J., et al. (2009) Prevalence and Risk Factors of Suspected Elder Abuse Subtypes in People Aged 75 and Older. Journal of the American Geriatrics Society, 57, 815-822.
http://dx.doi.org/10.1111/j.1532-5415.2009.02221.x [9] INSEE (2012) French National Institute of Statistics and Economic Studies. [10] Lachs, M.S. and Pillemer, K. (2004) Elder Abuse. Lancet, 364, 1263-1272.
http://dx.doi.org/10.1016/S0140-6736(04)17144-4 [11] Lachs, M.S., Williams, C.S., O’Brien, S., et al. (1997) ED Use by Older Victims of Family Violence. Annals of Emergency Medicine, 30, 448-454.
http://dx.doi.org/10.1016/S0196-0644(97)70003-9 [12] Clark-Daniels, C.L., Daniels, R.S. and Baumhover, L.A. (1990) Abuse and Neglect of the Elderly: Are Emergency Staff Aware of Mandatory Reporting Laws Department? Annals of Emergency Medicine, 19, 970-977.
http://dx.doi.org/10.1016/S0196-0644(05)82556-9 [13] Barer, B.M. (1997) The Secret Shame of the Very Old: “I’ve Never Told This to Anyone Else. Journal of Mental Health and Aging, 3, 365-375. [14] Rodriguez, M.A., Wallace, S.P., Woolf, N.H., et al. (2006) Mandatory Reporting of Elder Abuse: Between a Rock and a Hard Spot. The Annals of Family Medicine, 4, 403-409.
http://dx.doi.org/10.1370/afm.575 [15] Biostat, T.G.V. (2013) Online Software-UMR 707-University of Paris 6. [16] Collins, K.A. (2006) Elder Maltreatment. Archives of Pathology & Laboratory Medicine, 130, 1290-1296. [17] Rodriguez, M.A., Craig, A.M., Mooney, D.R. and Bauer, H.M. (1998) Patient Attitudes about Mandatory Reporting of Domestic Violence. Implications for Health Care Professionals. West Journal of Medicine, 169, 337-341. [18] Kennedy, R.D. (2005) Elder Abuse and Neglect: The Experience, Knowledge, and Attitudes of Primary Care Physicians. Family Medicine, 37, 481-485. [19] Kurrle, S.E., Sadler, P.M. and Cameron, I.D. (1992) Patterns of Elder Abuse. Medical Journal, 157, 673-676. [20] National Council of the College of Physicians (2011) Medical Demography Wide Living Areas in the Rhône-Alpes Region. [21] National Council of the College of Physicians (2012) Atlas of Medical Demography in France: Situation on January 2012 the 1st.
[1] Burston, G.R. (1975) Granny Battering. British Medical Journal, 3, 592.
http://dx.doi.org/10.1136/bmj.3.5983.592-a [2] Baker, A.A. (1977) Granny Battering. Nursing Mirror and Midwives Journal, 144, 65-66. [3] World Health Organization (2002) World Report on Violence and Health. Geneva. [4] The National Elder Abuse Incidence Study (NEAIS) (1998) Final Report. The National Center on Elder Abuse at the American Public Human Services Association. American Public Health Services Assocication, Washington DC. [5] Fulmer, T., Guadagno, L., Connolly, M.T., et al. (2004) Progress in Elder Abuse Screening and Assessment Instruments. Journal of the American Geriatrics Society, 52, 297-304.
http://dx.doi.org/10.1111/j.1532-5415.2004.52074.x [6] Wagenaar, D.B., Rosenbaum, R., Page, C. and Herman, S. (2010) Primary Care Physicians and Elder Abuse: Current Attitudes and Practices. The Journal of the American Osteopathic Association, 110, 703-711. [7] Pillemer, K. and Finkelhor, D. (1988) The Prevalence of Elder Abuse: A Random Sample Survey. Gerontologist, 28, 51-57.
http://dx.doi.org/10.1093/geront/28.1.51 [8] Garre-Olmo, J., et al. (2009) Prevalence and Risk Factors of Suspected Elder Abuse Subtypes in People Aged 75 and Older. Journal of the American Geriatrics Society, 57, 815-822.
http://dx.doi.org/10.1111/j.1532-5415.2009.02221.x [9] INSEE (2012) French National Institute of Statistics and Economic Studies. [10] Lachs, M.S. and Pillemer, K. (2004) Elder Abuse. Lancet, 364, 1263-1272.
http://dx.doi.org/10.1016/S0140-6736(04)17144-4 [11] Lachs, M.S., Williams, C.S., O’Brien, S., et al. (1997) ED Use by Older Victims of Family Violence. Annals of Emergency Medicine, 30, 448-454.
http://dx.doi.org/10.1016/S0196-0644(97)70003-9 [12] Clark-Daniels, C.L., Daniels, R.S. and Baumhover, L.A. (1990) Abuse and Neglect of the Elderly: Are Emergency Staff Aware of Mandatory Reporting Laws Department? Annals of Emergency Medicine, 19, 970-977.
http://dx.doi.org/10.1016/S0196-0644(05)82556-9 [13] Barer, B.M. (1997) The Secret Shame of the Very Old: “I’ve Never Told This to Anyone Else. Journal of Mental Health and Aging, 3, 365-375. [14] Rodriguez, M.A., Wallace, S.P., Woolf, N.H., et al. (2006) Mandatory Reporting of Elder Abuse: Between a Rock and a Hard Spot. The Annals of Family Medicine, 4, 403-409.
http://dx.doi.org/10.1370/afm.575 [15] Biostat, T.G.V. (2013) Online Software-UMR 707-University of Paris 6. [16] Collins, K.A. (2006) Elder Maltreatment. Archives of Pathology & Laboratory Medicine, 130, 1290-1296. [17] Rodriguez, M.A., Craig, A.M., Mooney, D.R. and Bauer, H.M. (1998) Patient Attitudes about Mandatory Reporting of Domestic Violence. Implications for Health Care Professionals. West Journal of Medicine, 169, 337-341. [18] Kennedy, R.D. (2005) Elder Abuse and Neglect: The Experience, Knowledge, and Attitudes of Primary Care Physicians. Family Medicine, 37, 481-485. [19] Kurrle, S.E., Sadler, P.M. and Cameron, I.D. (1992) Patterns of Elder Abuse. Medical Journal, 157, 673-676. [20] National Council of the College of Physicians (2011) Medical Demography Wide Living Areas in the Rhône-Alpes Region. [21] National Council of the College of Physicians (2012) Atlas of Medical Demography in France: Situation on January 2012 the 1st.