Leveraging VA geriatric emergency department accreditation to improve elder abuse detection in older Veterans using a standardized tool

Abstract

Elder abuse (EA) is common and has devastating health impacts, yet most cases go undetected limiting opportunities to intervene. Older Veterans receiving care in the Veterans Health Administration (VHA) represent a high-risk population for EA. VHA emergency department (ED) visits provide a unique opportunity to identify EA, as assessment for acute injury or illness may be the only time isolated older Veterans leave their home, but most VHA EDs do not have standardized EA assessment protocols. To address this, we assembled an interdisciplinary team of VHA social workers, physicians, nurses, intermediate care technicians (ICTs; former military medics and corpsmen who often conduct screenings in VHA EDs) and both VHA and non-VHA EA subject matter experts to adapt the Elder Mistreatment Screening and Response Tool (EM-SART) to pilot in the Louis Stokes Cleveland VA Medical Center geriatric ED (GED)program. The cornerstone of their approach is an interdisciplinary GED consultation led by ICTs and nurses who screen high-risk older Veterans for geriatric syndromes and unmet needs. The adapted EM-SART was integrated into the electronic health record and GED workflow in December 2020. By July 2022, a total of 251 Veterans were screened with nine (3.6%) positive on the prescreen and five (2%) positive on the

Bibliometric Study on Geriatric Emergencies: Intellectual Structure, Prominent Themes, and Future-Directing Topics

“…Frequent symptoms among elderly individuals visiting the ED include delirium, altered mental status, and confusion, requiring specialized assessments such as cranial computerized tomography (CT) scans to address their specific needs(2). In addition, EDs play a critical role in detecting elder abuse, a substantial and often unrecognized issue in the elderly population (3).…”

“…Delirium, altered mental status, and confusion are common presenting symptoms in the elderly population visiting the ED and thus require specialized care and assessment, such as cranial computed tomography (CT) (2). Additionally, the ED plays a critical role in detecting elder abuse, a significant and unrecognized problem in the elderly population (3).…”

Screening for elder mistreatment in a Swiss emergency department: a prospective cohort study

“…This observation would put emergency department personnel in a uniquely favourable position to identify potential mistreatment cases through simple routine screening in the emergency department and take appropriate actions involving social services or law enforcement early on if needed. As previously suggested, the high screening burden could be reduced by implementing a prescreen [37].…”