Screening for elder mistreatment in dental and medical clinics.
OBJECTIVE
Elder mistreatment (EM) is a potentially fatal and largely unrecognised problem in the United States. The purpose of this study was to determine the prevalence of EM in busy clinics and specifically, we report on the feasibility of screening for EM as well as the appropriate instrumentation for screening.


BACKGROUND
Prevalence estimates for elder mistreatment vary, but recent data from a national sample of community-residing adults over 60 years of age indicate that 11.4% of older adults report some form of elder mistreatment. There is a paucity of research related to screening in dental and medical clinics to understand the prevalence in such practice settings.


METHODS
A cross-sectional study was conducted from January 2008 to March 2009. We enrolled 241 patients at two clinics: a medical clinic (n = 102) and dental clinics (n = 139). A mini-mental status exam was conducted with a minimum of 18 or better for inclusion. An elder mistreatment screen was next used [elder assessment instrument (EAI-R) for medical and Hwalek-Sengstock elder abuse screening test (HS-EAST) for dental].


RESULTS
For the 241 patients, we were able to compare data from the EAI-R with the HS-EAST. This pilot work demonstrates the feasibility of screening for EM in busy clinics since we documented patient enrolment of 20% in the medical clinics and 66% in dental clinics. Patients are willing to answer extremely-sensitive questions related to elder mistreatment and are also willing to use computer technology for interviewing.


CONCLUSIONS
Dental and medical clinics are important practice venues to screen for elder mistreatment.
NYU College of Nursing, New York University, New York, NY 10003, USA. t.fulmer@neu.edu
Terry
T
Fulmer
Shiela
S
Strauss
Stefanie L
SL
Russell
Geetika
G
Singh
Jamie
J
Blankenship
Roja
R
Vemula
Billy
B
Caceres
Michael
M
Valenti
David
D
Sutin
D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003740:Dental Clinics; D004522:Educational Status; D004552:Elder Abuse / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D017533:Marital Status; D008403:Mass Screening / Q000379:methods*; D008609:Mental Status Schedule; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D010044:Outpatient Clinics, Hospital; D010865:Pilot Projects; D015995:Prevalence; D057566:Self Report; D014584:User-Computer Interface; D014754:Violence / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data