Elder abuse screening tools: a systematic review
| Date | 11 December 2017 |
| Pages | 368-379 |
| Published date | 11 December 2017 |
| DOI | https://doi.org/10.1108/JAP-10-2016-0026 |
| Author | Louise McCarthy,Susan Campbell,Bridget Penhale |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
Elder abuse screening tools:
a systematic review
Louise McCarthy, Susan Campbell and Bridget Penhale
Abstract
Purpose –Elder abuse results in high rates of morbidity and mortality. It has longstanding physical and
psychological effects and is difficult to detect. Due to fear or embarrassment, victims may make attempts to
hide it rather than to disclose and professionals are often reluctant to report it as they may worry about
worsening a situation. If detected early enough, serious harm can be prevented and lives saved. Screening
and screening tools can assist health and social care practitioners to detect abuse. This review of screening
tools was undertaken as part of an MSc in clinical research, funded by the National Institute for Health
Research; the purpose of this paper is to report on the review and its findings.
Design/methodology/approach –This was a systematic review with eligibility inclusion and exclusion
criteria decided in advance. Keywords and their synonyms were combined and then used to search health
and social care databases. Data items were collected from the included studies. The preferred reporting item
for systematic reviews and meta-analysis was followed for the reporting of the results. A narrative synthesis
approach was applied to the analysis.
Findings –A total of 34 full text studies were downloaded, read and analysed. In all, 11 met the inclusion
criteria and were included in the final analysis. Of these, three studies reported sensitivity and specificity,
with the remainder reporting validity and reliability testing. In total, 12 tools of varying length and quality were
found. The length and characteristics of tools affects the efficacy of their use. The clinical environment will
determine choice of screening tool to be used. Screening tools should be used within an overall system of
detection and management of abuse.
Research limitations/implications –The synthesis of results was challenging due to the lack of
homogeneity between the included studies. The variations in tool characteristics and qualities added to this
challenge. A further limitation was the lack of a gold standard tool in elder abuse.
Originality/value –This systematic review highlights a lack of robust evidence in the development and
validation of screening tools to detect elder abuse. Though there is an increasing awareness and knowledge
about elder abuse, its detection remains problematic and the lack of research in this area is worth
emphasising. Specific tools, centred on the clinical setting in which they are used, are recommended.
Keywords Older people, Screening, Elder abuse, Detection, Old age, Screening tools
Paper type Research paper
Introduction
Elder abuse is nota recent phenomenon but it has onlybeen the subject of sustained interest and
concern in recent years. The UK charity Action on Elder Abuse has existed for many years and
in 1995 developeda definition that is now used worldwide:“Elder Abuse is a single or repeatedact
or lack of appropriateaction, occurring withinany relationship where thereis an expectation of trust
which causes harm or distress to the older person”(Action on Elder Abuse, 2017a).
Different words are used to describe abuse. These include: harm, exploitation, mistreatment and
maltreatment. Elder abuse is broadly divided into the following categories: neglect, physical,
psychological/emotional, financial and sexual. Most commonly found types are neglect and
psychological or emotional, followed by physical abuse (Schofield and Mishra, 2003). There are
longstanding difficulties in definitions and debates remain around definitions, even among
experts (Pritchard, 1995). For example, the issue of intimate partner violence/domestic abuse
and elder abuse is complicated when it comes to a definition; should those people who have
Received 28 October 2016
Revised 21 July 2017
Accepted 31 August 2017
Louise McCarthy is a Research
Lead in Dementia and Later Life
at the Department of Research
and Development, Norfolk and
Suffolk NHS Foundation Trust,
Bury St Edmunds, UK.
Susan Campbell is a Lecturer
at the School of Health
Sciences, University of East
Anglia, Norwich, UK.
Bridget Penhale is a Reader in
Mental Health of Older People
at the School of Health
Sciences, University of East
Anglia, Norwich, UK.
PAGE368
j
THE JOURNAL OF ADULT PROTECTION
j
VOL. 19 NO. 6 2017, pp. 368-379, © Emerald Publishing Limited, ISSN 1466-8203 DOI 10.1108/JAP-10-2016-0026
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