Forensic Nurse Identification of Elder Abuse: Implementing the Elder Assessment Instrument

Abstract

Elder abuse is a significant public health concern and is thought to be largely underrecognized. The Centers for Disease Control estimates 1 in 10 older adults, aged 60 years old and over, who live independently were abused the previous year. The National Council on Aging estimates up to 5 million older Americans are abused every year. Poor detection in the hospital of elder abuse (EA) can have profound health consequences. Systematic reviews suggest benefits of utilizing valid screening tools for EA such as the Elder Assessment Instrument (EAI). Jean Watson’s Theory of Human Caring provided the conceptual underpinning of the project as forensic nurses assist their older patients to meet their basic human needs of safety while offering support in a helping-trust relationship. The clinical question guiding this project is whether using the EAI for patients aged 60 years old and over for possible abuse by forensic nurses, improves identification of EA over a three-month time frame. Johns Hopkins Nursing Evidence-Based Practice model guided the project, which describe several cornerstones of nursing practice, education, and research. Pre-intervention (N=18) participants who were suspected abused by initial screening question, were referred to a forensic nurse for assessment using no specific method to identify abuse. Post-intervention (N=9) participants were referred to a forensic nurse and assessed using the EAI. Data analysis demonstrated improved identification in all four areas of abuse. Pre-intervention (N=18), nine participants had physical abuse not addressed and nine had neglect not addressed. The EAI provides a comprehensive approach to identifying elderly patients who may be victims of abuse and has the potential to improve health outcomes and prevent further abuse from occurring.