Elder Abuse: ER Protects A Vulnerable Population

Elder abuse leads to depression, medical problems, and even death in older patients. In fact, hospital emergency rooms are now identifying and helping abused seniors. However, those subjected to emotional, physical, or financial abuse too often remain silent. As few as 1 in 24 cases of abuse against residents age 60 and older were reported to authorities, according to a New York study . Identifying and helping victims, therefore, poses significant challenges for doctors and nurses.

Elder Care: New York Presbyterian Hospital ER

The hospital emergency room is often the first line of defense for a senior citizen who is mostly homebound. Tony Rosen is the  founder and lead investigator of the Vulnerable Elder Protection Team (VEPT). He launched this program back in April at the New York-Presbyterian Hospital/Weill Cornell Medical Center ER.

Elder Care: The VEPT Team

Dr.’s Tony Rosen, Mary Mulcare, and Michael Stern plus two social workers are on call to respond to signs of elder abuse. Also available if needed are psychiatrists, legal and ethical advisers, radiologists, geriatricians, and security and patient-services personnel. Funding is provided by the Fan Fox and Leslie R. Samuels Foundation.

The VEPT protocol starts with a doctor interviewing the patient. Next, is a head-to-toe physical exam looking for bruises, lacerations, abrasions, areas of pain, and tenderness. Additional testing is ordered if the doctor suspects abuse.

Elder Care: Identifying Abuse

The VEPT team looks for specific injuries. For example, radiographic images will show both old and new fractures that can suggest a pattern of traumatic events. Specific types of fractures may indicate abuse, such as a forearm bone that can break when an older adult holds his arm in front of his face to protect himself.

When signs of abuse are found but the senior citizen does not cooperate, a psychiatrist determines if that elder has decision-making capacity. The team offers resources but can do little more if the patient isn’t interested. Unlike with Child Protective Services, Adult Protective Services does not become involved until a patient has been discharged, therefore hospitalization can keep elders safe until a better solution is found.

Elder Care: Long-Term Goals

The VEPT teams’ goal is to optimize acute care for elder victims and ensure their safety. They constantly tweak the program and liaison with emergency medical, law enforcement, and criminal justice services. Eventually, they want to help more  hospital emergency departments set up similar programs.