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Recognizing signs of elder abuse through a forensic lens

Elder abuse in nursing homes can take many forms. While some signs of elder abuse such as physical injuries may be obvious, others may be harder to detect. Some elderly patients may be suffering verbal abuse or financial exploitation, which are harder to recognize.

Advocates for elder safety have long been looking for new ways to both identify and prevent nursing home neglect. A recent clinical study encourages health care professionals to adopt a “forensic lens” approach “inspired by law enforcement to better identify and address cases of elder abuse.” The technique can help first responders, doctors and others not trained in law enforcement to determine whether neglect could have occurred.

Researchers from the USC Leonard Davis School of Gerontology examined two cases of suspected elder abuse in caregiving situations. On the surface, both cases appeared to be similar. However, it was only after viewing them through a forensic lens methodology that they could decide whether mistreatment had actually taken place.

“The ‘forensic lens’ is intended to help investigators evaluate the entire clinical, social and legal scenario when determining the cause of elder mistreatment,” commented Marti DeLiema, the study’s lead author. “Physicians and other health care providers can be trained for what to look for; just as a detective looks for clues in a crime scene, physicians can look for clues in a patient’s body and behavior.”

The two cases used in-home observations, detailed documentation of the patients’ conditions and non-accusatory caregiver interviews to determine whether intentional elder neglect had taken place. DeLiema admitted that careful investigation is likely to be challenging for busy health care professionals who are pressed for time. However, a growing number of hospitals are adopting policies to improve patient documentation which can serve as key evidence in elder abuse cases.