Abuse of the older person: is this the case you missed last shift?

The Australian Network for the Prevention of Elder Abuse specifies that elder abuse is ‘any act occurring within a relationship where there is an implication of trust, which results in harm to an older person. Abuse may be physical, sexual, financial, psychological, social and/or neglect’. Elder abuse can occur in any setting where an older person is targeted based on age or disability. Different types of elder abuse commonly occur together. A New South Wales Parliamentary Standing Committee held a review on elder abuse in 2016, identifying that ED staff are at the front line of identification of elder abuse. Furthermore, an Australian Law Reform Commission inquiry will report in 2017, with the aim of optimising legal frameworks to safeguard older Australians. Community awareness is key in elder abuse, as it is with other forms of violence. It reflects social norm and the lens through which we as emergency physicians assess, diagnose and manage abuse.7 In an Australian study, Helmes and Cuevas describe our society as having less value for older people, where doctors may be reluctant to report elder abuse when they have competing demands and where the consequences of reporting may leave victims more isolated particularly where perpetrators are ‘caregivers’.