National profiling of elder abuse referrals

BACKGROUND: there is little consistent data on patterns of reporting of elder abuse in Europe. Between 2002 and 2007, the Irish Health Service Executive developed dedicated structures and staff to support the prevention, detection and management of elder abuse without mandatory reporting. Public awareness campaigns, staff training and management briefings heightened awareness regarding this new service. Central to this process is the development of a national database which could provide useful insights for developing coordinated responses to elder abuse in Europe. OBJECTIVE: to report the rate of referrals of elder abuse, patterns of elder abuse and outcomes of interventions related to a dedicated elder abuse service in the absence of mandatory reporting. METHODS: data on all referrals were recorded at baseline by a national network of Senior Case Workers dedicated to elder abuse, with follow-up conducted at 6 months and/or case closure. All cases were entered on a central database and tracked through the system. The study design was cross-sectional at two time points. RESULTS: of 1,889 referrals, 381 related to self-neglect. Of the remaining 1,508, 67% (n = 1,016) were women. In 40% (n = 603) of cases, there was more than one form of alleged abuse. Over 80% of cases referred related to people living at home. At review 86% (n = 1,300) cases were closed, in 101 client had died, 10% of these clients had declined an intervention. Cases are more likely to be open longer than 6 months if substantiated 36 versus 21% in the closed cases. Consultation with the police occurred in 12% (n = 170) of cases. The majority of clients (84% n = 1,237) had services offered with 74% (n = 1,085) availing of them. Monitoring, home support and counselling were the main interventions. CONCLUSION: the number of reported cases of abuse in Ireland indicates an under-reporting of elder abuse. The classification of almost half of the cases as inconclusive is a stimulus to further analysis and research, as well as for revision of classification and follow-up procedures. The provision of services to a wide range of referrals demonstrated a therapeutic added benefit of specialist elder abuse services. The national database on elder abuse referrals provides valuable insight into patterns of elder abuse and the nature of classification and response. The pooling of such data between European states would allow for helpful comparison in building research and services in elder abuse.