Screening

A number of screening measures have been developed and tested in different settings, including the emergency department, clinics, and at home.[41] There is no single globally accepted screening tool for abuse of older adults; however, there are several validated tools in use. If screening tests do not indicate abuse, then no immediate action is required.[37][42][43][44]​​[45]​ However, owing to the low sensitivity of some screening tests, continued monitoring is advised. Conversely, a positive screen does not necessarily mean abuse is happening, but guides the need for further evaluation.

At the Elder Mistreatment Symposium convened by the Centers for Medicare and Medicaid Services in 2013 in the US, three screening tools were identified for increased use in practice for the screening of abuse of older adults. These were the Elder Abuse Suspicion Index (EASI), the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS).[41]

Elder Abuse Suspicion Index

The EASI is designed to be completed by a healthcare professional on cognitively intact older adults. It consists of 6 questions and takes less than 5 minutes to complete. If positive, the patient should be referred to adult protective services or an equivalent agency. The EASI has shown validity in eight countries, and has been validated for use in family practices and ambulatory clinic settings.[41][48]​​

Hwalek-Sengstock Elder Abuse Screening Test

The H-S/EAST is completed by self-report or by a healthcare professional. It has good cross-cultural adaptation and can be used in the emergency or outpatient setting.[41][49]​​

Vulnerability to Abuse Screening Scale

The VASS is used to identify older women at risk for abuse. It is a self-reported questionnaire of dependency, dejection, coercion, and vulnerability.[50]

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