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Objective: To establish the prevalence and patterns of elder abuse, and outcomes of intervention, among patients of four Australian Aged Care Assessment Teams., Design: Descriptive study, with victims identified retrospectively from medical records for the first three months, and prospectively form the remaining nine months, of 1994., Setting: Four area-based Aged Care Assessment Teams in three States., Patients: Referred patients over 65 years of age who lived in private homes and who met a predetermined definition of elder abuse., Main Outcome Measures: Prevalence of abuse, types of abuse and the effect of interventions., Results: The overall prevalence of elder abuse in the study population was 1.2% (95% CI, 0.4%-2.0%). The rate identified retrospectively was double that identified prospectively. Psychological abuse was the most common form of abuse detected. Patterns of abuse were identified and related to psychopathology of the abuser (30%), dependency of the older person and carer stress (25%), domestic violence (19%), carer abuse (18%) and financial dependency (8%). Interventions and outcomes varied according to the pattern of abuse., Conclusion: Our findings on the factors causing elder abuse are consistent with those identified in previous Australian studies. The prevalence of elder abuse detected in this study was lower than that in other Australian and overseas studies. A more uniform approach to detection is necessary, which may be aided by improved identification and management techniques, and appropriate training of health professionals in aged care services in case definition, interventions and management.

Objective: To find out what difficulties general practitioners (GPs) experience with diagnosing and managing dementia., Design: Postal questionnaire to a random stratified sample of one in seven active Australian GPs (2182 of 14,932)., Results: 1473 GPs (67.5%) responded to the questionnaire. The results indicated reasonable knowledge about diagnostic features of dementia and good insight into common issues facing family carers. Even so, GPs had difficulties with diagnosis and management of dementia and wanted assessment protocols and educational programs. A minority of GPs regularly screened elderly patients for cognitive impairment but the majority relied on passive means of diagnosing dementia. Although generally positive about Aged Care Assessment Teams (ACATs) and Aged Care Community Services (ACCS), GPs expressed some concerns about these services., Conclusions: Recommendations arising from the survey were: development of an assessment protocol and a screening instrument, regular cognitive check-ups for patients over 75 years, educational programs, improved coordination with Aged Care Assessment Teams and Community Services, inventories and registers of local community services and residential facilities, and appropriate Medicare rebates.

Only recently has abuse of the elderly been recognised as a problem. The author describes the types of abuse encountered, provides clues on how to detect them, outlines reasons for the occurrence of abuse and suggests what to do when a case of abuse is identified.

Objective: To establish the rate of occurrence and patterns of elder abuse, and outcomes of intervention, in an Australian population., Design: Retrospective review of medical records over a 12-month period from July 1990 to June 1991., Setting: An area-based geriatric and rehabilitation service attached to a district hospital., Patients: Referred patients over 65 years of age, who lived in private homes and who met a predetermined definition of elder abuse., Results: The rate of occurrence of elder abuse in the study population was 4.6%, with 29 cases of psychological abuse, 25 cases of physical abuse, 16 cases of neglect, and 13 cases of material/financial abuse. Patterns of abuse were identified and related to dependency of the older person (42%), psychopathology of the abuser (37%), family violence (14%), and carer stress (5%). Interventions and outcomes varied according to the pattern of abuse., Conclusion: The rate of occurrence and patterns of abuse of the elderly have been established for the first time in an Australian population. Intervention aimed at reducing the impact of elder abuse is effective, and should be tailored to the pattern of abuse that is occurring.

Objective: To report a series of older patients who had been physically abused or neglected and to describe their disabilities and social situation, the abuser, interventions offered and outcomes., Design: A retrospective case series. Patients were included if they met the requirements of a predetermined definition of physical abuse or neglect., Setting: An area-based geriatric and rehabilitation service attached to a district hospital., Patients: Fifteen men and women aged over 65 who met the requirements of our definition of abuse and who were referred to the service over a 12-month period. For each patient an abuser was identified., Results: Risk factors for elder abuse were a high degree of dependency of the elderly person resulting from cognitive or physical impairment; psychopathology in the abuser or stress on the carer. Intervention was effective for a majority of the patients., Conclusions: The findings are similar to those of overseas studies. Awareness of the problem and early intervention with counseling, provision of appropriate services and accommodation are likely to be successful in limiting the impact of elder abuse.