Action on Elder Abuse: A New South Wales pilot project on the role of legal and health practitioners in elder abuse screening, response and prevention

This article reports on an elder abuse pilot project that involved legal and health practitioners (n=17) in a regional centre in New South Wales. The aim of the project was to design and test the feasibility and acceptability of a pilot intervention to improve detection and response for older clients at risk of or experiencing various forms of elder abuse. Using a qualitative approach, interviews and focus groups elicited practitioners’ experiences in identifying and responding to elder abuse among their older clients and their views on the use of structured screening processes. Participants reported they mostly encounter situations of financial exploitation and psychological abuse, perpetrated by adult children against older parents. No practitioners reported the use of an elder abuse-specific screening tool, but perceived the benefits of structured screening questions to enable conversations about elder abuse and to support earlier identification of problem situations. Barriers to elder abuse screening included practitioners’ concerns about communication strategies, professional role boundaries, and inadequate response options. Participants supported a ‘triage’ approach with graduated use of screening questions and responses scaled to the immediacy and severity of the problem. Respect for the autonomy of older people was emphasised, along with professionals’ key role in providing advice and resources to empower their older clients. This study applies the contextual theory of elder abuse, which highlights the individual, relational, community and societal contexts in which abuse occurs and can be identified, mitigated and prevented. Investigation of the role and perspectives of legal and health professionals helps to further develop this contextual theory.