Few Doctors Report Abuse of Elderly Patients
A recent article in The Providence Journal notes that although doctors in almost every state are required by law to report suspected elder abuse of their patients, hardly any of them do, even if they fear that their silence may subject an elderly person to continued abuse at the hands of a caregiver or in a nursing home. Physicians report just 2 percent of the elder abuse and neglect cases recorded each year by state protective service agencies, according to medical and legal experts and recent articles published in medical journals. One study, published in 2005 in a journal focusing on geriatric medicine, says that the actual figure may be even lower. 44 states and the District of Columbia have laws that mandate physician reporting of suspected elder abuse. In New York, Public Health Law 2803-d requires a report when there is reasonable cause to believe that a person receiving care or services in a residential health care facility has been physically abused, mistreated or neglected by other than a person receiving care or services in the facility. Reports of suspected physical abuse, mistreatment or neglect must be made immediately by telephone and in writing within forty-eight hours to the state Health Department. Significantly, a professional will be held guilty of unprofessional conduct in the practice of his or her profession not only for being the abuser, but also for failing to report the abuse as required by the law. The lack of physician reporting is a huge problem, experts say, because as the elderly population continues to grow and doctors become ever more pressed for time in meeting the demands for care, more elder abuse will go undetected. Doctors are often the only people outside an elderly victim's home who have contact with the victim. Every year, an estimated 2.1 million older Americans are victims of physical, psychological or other forms of abuse, according to the American Psychological Association. Congress says the number could be closer to 5 million. Most of the abused or neglected elderly live in the community - not in nursing homes or assisted-living facilities -- and 90 percent of the time, the perpetrator is a family member, most often an adult child or spouse, according to the National Center on Elder Abuse. There are a myriad of reasons why doctors don't report elder abuse, say experts who have studied the issue. A doctor may not recognize what they are seeing as having resulted from abuse, and elder abuse is often hidden. Some doctors don't report suspected abuse because their patients beg them not to. Some doctors believe the patient will be worse off if they don't adjust well to living in a nursing home, or that the abuse at home will escalate, as a form of retribution, if they notify authorities about mistreatment. Many elderly people are dependent on an abuser to meet needs that otherwise would be unmet. In some studies, doctors say they fear that reporting suspected abuse of an elder may open them up to being sued by the abuser, if the complaint doesn't turn into a successful prosecution - even though in most cases, the doctor's identity remains confidential and good-faith reporting makes one immune from liability. New York's Public Health Law 2803-d provides that any person who in good faith makes a report pursuant to the section shall have immunity from any liability, civil or criminal, for having made such a report.
Elder abuse | |||
Only 1 in 14 incidents of elder physical abuse in domestic settings is ever reported to the police. | |||
Physicians report only 0.6 percent to 2 percent of the elder abuse and neglect reports received by state protective service agencies, according to studies in recent years. | |||
Primary care may be a first response to elder abuse. In 2001, adults ages 65 years and older averaged 13.7 physician visits for the year. | |||
The National Elder Abuse Incidence Study, published in 1996, found that elders unable to care for themselves were at greater risk of experiencing abuse and that 60 percent of victims whose abuse was substantiated had some degree of mental impairment. | |||
In 2003, two of every three elder abuse victims were women and 43.7 percent were age 80 or older. | |||
A 2004 study found that 89.3 percent of elder abuse takes place in a domestic setting. | |||
Types of elder maltreatment substantiated include: | |||
self-neglect | 37.2% | ||
caregiver neglect | 20.4% | ||
emotional, psychological or verbal abuse14.8% | |||
financial exploitation | 14.7% | ||
physical abuse | 10.7% | ||
sexual abuse | 1% |