GPs told they must report elder abuse

Australian GPs have officially recognised their responsibility to report elder abuse, citing several reasons – including time constraints – as to why this has not previously occurred.

elder abuse

Australian GPs have officially recognised their responsibility to be alert for signs of elder abuse and report their concerns to appropriate bodies, citing several reasons – including time constraints – as to why this has not occurred in the past.

Under new guidelines rolled out by the Royal Australian College of General Practitioners (RACGP), doctors are being asked to enact safety plans for patients they believe are being abused and report their concerns to police or to guardianship authorities.

The college has recognised that GPs are often the first independent professional to see an elderly victim of abuse and has released its first aged care clinical recommendations for doctors.

It offers several reasons why that abuse has not been automatically communicated to authorities in the past, saying in a statement: “These include lack of awareness, insufficient knowledge regarding identification or follow-up of a potential case, ethical issues, time constraints and the victim’s potential reluctance to report the abuse.”

Each year, about one in six Australians aged 60 and over experience some form of elder abuse whether that be financial, physical, sexual or psychological abuse. That number is expected to skyrocket as Australia’s population ages.

The Australian Institute of Family Studies reports: “It is likely that between two per cent and 14 per cent of older Australians experience elder abuse in any given year, with the prevalence of neglect possibly higher.

“The problem of elder abuse is of increasing concern as in the coming decades unprecedented proportions of Australia’s populations will be older: in 2050, just over a fifth of the population is projected to be over 65 and those aged 85 and over are projected to represent about five per cent of the population.”

RACGP president Harry Nespolon explained that elder abuse was a complex and insidious problem because most often the abuser was a trusted acquaintance.

“It is a lot more common than most people think,” he said, “and most of the time the elderly patients are being abused by the ones they are also loved by: their children, partners or family members.

“It’s something GPs would come across at least once a month, if not more frequently.”

Dr Nespolon says that if GPs suspect a patient is a victim of elder abuse, they should invoke the prescribed safety plan.

In the case of financial elder abuse, that may involve contacting the Guardianship and Administration Board Victoria. In cases of sexual or physical abuse, they should contact the police.

If the abuse is occurring at a facility such as a nursing home, they are urged to report their suspicions and consider lobbying to have the patient moved out of the institution.

The college says that more than a third of doctors’ consultations are with people aged over 65.

“Often a GP has been with the patient for 30 or 40 years, so they’ve seen them through their divorces, all their crises with their children, every major medical problem and their transition into nursing homes,” Dr Nespolon says.

“They have a great deal of trust with the patient and are more likely to notice changes in their behaviour because of the length of time they have known them.”

Aged Care Crisis spokesperson Lynda Saltarelli has praised the guidelines.

She told The Age and The Sydney Morning Herald: “Elder abuse really requires a cooperative approach from the whole of the community rather than a top-down approach from governments.

“What's really missing in Australia is a clear description of what constitutes elder abuse because at the moment it can be quite non-specific.

“We’re still stuck in the Dark Ages because there is such a lack of information on the number of incidents of elder abuse, where this abuse is occurring or even data on who is inflicting the abuse.”

In October last year, the aged care royal commission released an interim report titled Neglect that described many appalling instances of “inhumane treatment of elderly people”. The inquiry is ongoing.

You can view the RACGP guidelines here.

Are you surprised the RACGP is only now formalising a process to report suspected elder abuse?

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    To make a comment, please register or login
    15th Jan 2020
    happening in my family. My cousin discovered one of his siblings has completely wiped out their mothers savings, and was not even paying the bills she needed to live in the end. You want to know the crazy thing about it all, is that the "abuser" was her FAVOURITE, by a long way. My Aunty would constantly say to me that this son was the only person that cared for her etc. Her favourtism, has come back to bite her on the bum so to speak. The rest of the family are getting back control from this other son and trying to get her bills paid etc. My Aunty will most likely end up in a nursing home earlier than she would have liked because of what her 'favourite" has done to her. yes there is a case for Elder abuse here, but Aunty still doesn't want her favourite charged. What can you do!
    15th Jan 2020
    Indeed - that is a form of elder abuse - I've seen something akin to that with the ex's kids - the eldest of whom held the 'power of attorney' for their grandmother's life... and the others had a lot of trouble getting him to account for expenditures etc... no solid proof - but the way things went, it looked pretty bad - bad enough to ensure that the two younger siblings will not speak to the eldest any more.

    The ex, on the other hand, is shielded from such shenanigans, since she has me as carer... I'm the guy doing reconstruction and relief after fires work for no cash, not even expenses, and who is seeking to raise funds to support an Australian fleet of dedicated water bombing aircraft... all for NO recompense in any way -- not even expenses. These things cost me to do.

    I don't need medals and I don't want money... I can handle the fires and the droughts and the blood and the lives lost - what I want from you with your faggotty white suit is some falcon respect!!! ..(oops got carried away there)...

    15th Jan 2020
    Well, jeez - if I walked into a 'facility' and found inhabitants (not inmates!) with bruises on their wrists and ankles from being tied etc - I'd want to know why.... or any other things as well..

    Of course, one needs to review their medical records and see what is going on - some story tellers may be Non Compos, and bruising is easy when on certain medications... but the actual location of any injury should be an indicator of potential abuse.
    16th Jan 2020
    As you get older your skin actually starts to die. My grand mother lived to 105 & 11 months, and her skin was like
    almost paper in the end. extremely fragile.
    The slightest touch or bump and she would come out black and blue.
    Not many people live to be that old, so the majority of us are not aware of the problems the really really old
    people have.

    Why people want to live to be really old is beyond me. My grandmother complained about it
    every day. She passed away in her sleep, as you would expect at that age.

    16th Jan 2020
    It is all very good to have GPs involved in reporting elder abuse (should have always happened), however I have a problem with a couple of assumed resolutions:

    Firstly, as in the case of child abuse, reporting does not mean any action will be taken as Govt employees are clearly ill-equipped to deal with complex family issues, and always claim lack of staffing caused them to overlook reported cases. There MUST be a defined process with experts involved in mandated short timeframes to get resolution, which takes you back to funding (besides the process)!

    Secondly, reporting family matters to Police is completely nonsensical except in clear cases of evident abuse requiring immediate separation of the older person from the abuser. Otherwise, as in DVO cases, police only make a hash of complex family relationships with their ham-handed approaches.

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