GPs told to report 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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Written by Janelle Ward

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