Content area
Full Text
The EM-SART tool is a good option for elder mistreatment screening within the emergency department setting.
ABSTRACT Developing scalable elder mistreatment (EM) screening tools for emergency department (ED) use should be a public health priority given EM's high prevalence and its low identification rate within ED settings. The National Collaboratory to Address Elder Mistreatment developed the Elder Mistreatment Screening and Response Tool (EM-SART) to address this challenge. EM-SART integrates components of the ED-specific Senior AID screening tool, while incorporating pre-screen and response components. Information about strengths and limitations of the EM-SART will be collected as this tool is disseminated across selected EDs. | key words: elder mistreatment, emergency departments, Elder Mistreatment Screening and Response Tool
Ilder mistreatment (EM) is a common and morbid problem that causes suffering and adverse lth outcomes. Studies estimate EM prevalence to be around 10 percent in America's communitydwelling older adults (Acierno et al., 2010; Lachs and Pillemer, 2015). Negative sequelae known to be associated with EM include increased likelihood of being hospitalized, increased rates of depression, anxiety, and premature mortality (Lachs and Pillemer, 2015).
Elders experiencing mistreatment often rely upon emergency departments (ED) for care, which makes the ED an important setting for identifying EM cases. The presence of social workers and other staff and access to the hospital allow EDs to make a robust, coordinated response to patients suffering from EM.
The prevalence of EM among cognitively intact older adults receiving care in the ED is approximately 7 percent, and the frequency of EM in older ED patients with cognitive impairment likely is higher. Despite EM's high estimated prevalence in the ED, and the potential for hospital staff to identify cases, EM still is often missed in the ED (Evans et al., 2017). In 2017, in a nationally representative sample, only about .01 percent of older adults presenting to U.S. EDs formally received an EM diagnosis, which is more than 100 times less than the estimated prevalence of EM in U.S. EDs (Evans et al., 2017). Further, the use of a single question during ED triage (such as "Are you safe at home?") has proven inadequate to identify EM (Stevens et al., 2018).
A partial reason for the low rate of EM case identification is that no EM...