Published Work by AGEM Members

 

AGEM Author Spotlight: David Hancock, PhD, Instructor of Gerontology in Emergency Medicine at Weill Cornell Medical College

Elder Mistreatment Documentation by Prehospital Clinicians: An Analysis of the National Emergency Medical Services Information System Database

Elder mistreatment, including abuse and neglect, is a critical public health issue affecting many older adults, with severe consequences such as depression, chronic illness, and increased healthcare costs. Prehospital clinicians (PHCs) including EMTs and paramedics are uniquely positioned to detect and report elder mistreatment due to their ability to observe patients' home environments. However, current documentation practices do not often focus on identifying elder mistreatment, leading to underreporting. This study analyzed elder mistreatment documentation by PHCs using the National Emergency Medical Services Information System (NEMSIS) database, covering over 9.6 million EMS encounters in 2018 for patients aged 60 and above. Elder mistreatment was identified in only 0.02% of these encounters, primarily as causes of injury. Physical abuse was the most documented form of mistreatment (20.8%), followed by sexual abuse (18.2%), while neglect and psychological abuse were rarely reported. The study highlights significant barriers to elder mistreatment identification, including limited training, lack of protocols, and challenges in reporting. Recommendations include integrating elder mistreatment into PHC protocols, developing standardized screening tools, and providing targeted training to improve recognition and reporting of elder mistreatment. The study concludes that while PHCs have a crucial role in identifying EM, systemic changes are needed to improve their ability to recognize and intervene effectively in cases of elder mistreatment.

 

David W. Hancock is an Instructor of Emergency Medicine in the Division of Geriatric Emergency Medicine, Department of Emergency Medicine at Weill Cornell Medicine. He is a PhD-trained social psychologist (go Texas Tech!) with a background in psychometrics, substance abuse, and ageism. His current work is focused on the intersection of elder mistreatment and dementia family caregiving.