A Study of Elder Neglect in the Emergency Department

Yoon, Young Hoon; Moon, Sung Woo; Hong, Suk Hyun; Kim, Jong Kyu; Choi, Sung Hyuk; Lee, Sung Woo; Hong, Yun Sik

Abstract

PURPOSE
The first visit to the emergency department of patients subjected to elder abuse should influence the direction of treatment in both the inpatient and the outpatient departments and thus the outcome. We tried to find risk factors of elder abuse by using information from families of death-on-arrival patients over age of 60 years and by evaluating the situation of the actual condition of elder abuse.
METHODS
From January 2003 to August 2003, we prospectively interviewed 93 families of patients over 60 years of age who visited the emergency center of Korea University Hospital and who were dead on arrival. We classified them into three groups: neglected, actively neglected and nonneglected. Risk factors analyzed were age, sex, alcohol abuse, cerebrovascular accident, and depression. We examined time during which families left their elderly to die without visiting a physician after noticing abnormal signs.
RESULTS
Thirty-nine (39) cases (41.94%) were classified as neglected and 13 (13.98%) cases as actively neglected. Statistically meaningful risk factors were age, alcohol abuse, and cerebrovascular accident in the actively neglected groups. There was no meaningful risk factor in the neglected group. The time during which families left their parents to die without medical decision was 35+/-12.0 days in the neglected group, 35+/-19.0 days in the actively neglected group, and 4+/-1.1 days in non-neglected group. Among those left to die without a visiting physician, 25 cases were in neglected group (56.8%), and 9 cases (20.5%) were in the actively neglected group.
CONCLUSION
Emergency physicians can make a great contribution to the treatment of elder abuse by recognizing the risk factors, connecting the patients with prevention centers, and maintaining long-term outpatient follow up after the first visit to the emergency department.