Elder abuse – concerns about your older patients

In caring for their older patients, medical and other health practitioners might have concerns about possible elder abuse. 

Elder abuse has been defined by the World Health Organisation as:

“a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person"

It can include financial, physical, psychological and sexual abuse, and arise from intentional or unintentional neglect.

It can be difficult for practitioners to know what to do about their suspicions of elder abuse. 
Complex considerations can arise around issues such as willingness to disclose abuse, capacity, insight, safety, substitute decision-makers and confidentiality. 

There are no mandatory reporting obligations on practitioners around suspected elder abuse as there are for child protection.  Mandatory reporting obligations involving older patients are restricted to approved providers for certain suspected assaults involving residents in their care.    

You may encounter situations of suspected elder abuse where you feel it is either necessary or appropriate to:

• liaise with other professionals
• refer your patient to another person or body for further assistance, such as aged care assessment teams  and / or 
• report your concerns to a responsible body, such as the police or other government agency 

There is no single body responsible for handling suspected elder abuse.  Where to seek support, refer or report depends on the nature of the suspected abuse and its location. 
For example:

• suspected abuse involving a serious or imminent risk of harm to an older patient might be most appropriately reported to the police
• the Commonwealth Aged Care Complaints Commissioner handles complaints involving government-funded aged care
• various states and territories have set up elder abuse helplines or prevention units, which can provide assistance in determining how best to respond to your concerns 

MIGA has recently been involved in a number of inquiries and reviews, seeking clear guidance for the profession around what to do in situations of suspected elder abuse and appropriate protections for practitioners who act on their concerns. 

The RACGP and various government bodies have provided guidance around assessing and responding to suspected elder abuse – links to these resources are below.  These links also contain key contacts for each state and territory around advice, referrals and reporting of elder abuse. 

If you are confronting a situation of suspected elder abuse and you are unsure what to do, contact MIGA’s claims solicitors. 
 
Further information

• Australian Government My Aged Care – Elder abuse concerns
• RACGP Clinical Guidelines, Section 10.1 Elder Abuse

Links current at 20 May 2019