Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Equity of opportunity for safe care: Raising awareness of elder abuse in older adults with cancer. (#73)

Catherine Devereux 1 , Mei Krishnasamy 1 2 3 , Catherine McMutrie 1
  1. Peter MacCallun Cancer Centre, Melbourne , VIC
  2. The University of Melbourne, Melbourne, VIC, Australia
  3. Victorian Comprehensive Cancer Centre, Melbourne , VIC, Australia

Background
Almost one in six older Australians experience elder abuse.  Worryingly, only a third of people impacted seek support.  Widespread lack of awareness of elder abuse amongst health professionals impacts the safety of older Australians.  

Aims

We set out to explore and describe cancer consumers’ and health professionals’ awareness of and attitudes towards identifying elder abuse in an acute hospital setting.  

Methods

We completed a descriptive, exploratory study.  Nineteen cancer consumers and 18 health professionals participated in audio-recorded, qualitative interviews and focus groups.  Data were analysed thematically and will contribute to the development of co-designed awareness raising resources.

Results

Consumers described elder abuse as an extension of societal ageism, experienced as disrespect and control.  Reliance on family members for care was described as a disincentive to disclose abuse. Consumers identified opportunity for gentle, unhurried conversations with skilled clinicians as an enabler to disclose abuse.  They also emphasised the importance of appropriate and well managed response pathways, if abuse is disclosed.

Nurses and doctors acknowledged the importance of being able to recognise and respond appropriately to elder abuse.  Although many described intuitively “sensing something was wrong”, they described lack of knowledge and confidence to intervene.  Social workers reported that many older people believe that elder abuse is limited to physical harm, and reported that identification of abuse often occurred when patients were referred to them for other reasons.  Supporting an older person who discloses abuse, but declines help or intervention, was reported to be particularly burdensome.

Conclusions

Identifying and responding to elder abuse is challenging in the context of busy hospital environments.  Our study has generated novel data from patient and clinician perspectives about attitudes to inquiring about abuse, and, recommendations for appropriate approaches and escalation processes when abuse is identified.