Health Policy

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Clinical Briefs - Clinical Briefs

Preventive Care for the Elderly: Getting By in the Absence of Evidence - Editorials

CDC Releases Updated Plan for Emerging Infectious Diseases - Special Medical Reports

The U.S. Blood Supply - FDA Perspective

Healthy People 2010: The Role of Family Physicians in Addressing Health Disparities - Medicine and Society

Is Universal Coverage the American Way? - Feature

Rationale for a 39-Week Elective Delivery Policy - Editorials

Back to the Future: The Way Forward in Health Care Reform - Opinion

Relying on NPs and PAs Does Not Avoid the Need for Policy Solutions for Primary Care - Graham Center Policy One-Pagers

Detecting Elder Abuse and Neglect: Assessment and Intervention - Article

ABSTRACT: Elder mistreatment includes intentional or neglectful acts by a caregiver or trusted person that harm a vulnerable older person. It can occur in a variety of settings. One out of 10 older adults experiences some form of abuse or neglect by a caregiver each year, and the incidence is expected to increase. Although the U.S. Preventive Services Task Force found insufficient evidence that screening for elder abuse reduces harm, physicians in most states have professional and legal obligations to appropriately diagnose, report, and refer persons who have been abused. Screening or systematic inquiry can detect abuse. A detailed medical evaluation of patients suspected of being abused is necessary because medical and psychiatric conditions can mimic abuse. Signs of abuse may include specific patterns of injury. Interviewing patients and caregivers separately is helpful. Evaluation for possible abuse should include assessment of cognitive function. The Elder Abuse Suspicion Index is validated to screen for abuse in cognitively intact patients. A more detailed two-step process is used to screen patients with cognitive impairment. The National Center on Elder Abuse website provides detailed, state-specific reporting and resource information for family physicians.

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