The Article in Brief

Background Although doctors are required by law to report elder abuse, they do so at low rates. In this study, researchers interviewed primary care doctors about their experiences and perspectives on required reporting of elder abuse. The goal of the study was to gain insights to help train medical professionals and students on elder abuse issues.

What This Study Found Doctors identified paradoxes, or contradictions, in the required reporting of elder abuse, including the following: (1) A strong bond between patient and doctor can create the trust needed for a patient to disclose abuse, which increases the likelihood that the abuse will be reported. Doctors who have a strong bond with a patient, however, may be hesitant to report abuse for fear that the patient will feel deceived and their relationship will be damaged. (2) A doctor may report abuse because of a desire to improve the patient’s quality of life by removing the elder from the abusive situation. But a doctor may be less likely to report elder abuse out of concern that it will decrease the patient’s quality of life in other ways (such as revenge or another negative response by the abuser). (3) Required reporting is a way to potentially help the patient and therefore increases the doctor’s control over the patient’s well-being . Because reporting is required, however, it also decreases the doctor’s ability to decide how to best help the patient.

Implications

• Although these paradoxes may be hidden or unconscious, they appear to influence doctors’ decisions about whether report elder abuse.
• There is a need to increase primary care doctors’ awareness about elder abuse and its reporting.
• There has been progress in training health care professionals about child abuse and intimate partner violence, but it is unclear to what extent the topic of elder abuse has been included in such tra
• There are mismatches between required reporting laws and the realities of primary care practice. Reducing these mismatches, as well as the paradoxes they create, could help increase reporting of elder