271029 Are Elder Deaths Due to Caregiver Neglect Going Undetected?

Tuesday, October 30, 2012 : 11:18 AM - 11:30 AM

Aileen Wiglesworth, PhD , Program in Geriatrics, University of California, Irvine, Orange, CA
Laura Mosqueda, MD , Department of Family Medicine, Univeristy of California, Irvine, Orange, CA
Background: A phone survey and site visits to California County Coroner/Medical Examiner (C/ME) offices uncovered concerns that Coroner Investigators (CIs) fielding reports of deaths are not detecting suspicious elder deaths due to caregiver neglect. Elder Death Review Teams have discovered many of these kinds of cases when it is too late to do an investigation. Methods: Three C/ME offices participated in a pilot study of the Elder Suspicious Death Field Screen (ESDFS). The tool was designed to detect evidence that a death was due to caregiver neglect for CIs who handle calls reporting elder deaths. After a six-month pilot test, cases were selected for review by an expert panel to determine if they had been investigated appropriately. Results: Use of the ESDFS was limited, and follow-up interviews provided insight on impediments to use, including reluctance of reporting parties to provide the needed information. Nevertheless, of the 115 elder deaths for which the ESDFS was used, the expert panel reviewed 55. The panel assessed that 67.3% were handled inappropriately. The reporting party failed to view the body as requested for 52.7%. Signs of neglect such as pressure ulcers or other injuries could not be ruled out in these cases. Conclusions: Police officers, nurses and other professionals who report deaths, are unaware of the need to rule out elder death by neglect, and laws do not require them to uncover the body for viewing. C/ME offices are unable to ensure detection of elder neglect cases, and prevalence of fatal neglect is unknown.

Learning Areas:
Other professions or practice related to public health
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the process that Coroner/Medical Examiner (C/ME) offices follow in deciding to investigate a suspicious death. Explain how these procedures may cause C/ME offices to overlook elder deaths due to caregiver neglect. Discuss some impediments to improving these procedures. Discuss some approaches for improving the chances that an elder death due to caregiver neglect will be detected and investigated.

Keywords: Aging, Death

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Gerontologist and I have served as Lead Reseaarcher on elder and dependent abuse research grants funded by The National Istitute of Aging, the National Institute of Justice, the California Department of Health Services, the Archstone Foundation and the National Multiple Sclerosis Society.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.