In order to develop a screening tool to enhance the detection of elder abuse and neglect and reporting rates among emergency medical technicians (EMTs), the primary aim of this study was to identify the most salient indicators of elder abuse and neglect for potential inclusion in a screening tool, with attention to the identification of practical elements of the tool that would optimize EMT uptake and use in the field, such as format, length, number of items, and types of response options available.
Qualitative data were collected from 23 EMTs and Adult Protective Services (APS) caseworkers who participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders using inductive thematic identification and data reduction. Findings were subject to interpretation by the research team. EMTs and APS caseworks identified eight domains of items that might be included on a screening tool: (1) exterior home condition; (2) interior living conditions; (3) social support; (4) medical history; (5) caregiving quality; (6) physical condition of the older adult; (7) older adult's behavior; and, (8) EMTs' instincts. The screening tool should be based on observable cues in the physical or social environment, be very brief, easily integrated into electronic charting systems, and provide a decision rule for reporting guidance to optimize utility for EMTs in the field. Future research should narrow identified items and evaluate how these domains positively predict confirmed cases of elder abuse and neglect. (Publisher abstract modified)
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