Measure screens for elder maltreatment

Measure screens for elder maltreatment
(April 2009 Issue)

By Ami Albernaz

Since the beginning of the year, psychologists taking part in the Physician Quality Reporting Initiative (PQRI), the Medicare reporting program, have been able to complete a measure to screen for elder maltreatment and document next steps in addressing the problem.

The "Elder Maltreatment Screen and Follow-Up Plan" is intended to provide help for people ages 65 and older who suffer physical or emotional abuse or neglect. Psychologists who participate will receive an additional two percent of their total allowed charges to Medicare.

Abuse of older adults has been historically difficult to estimate. An American Psychological Association report titled "Elder Abuse and Neglect: In Search of Solutions" estimated that for every reported case of elder abuse and neglect, there could be as many as five unreported cases. Victims might fear retribution from abusers or might not recognize the abuse. Additionally, research suggests that elders who have been abused die earlier than those who are not abused.

"There's a lot of hype about elder abuse and neglect in nursing homes," says Merla Arnold, Ph.D, R.N., chair of the APA work group that created the measure, "but it looks like the highest risk for abuse and neglect are those older adults living out in the community, without social support."

The measure is meant to encourage psychologists who work with the elderly to ask about abuse and neglect and to encourage them to follow up on any uncovered problems. Questions on the measure relate to abandonment, financial exploitation, sexual abuse and self-neglect (lifestyle factors such as reclusion, for instance), as well as physical and emotional abuse and neglect by family members, friends or institutional caregivers.

The PQRI is a voluntary reporting program that provides financial incentives for health care providers participating in Medicare to submit data on specified measures. Traditionally for physicians, the program was expanded to psychologists in July 2007 with the addition of a measure on major depressive disorder. Today, the PQRI has seven measures that psychologists can complete. In addition to the elder maltreatment measure, they include antidepressant medication assessment and assessing suicide risk.

Because the measure has been available for only a few months, there is no feedback on it just yet, Arnold says.