Voices from the frontlines: Examining elder abuse from multiple professional perspectives

Little is known about the experiences of health professionals in reporting suspected elder abuse and neglect (EAN) or the perceptions of Adult Protective Services (APS) in responding to reports. The purpose of this article is to examine the attitudes and perceptions of health professionals in responding to elder mistreatment and to compare these attitudes and perceptions to those of APS workers who investigate abuse. Focus groups were conducted with APS workers (n=9) and two types of health professionals: geriatric care managers (n=4) and hospice staff (n=13). Transcripts were coded inductively, and emergent themes were compared across groups using thematic analysis. Health professionals and APS workers acknowledged similar challenges resolving cases of EAN - particularly victim refusal of services or denial of abuse, limited APS authority, and large caseloads. APS workers identified unnecessary referrals and poor communication among providers as barriers to effectiveness. Health care workers noted they sometimes ignored mandatory reporting requirements, preferring to work directly with patients and families to remedy abuse. Results suggest that mandatory reporting may be a necessary but insufficient approach. Cross-agency collaboration between APS and health professionals may help enhance communications, clarify expectations, and potentially improve outcomes. Person-centered responses that link victims with community-based services should also be explored to improve victim cooperation and to increase confidence in the adult protection system.