TY - JOUR
AU - L. K. Makaroun
AU - N. Shin
AU - K. L. Hruska
AU - T. Rosen
AU - M. E. Dichter
AU - C. T. Thorpe
AU - K. L. Rodriguez
AU - A. O'Hare
AU - A. M. Rosland
A1 - 
AB - BACKGROUND AND OBJECTIVES: Elder abuse (EA) is common and has significant health impacts. New initiatives seek to capitalize on opportunities to respond to EA from within the healthcare system, but little is known about what clinicians may need to be successful in these efforts. Our objective was to understand perceived barriers and facilitators to managing all phases of EA within an integrated healthcare system from the perspectives of frontline clinicians from a range of different disciplines. RESEARCH DESIGN AND METHODS: Thirty-seven clinicians (10 social workers, 9 physicians, 7 psychologists, 6 nurses, and 5 advanced practice providers) from different clinical sites within 2 large Veterans Health Administration (VHA) medical centers participated in semistructured interviews. The interview guide was designed to elicit facilitators and barriers to discrete stages in the process of addressing EA, including detection, reporting, intervention, and monitoring. Transcripts were coded using deductive (based on a prespecified conceptual model) and inductive approaches and analyzed using thematic analysis. RESULTS: Most (78%) participants were women, ranging in age from 33 to 64 years, and practicing in a variety of settings (e.g., primary care and emergency department) with between 4 and 25 years of VHA experience. We identified 5 interrelated themes that cut across the different stages of EA care: situational context (theme 1), degree of trust in familial and healthcare relationships (theme 2), extent of education and skills (theme 3), and existing system infrastructure (theme 4) all contributed to clinician empowerment and motivation toward action (theme 5). DISCUSSION AND IMPLICATIONS: Efforts to enhance skills training, build trusting relationships, and improve system infrastructure could help to equip clinicians to engage in healthcare system interventions to reduce harm from EA.
AD - VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.; Department of Emergency Medicine, Weill Cornell Medical College/New York-Presbyterian Hospital, New York, New York, USA.; VA Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.; School of Social Work, Temple University Philadelphia, Philadelphia, Pennsylvania, USA.; Division of Pharmaceutical Outcomes and Policy, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA.; VA Puget Sound Healthcare System, Seattle, Washington, USA.
AN - 40386027
BT - Innov Aging
C5 - Education & Workforce; Healthcare Disparities
CP - 5
DO - 10.1093/geroni/igaf012
DP - NLM
ET - 20250210
IS - 5
JF - Innov Aging
LA - eng
N2 - BACKGROUND AND OBJECTIVES: Elder abuse (EA) is common and has significant health impacts. New initiatives seek to capitalize on opportunities to respond to EA from within the healthcare system, but little is known about what clinicians may need to be successful in these efforts. Our objective was to understand perceived barriers and facilitators to managing all phases of EA within an integrated healthcare system from the perspectives of frontline clinicians from a range of different disciplines. RESEARCH DESIGN AND METHODS: Thirty-seven clinicians (10 social workers, 9 physicians, 7 psychologists, 6 nurses, and 5 advanced practice providers) from different clinical sites within 2 large Veterans Health Administration (VHA) medical centers participated in semistructured interviews. The interview guide was designed to elicit facilitators and barriers to discrete stages in the process of addressing EA, including detection, reporting, intervention, and monitoring. Transcripts were coded using deductive (based on a prespecified conceptual model) and inductive approaches and analyzed using thematic analysis. RESULTS: Most (78%) participants were women, ranging in age from 33 to 64 years, and practicing in a variety of settings (e.g., primary care and emergency department) with between 4 and 25 years of VHA experience. We identified 5 interrelated themes that cut across the different stages of EA care: situational context (theme 1), degree of trust in familial and healthcare relationships (theme 2), extent of education and skills (theme 3), and existing system infrastructure (theme 4) all contributed to clinician empowerment and motivation toward action (theme 5). DISCUSSION AND IMPLICATIONS: Efforts to enhance skills training, build trusting relationships, and improve system infrastructure could help to equip clinicians to engage in healthcare system interventions to reduce harm from EA.
PY - 2025
SN - 2399-5300
SP - igaf012
ST - Healthcare Clinicians' Perspectives on Managing Suspected Elder Abuse: "We Don't Want to Just Swoop in and Do What We Think Is Best"
T1 - Healthcare Clinicians' Perspectives on Managing Suspected Elder Abuse: "We Don't Want to Just Swoop in and Do What We Think Is Best"
T2 - Innov Aging
TI - Healthcare Clinicians' Perspectives on Managing Suspected Elder Abuse: "We Don't Want to Just Swoop in and Do What We Think Is Best"
U1 - Education & Workforce; Healthcare Disparities
U3 - 10.1093/geroni/igaf012
VL - 9
VO - 2399-5300
Y1 - 2025
ER -