Elder abuse and neglect: the experience, knowledge, and attitudes of primary care physicians.

BACKGROUND AND OBJECTIVES: Two million elderly Americans are abused or neglected each year. Elderly patients visit their physicians approximately five times each year. Yet physicians initiate only about 2% of the reported cases of abuse and neglect. This study's purpose was to assess the experience, knowledge, and attitudes of primary care physicians toward elder mistreatment.

METHODS: A self-report questionnaire was mailed to a random sample of 500 primary care physicians. The population included 250 family physicians and 250 general internists in Ohio, divided equally between large urban, suburban, and rural practice settings.

RESULTS: The overall response rate was 78%, with 216 family physicians and 176 internists responding. Nearly 72% of those responding reported no exposure or only minimal exposure to the physical, emotional, or sexual abuse of the elderly. More than half of the respondents in both groups reported that they had never identified a case of elder mistreatment. Both family physicians and general internists estimated its prevalence as roughly less than 25% of the prevalence documented in the medical literature, and both were reluctant to accept the problem as universal. More than 60% of clinicians in both groups indicated they had never asked their elderly patients about abuse. Family physicians tended to have a better knowledge of those elements encompassing elder mistreatment and were more aware of management options.

CONCLUSIONS: Physicians need more education about elder mistreatment.