Adapting the Elder Abuse Suspicion Index© for Use in Long-Term Care: A Mixed-Methods Approach

Currently available elder abuse screening and identification tools have limitations for use in long-term care (LTC). This mixed-methods study sought to explore the appropriateness of using the Elder Abuse Suspicion Index© (a suspicion tool originally created for use with older adults in the ambulatory setting with Mini-Mental State Examination scores ≥ 24) with similarly cognitively functioning persons residing in LTC. Results were informed by a literature review, Internet-based consultations with elder abuse experts across Canada (n = 19), and data obtained from two purposively selected focus groups (n = 7 local elder abuse experts; n = 7 experienced front-line LTC clinicians). Analyses resulted in the development of a nine-question tool, the EASI-ltc, designed to raise suspicion of EA in cognitively intact older adults residing in LTC (with little or no cognitive impairment). Notable modifications to the original Elder Abuse Suspicion Index© (EASI) included three new questions to further address neglect and psychological abuse, and a context-specific preamble to orient responders.