Table 1

Elder Abuse Suspicion Index: Questions 1 through 5 are asked of the patient and question 6 is answered by the physician; 1 or more positive responses on questions 2 to 6 could suggest elder abuse.

QUESTIONS: OVER THE PAST 12 MONTHS …ANSWER (CIRCLE ONE)
1. Have you relied on people for any of the following: bathing, dressing, shopping, banking, or meals?YesNo
2. Has anyone prevented you from getting food, clothes, medication, glasses, hearing aids, or medical care, or from being with people you wanted to be with?YesNo
3. Have you been upset because someone talked to you in a way that made you feel shamed or threatened?YesNo
4. Has anyone tried to force you to sign papers or to use your money against your will?YesNo
5. Has anyone made you afraid, touched you in ways that you did not want, or hurt you physically?YesNo
6. Doctor: Elder abuse might be associated with findings such as poor eye contact, withdrawn nature, malnourishment, hygiene issues, cuts, bruises, inappropriate clothing, or medication compliance issues. Did you notice any of these today or in the past 12 months?YesNo