Using a Standardized Patient Encounter to Teach Psychiatry Residents How to Recognize and Respond to Elder Abuse
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LETTER TO THE EDITOR
Using a Standardized Patient Encounter to Teach Psychiatry Residents How to Recognize and Respond to Elder Abuse Richa Lavingia 1 & Jennifer L. Bryan 2 & Ali Abbas Asghar-Ali 2 Received: 17 April 2020 / Accepted: 5 October 2020 # This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply 2020
To the Editor: Approximately 10% of older adults (65 years and older) in the USA are victims of abuse, which includes financial abuse, psychological abuse, physical abuse, sexual abuse, and neglect (by self or caregiver) [1]. Self-neglect is the most common form of abuse reported to Adult Protective Services [2, 3]. Available estimates on elder abuse likely underestimate its prevalence, given the reliance on self-reported data [1]. The lack of elder abuse education and knowledge about reporting procedures contribute to underreporting by physicians [4]. A survey of residency program directors across primary care specialties found that elder abuse education is not delivered consistently or highly prioritized in many programs [5]. There are no data regarding the extent to which psychiatry residency programs include elder abuse in their educational curricula. This study assessed whether a standardized patient (SP) encounter can address the gap in elder abuse education. We piloted an encounter on self-neglect with psychiatry residents. We focused on self-neglect as it is the most commonly reported form of elder abuse. The case featured a 75-year-old patient, accompanied by a neighbor, who was admitted for hyperglycemia and exhibited signs of self-neglect, including weight loss and poor living conditions. Residents were paired, with one playing the role of a psychiatrist and the other the role of a social worker. This
Modified versions of this abstract were submitted for presentation at the American Association for Geriatric Psychiatry Annual Meeting (scheduled for March 2020; conference cancelled). * Ali Abbas Asghar-Ali [email protected] 1
Baylor College of Medicine, Houston, TX, USA
2
VA South Central Mental Illness Research, Education and Clinical Center (SC MIRECC), Houston, TX, USA
format was used to highlight the interprofessional nature of elder abuse identification and management. The learning objectives were for participants to be able to (1) identify red flags that suggest risk for elder abuse, (2) assess an older adult’s safety at home, (3) incorporate a collateral source in elder abuse assessment, and (4) identify the next best steps once abuse is detected. Residents received two PowerPoint files 1 week prior to the session. One provided a general overview of elder abuse, including definitions, evaluation, and mandatory reporting. The second discussed financial exploitation and assessing decision-making capacity in older adults. The experience consisted of a patient encounter, feedback, and debriefing. Residents were given 2 min to read a door note with patient information, 20 min to spend with the SPs, 5 min to receive feedback from t
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