Perceptions of older adults and health professionals about digital screening tools for elder mistreatment in the emergency department

Background: Healthcare settings represent a missed opportunity to systematically identify and address mistreatment. Objective: Our objective was to obtain perspectives of older adults, caregivers, and emergency care providers regarding screening and intervention for elder mistreatment in the emergency department (ED) with a focus on utilizing digital health tools to facilitate the process. These findings will inform the development of a Web-based, digital health tool optimized for a tablet device to educate, screen, and facilitate reporting of elder mistreatment among patients presenting to the ED. Method: We conducted a qualitative study utilizing three in-person focus groups (N=31) with older adults from the community, caregivers for older adults, and clinicians and social workers who worked in the ED. Using a semi-structured interview guide, we identified attitudes about the process of divulging abuse, attitudes towards the ED as the location for screening and information delivery, and perceptions of digital tools for screening and information. Results: Participants identified numerous challenges to the disclosure of mistreatment, including feelings of vulnerability and concerns about losing their homes, social supports, and connection to caregivers. In contrast, they were uncertain about the benefits of disclosure. Digital tools were seen as helpful in terms of overcoming numerous challenges to screening, but participants suggested maintaining a human element to interactions. Conclusion: While challenges to elder mistreatment screening were identified, participants had recommendations for optimizing such efforts and responded positively to digital health tools as a means of screening.