Addressing elder abuse in general practice

This paper discusses how a social psychology principle, the bystander effect, can help us determine whether elder abuse policy, guidelines, and learning materials aid general practitioners (GPs) to make decisions to intervene in suspected elder abuse cases. GPs are mandated to recognise, assess, understand, and manage elder abuse and neglect. However, research demonstrates that GPs do not consistently notice elder abuse signs, struggle to define cases as abusive, do not always recognise their professional responsibility to intervene, experience a lack of education about elder abuse response, and hold ethical concerns about damaging the GP / patient relationship by intervening. The professional bystander intervention model describes five steps to helping which mirror these GP challenges very closely: (1) noticing relevant cues; (2) construing the situation as suspected elder abuse; (3) deciding the situation is a personal responsibility; (4) knowing how to deal with the situation; and (5) deciding to intervene. Based on an analysis of key elder abuse sources, the authors illustrate five major themes from the data and focus on the central theme; separating intention to harm and carer stress when defining elder abuse. Our analysis reveals that the sources include information that may help GPs to define elder abuse, particularly when carer stress is present, however, their efficacy to do so may depend on the ability of individual GPs to separate these concepts