The substantiation rate within this study of 23% is significantly
lower than has been found in US studies—the 2000
[26] and 2004 surveys of Adult Protection Services reported
a substantiation rate of 48 and 46%, respectively—but consistent
with at least one European survey where the substantiation
rate was 26% [27]. In the case of physical abuse, there is greater likelihood of substantiation than for other abuse
types and it is more likely to be perpetrated by males. The
high rate of inconclusive outcomes has been documented in
another official report on elder abuse services [19] but does
not seem to have figured as yet in the research literature. The
introduction of classifications such as ‘Unlikely on balance of
probability’ and ‘Likely on balance of probability’ may prove
more a more flexible, and clinically useful form of defining
categories of outcome. However, some reassurance can be
gained from the high level of referral for services, regardless
of classification of outcome. The SCW role is to ameliorate
the situation and to improve factors affecting the client
adversely and not exclusively focused on determining if abuse
is substantiated.
Even at this initial stage these data are informing policy
development and awareness campaigns. Specifically findings
in relation to financial abuse have led to an awareness/
media campaign. Evidence illustrating the extent of abuse
occurring in the home and community settings has led to
the development and national distribution of an elder abuse
community awareness DVD.
Further development of this referral database will be
required, and in particular inclusion of measures of
quality-of-life and empowerment, and the establishment of
clear criteria for measurement of take up of services. It is
intented to agreed criteria for case outcome determination,
a by-product of which would be a reduction in the number
of inconclusive outcomes. It is also intended to establish
more precise criteria for the closure of cases. This would
inter alia contribute to more precise objective responses. It
would also be appropriate to focus on the reliability and
validity of our data collection tool to minimise subjectiveness
of responses. The continued collection of consistent
national data over time will provide invaluable trend information
on elder abuse in a European context and ultimately
guide us in tackling this problem.