Abstract
Background: Elder abuse and neglect are highly under-reported in the United States. This may be partially
attributed to low incidence of reporting among emergency medical technicians’ (EMTs), despite state-mandated
reporting of suspected elder abuse. Innovative solutions are needed to address under-reporting. The objective was
to describe EMTs’ experience detecting and reporting elder abuse.
Methods: Qualitative data were collected from 11 EMTs and 12 Adult Protective Services (APS) caseworkers that
participated in one of five semi-structured focus groups. Focus group data were iteratively coded by two coders.
Results: Findings suggest a number of barriers prevent EMTs from reporting elder abuse to APS. Participants
suggested that limited training on elder abuse detection or reporting has been provided to them. EMTs suggested
that training, creation of an automated reporting system or brief screening tool could be used to enhance EMT’s
ability to detect and communicate suspected cases of elder abuse to APS.
Conclusions: Results from the present study suggest that EMTs may be uniquely situated to serve as elder abuse
and neglect surveillance personnel. EMTs are eager to work with APS to address the under-reporting of elder abuse
and neglect, but training is minimal and current reporting procedures are time-prohibitive given their primary role
as emergency healthcare providers. Future studies should seek to translate these findings into practice by
identifying specific indicators predictive of elder abuse and neglect for inclusion on an automated reporting
instrument for EMTs.
Keywords: Elder abuse, Neglect, Exploitation, Older adult, Screening
Abbreviations: APS, Adult protective services; EA, Elder abuse, neglect, and exploitation; EMTs, Emergency medical
technicians; FWSCC, Fort Worth [TX] Safe Communities Coalition; US, United States.