What Is the Elder Abuse Suspicion Index© (EASI)?

Elder abuse, also called "older adult abuse," is a serious problem that will increase in the coming years as the older adult population increases.

It's estimated that those over 65 will grow to 20% of the U.S. population by 2030. As the Baby Boomer generation is retiring and living longer, many will also face the challenges arising from older adult abuse.

However, older adults and their loved ones don't need to face these challenges alone.

How Does the EASI Work?

The EASI is a list of six questions intended to raise a primary care doctor or medical professional's suspicion of elder abuse. This simple abuse screening helps them determine whether a case should be reported to authorities.

Social workers or adult protective services (APS) can also use it to conduct any older adult social services.

The six questions are as follows:

1. Have you relied on people for any of the following: bathing, dressing, shopping, banking, or meals?
2. Has anyone prevented you from getting food, clothes, medication, glasses, hearing aids, or medical care, or from being with people you wanted to be with?
3. Have you been upset because someone talked to you in a way that made you feel shamed or threatened?
4. Has anyone tried to force you to sign papers or to use your money against your will?
5. Has anyone made you afraid, touched you in ways you did not want, or hurt you physically?
6. [For Doctor]: Did you notice any of the following in the last 12 months: poor eye contact, withdrawn nature, malnourishment, hygiene issues, cuts, bruises, inappropriate clothing, or medication compliance issues?

A "yes" response to any of these questions should raise concerns about elder abuse and lead to a follow-up inquiry.

The EASI is intended to be a quick assessment tool and can be used to strengthen the reporting requirement. A study on the effectiveness of the EASI found that it took, on average, two minutes to administer. 97.2% of doctors found that its use would have either some or a large impact on their practice.

What Is Older Adult Abuse?

Abuse can happen to any older person despite their financial situation, culture, gender identity, physical health, mental health, or care setting. While these can be risk factors, abuse can happen to anyone. Signs of abuse can be hard to see, and the situation may feel shameful to the victim.

Elder mistreatment and abuse can take many forms, including:

• Physical abuse
• Family violence
• Intimate partner violence
• Domestic violence
• Sexual abuse
• Emotional abuse
• Psychological abuse
• Abandonment
• Financial abuse and exploitation
• Neglect
• Self-neglect

While these are distinct categories of abuse, it's important to note that older adults can suffer from multiple types of elder abuse at once. This is commonly referred to as "polyvictimization."

Older Adult Abuse and Memory Loss

It's important to note that elder abuse can occur when a senior suffers from dementia or another condition affecting their mental capacity or judgment. But this is not always the case.

An older adult with intact mental capacity can still be vulnerable to abuse if they:

• Have increased dependence on others
• Have feelings of loneliness or fear
• Place a high degree of trust in others (such as caregivers or family members) with harmful intentions

Challenges in Identifying and Reporting Abuse

One of the major challenges in combating elder abuse is the identification and reporting of such abuse. The U.S. Department of Justice estimates one in every 24 cases of elder abuse is reported to authorities. Cases of neglect and financial exploitation are the majority of underreported cases.

This is due to fear of reporting abuse or simply the inability to access law enforcement or other support resources.

Medical Professionals Reporting Suspected Abuse

With the particular challenges listed above, authorities have focused on healthcare professionals to identify abuse. Their regular contact with elderly patients places them in a unique position to identify and report suspected abuse.

In fact, most older adult abuse cases are already reported by physicians and health care providers. They are often under legal obligations to report under the laws of their state.

Problems arise, however, in cases where elder abuse is not as easily identifiable. That is where the EASI comes in. It was specifically designed to provide medical professionals with a standardized questionnaire to identify potential elder abuse cases.

Additional Resources

For additional information on reporting elder abuse, see FindLaw's Reporting Elder Abuse or the resources provided by the National Center on Elder Abuse.

For more information on elder abuse generally, see FindLaw's Elder Abuse Overview.

If you suspect a case of elder abuse, consulting an attorney specializing in older adult law may also be helpful. For an older adult law attorney in your area, see FindLaw's attorney directory.