Risk on Elder Abuse and Mistreatment - Instrument: Development, psychometric properties and qualitative user-evaluation

Prevalence data of elder abuse from social and health services only present a tip of the iceberg. A large amount of situations of abuse is left undetected. Professionals often lack knowledge and skills on the topic of abuse. Consequently, this paper focuses on supporting professionals to prevent and assess elder abuse by developing and testing the Risk on Elder Abuse and Mistreatment Instrument (REAMI), using a mixed method design. Quantitative data from a widespread screening among 1920 older clients of home care are analysed with exploratory and confirmatory analysis. In addition, 24 professionals who have used the REAMI have been qualitatively interviewed about their practical experience and critical reflection on the instrument and its use. These interviews were transcribed and content analysed. Findings provide evidence of good internal reliability and internal validity of the REAMI and its three dimensions: 1) risk factors of the older person, 2) risk factors of the environment, 3) signals of abuse and mistreatment. Users report an increase of knowledge and awareness among staff, satisfaction with the possibilities for prevention and the user-friendliness and brevity of the REAMI. However, some users are missing a follow-up protocol: what to do when risks are assessed? In the discussion, the argument is developed that the REAMI can be used to examine risk at elder abuse, although an overarching protocol to support prevention and intervention which embeds the detection instrument is needed.