TABLE 6-1Maltreatment Screening Instruments

Instrument and CitationPurposeType of Elder MaltreatmentEvaluationValidation MethodValidation SettingReliability Estimates
BASE
The Brief Abuse Screen for the Elderly

Reis et al. (1993)
5 items

Trained practitioner evaluation of caregiver and elder.

To help the practitioner assess the likelihood of abuse.
Physical, psychological, neglect, financialReis et al. (1993)

Paper presented at the Canadian Association on Gerontology
Face Validity

86-90% agreement by 3 different trained practitioners.
Home assessment of health and social services agency cases.Not analyzed
IOA
Indicators of Abuse Screen

Reis and Nahmiash (1998)
29 items

Trained practitioner assessment of caregiver and elder.

To enable practitioners to identify abuse cases among health and social services agency clients.
Physical, psychological, neglectReis and Nahmiash (1998)Construct Validity

The performance of the IOA was evaluated against the BASE measure. Scores of 16 and above have a sensitivity of 85% and a specificity of 99%.
Home assessment of 341 health and social services agency cases (55 and older).Chronbach's alpha = 0.91
H-S/EAST
Hwalek-Sengstock Elder Abuse Screening Test-Revised

Hwalek and Sengstock (1986)
15 items

Elder as respondent. To help agencies identify situations likely to be or become abusive or neglectful.
Physical, psychological, financialHwalek and Sengstock (1986)Predictive Validity services cases.

Using known abuse cases and control cases, 9 items were 94 % accurate in classifying cases into abuse and nonabuse cases.
97 social-health 100 elders living in public housingNot analyzed
Moody et al. (2000)Predictive Validity

Using known abuse/nonabuse cases, discriminate function analysis showed that 6 items were as effective as the 9-item model in classifying cases (71.4%) as abused.
EAI
Elder Assessment Instrument (revised)

Fulmer et al. (2000)
35 items

Caregiver as respondent.

To identify individuals at high risk of mistreatment who should be referred for further assessment.
Abuse, neglect, exploitation, abandonmentFulmer and O'Malley (1987)Content validity: 0.83Acute care.Chronbach's alpha = 0.84
CASE
Caregiver Abuse Screen

Reis and Namiash (1995)
8 items specifically worded to be nonblaming.

Filled out by caregiver.

To identify caregivers who are more likely to be abusers.
Physical, psychological, neglectReis and Namiash (1995)Predictive Validity

Using known abusers and a control groups, overall scores of abusers were significantly higher on the CASE (mean 3.2) than nonabusers (mean 1.9).

Construct Validity

CASE scores were positively correlated (0.41) with IOA scores.
44 known abusive caregivers and 45 nonabusive caregivers receiving care from a social services center.Chronbach's alpha = 0.71

From: 6, Screening and Case Identification in Clinical Settings

Cover of Elder Mistreatment
Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America.
National Research Council (US) Panel to Review Risk and Prevalence of Elder Abuse and Neglect; Bonnie RJ, Wallace RB, editors.
Washington (DC): National Academies Press (US); 2003.
Copyright © 2003, National Academy of Sciences.

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