If you suspect abuse, ask these questions

Here is a sample interview with a possible perpetrator of elder abuse, excerpted from the Elder Abuse Diagnostic and Intervention Protocol at Harborview Medical Center in Seattle:

"Thank you for waiting while I interviewed your mother. Now it’s your turn. I need your help. I am doing a psychosocial assessment of your mother’s current functioning and situation in order to determine what services are appropriate at this time. I would like to spend some time with you and have you tell me your perception of how things are here."

1. "Tell me what you want me to know about your mother."

2. "What is her medical condition? What medicine does she take?"

3. "What kind of care does she require?"

4. "How involved are you with your mother’s everyday activities and care?"

5. "What do you expect her to do for herself?"

6. "What does she expect you to do for her?"

a. And are you able to do them?

b. And do you do them?

c. Have you had any difficulties? What are they?"

7. "Please describe a typical day for yourself."

8. "How do you cope with having to care for your mother all the time?"

9. "Do you have support or respite care?

a. Who or what?

b. Are there other siblings to help?"

10. "What responsibilities do you have outside the home? Do you work? What are your hours? What do you do?"

11. "Would you mind telling me your income?" (If question seems touchy to the caregiver, say, "I just wondered if the pills she needs to take are affordable for your family." At the same time, you are assessing the caregiver’s degree of dependence on the elderly client’s income/pensions/assets.)

12. "Is your mother’s Social Security check directly deposited in the bank?"

13. "Who owns this house? Do you pay rent? Whose name is on the deed?"

14. "If you help her mother pay her bills, how do you do it? Is your name on her account? Do you have power of attorney? Does it have a durable clause? When did you get it?"

Save more delicate questions for last:

1. "You know those bruises on your mother’s arms (head, nose, etc.), how do you suppose she got them?" (Document response verbatim). If possible, follow up with request that caregiver demonstrate how injury may have happened.

2. "Your mother is suffering from malnourishment and/or dehydration" or "Your mother seems rather undernourished and thin; how do you think she got this way?"

3. "Is there a reason for waiting this long to seek medical care for your mother?"

4. "Caring for someone as impaired as your mother is a difficult task. Have you ever felt so frustrated with her that you may have pushed her a little harder than you expected? How about hitting or slapping her? What were the circumstances?" (Record verbatim.)

5. "Have you ever had to tie your mother to a bed or chair, or lock her in a room when you go out at night?"

6. "Have there been times when you’ve yelled at her or threatened her verbally?"