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. Author manuscript; available in PMC: 2019 Aug 1.
Published in final edited form as: Clin Geriatr Med. 2018 Jun 15;34(3):435–451. doi: 10.1016/j.cger.2018.04.007

Table 5.

Questions for Use in Asking Patients about Elder Abuse

In the last 6 months:
PHYSICAL ABUSE
  • 1)

    Has anyone tried to harm you? Have you been hit, slapped, pushed, grabbed, strangled, or kicked?

  • 2)

    Are there guns or other weapons in your home? Does anyone close to you have access to guns or other weapons?
SEXUAL ABUSE
  • 3)

    Has anyone touched you in ways or places you did not want to be touched?
NEGLECT/FUNCTIONAL STATUS
  • 4)

    Have you relied on people for any of the following: bathing, dressing, shopping, banking, or meals?

    1. If yes, have you had someone who helps you with this?

    2. If yes, how often do you receive help? Is this help enough?

    3. Have they done a good job? Are they reliable?

    4. What happens if no one is available to help?

  • 5)

    Has anyone prevented you from getting food, clothes, medication, glasses, hearing aids, medical care, or anything else you need to stay healthy?
PSYCHOLOGICAL ABUSE
  • 6)

    Has anyone close to you called you names, put you down, or yelled at you?

  • 7)

    Has anyone close to you ever threatened to punish you or put you in an institution?

  • 8)

    Have you felt sad or lonely at home?

  • 9)

    Have you felt afraid of anyone close to you?

  • 10)

    Do you distrust anyone close to you?

  • 11)

    Does anyone close to you drink or use drugs?
FINANCIAL EXPLOITATION
  • 12)

    Has anyone tried to force you to sign papers against your will, or that you did not understand?

    1. Has anyone pressured you to give them money or property?

  • 13)

    Has anyone taken money or things that belong to you without asking?

  • 14)

    Does anyone close to you rely on you for housing and/or financial support?
*

Please explore any positive responses in more detail.