Falls (+) screen
if any question is answered affirmatively
Depression (+) screen
if score > 1. Answers of "One Day" garner a score of 1 point. "More than one day" garner a score of 2 points.
Abuse (+) screen
if any questions (including staff question) are answered affirmatively.
This app is designed to screen cognitively intact patients aged 65 years and older for depression, elder abuse and fall risk.
Your responses to the questions in these screenings will only be used to identify resources that may help you.
All of your information will be kept confidential.
If you do not agree to participate in this screening, please notify a staff member.
- On each slide, read the questions.
- Using your finger, touch the circle next to the appropriate answer to the question.
- When you have finished answering the question(s) on the slide, touch the "NEXT" button.
- Ask for help if you need it.
- Stop when instructed and return this device to a staff member.
Have you fallen in the last year?
Do you feel unsteady when standing or walking?
Are you worried about falling?
In the past 2 weeks, how many days have you had an unexplained change in appetite?
In the past 2 weeks, how many days have you had an unexplained lowered mood on a day to day basis?
In the past 2 weeks, how many days have you had unexplained disturbed sleep?
In the past 2 weeks, how many days have you experienced less energy or less interest in performing your usual daily activities?
In the past 2 weeks, how many days have you experienced thoughts of worthlessness, guilt or that your life is not worth living?
We will now ask about life situations or relationships that may have occurred during the last 12 months.
In the last 12 months, have you relied on people for any of the following: bathing, dressing, shopping, banking or meals?
In the last 12 months, 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?
In the last 12 months, have you been upset because someone talked to you in a way that made you feel shamed or threatened?
In the last 12 months, has anyone tried to force you to sign papers or to use your money against your will?
In the last 12 months, has anyone made you afraid, touched you in ways that you did not want or hurt you physicially?
Thank you for participating in this screening.
Please return this device to a staff member.
ATTENTION STAFF MEMBER
Elder abuse may be associated with findings such as: Poor eye contact, withdrawn nature, malnourishment, hygiene issues, cuts, bruises, inappropriate clothing, or medication-compliance issues.
Did you notice any of these today?
Red indicates a positive screen. Green indicates a negative screen. You can review the answers below and if you have any positive screens, click the "Get (+) Recommendations" button below.
Please notify the provider caring for this patient in the Emergency Department if the patient has any positive screens below.
- Talk to the patient about minimizing fall risk at home
- Offer case management evaluation for possible home physical therapy
- Consider evaluating the patient's gait in the ED or performing the "Get up and go" test prior to discharge
- Consider reviewing the patient's medication list to look for possible causes of dizziness or unsteady gait
- Ask about thoughts of suicidality
- Consider providing outpatient psychiatric resources
- Offer to notify the patient's primary care doctor and encourage close follow-up
- Discuss the possibility of abuse or neglect with the patient without family or caregivers present
- Determine if the patient can safely be discharged from the hospital
- If discharge is deemed appropriate, create a safety plan with the patient
- Notify adult protective services even if abuse or neglect is only suspected and no evidence is available
- Consider contacting the patient's primary care doctor
- STEADI- "Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention." Adapted with permission from materials developed by the Centers for Disease Control and Prevention.
- Chakkamparambil, Binu, et al. "Development of a brief validated geriatric depression screening tool: The SLU "AM SAD"." The American Journal of Geriatric Psychiatry 23.8 (2015): 780-783.
- Yaffe MJ, Weiss D, Lithwick M. Seniors' Self-Administration of the Elder Abuse Suspicion Index (EASI): A Feasibility Study. Journal of Elder Abuse and Neglect Journal of Elder Abuse and Neglect. J Elder Abuse Neglect 2012; 24 (2) 277-292. www.Mcgill.ca/familymed/research/projects/elder
- Lead author, Dr. Mark Yaffe- firstname.lastname@example.org
Copyright 2019, American College of Emergency Physicians, Dallas, Texas. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means or stored in a database or retrieval system without prior written permission of the publisher.
To contact ACEP, call 800-798-1822, or 972-550-0911, or write to PO Box 619911, Dallas, TX 75261-9911. Your comments and suggestions are always welcome.