A community programme for elder abuse and self-neglect improved wellbeing measures over six months

Design

Pragmatic randomised controlled trial with blinded outcome assessment

Population

114 older adults at risk of or experiencing abuse or self-neglect

Primary outcome

Life satisfaction, stress, self-efficacy, social support, problem concern

Effect

Greater improvement with RISE in all except problem concern (P ≤ .023)

Evidence for interventions in elder abuse and self-neglect is sparse. This pragmatic randomised trial, with blinded outcome assessment, enrolled older adults screened as at risk of or experiencing abuse or self-neglect. After an initial consultation, they received either the community-based RISE programme or consultation and referral information alone.

Of 114 participants, 79 completed six-month follow-up. RISE participants improved more on life satisfaction, perceived stress, self-efficacy, and emotional and informational support. Concern about the presenting problem did not differ between groups. Programme satisfaction was higher with RISE.

The trial was small, attrition was substantial, and outcomes were psychosocial rather than measures of abuse recurrence or safety.

Where services lack a structured response to elder abuse, this supports a community-based model, alongside safeguarding duties that remain unchanged.

• Ask about abuse and self-neglect when assessing older adults, particularly those living alone.
• RISE improved life satisfaction, stress and support compared with referral alone.
• Concern about the presenting problem did not change differently.
• Follow local safeguarding procedures whatever community support is available.
• About three in ten participants were lost by six months.

Why it matters

Clinicians who identify elder abuse often have nowhere effective to refer, and this is randomised evidence for one option.

Don't overread it

The trial measured wellbeing, not whether abuse or neglect actually stopped.

The statistics, in plain English

The P values show differences unlikely to be chance, but without effect sizes reported in the abstract, how large the improvements were is unclear. Losing about 30% of participants can bias results.

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