In Australia, GPs are mandated to recognise, assess, understand, and manage suspected cases of elder abuse and neglect. This is vital in reducing the negative effects of elder abuse including reduced mobility, increased disability, physical pain, mental stress, anxiety, mortality, economic loss, residential uncertainty, dependence on public housing/welfare, unnecessary placement into residential aged care facilities, family relationship breakdown, and increased social isolation. However, studies suggest that GPs struggle with elder abuse interventions for several reasons (see table below).
A well-known social psychology theory, the bystander effect, suggests that the underlying nature of these struggles are not new. For over 50 years social psychologists have been using the bystander effect to understand why people don’t intervene in situations where it would seem morally necessary to do so. The five stages of the bystander effect closely mirror the struggles faced by GPs found in the literature:
| Struggles faced by GPs addressing elder abuse | The Bystander Effect Model for Effective Intervention |
| Not consistently noticing the signs of elder abuse | Stage 1: Noticing something wrong |
| Not being able to define suspected cases as elder abuse | Stage 2: Deciding the event is an emergency |
| Not always recognising the professional responsibility to intervene | Stage 3: Deciding on degree of personal responsibility |
| Knowledge gaps about how to intervene in elder abuse cases | Stage 4: Deciding the specific mode of intervention |
| A lack of confidence in the implementation of an intervention | Stage 5: Implementing the intervention |
To understand the major themes that underlie a lack of GP intervention in cases of elder abuse I am conducting three qualitative studies focussing on:
- Document Analysis of NSW Elder Abuse policies, clinical guidelines, and online learning materials.
- Thematic analysis of in-depth interviews with Australian GPs
- Thematic analysis of in-depth interviews with older Australians
Each of these studies uses the bystander effect as a theoretical framework to collectively answer the following research question:
‘How might the bystander effect help us to understand the attitudes and decision-making experiences of Australian GPs towards addressing elder abuse in general practice, and to what extent do these experiences align with current elder abuse policies, guidelines, and online learning materials, and the expectations of older Australians?’
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