Protecting Our Vulnerable Population: Screening for Mistreatment in Palliative Care

Topic: Education


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Palliative Care (PC) patients are a vulnerable population. While the incidence of mistreatment in other vulnerable populations has been defined, approaching 10% of elderly, the incidence in PC has not. We sought to assess the rate of PC patients who establish concern for mistreatment (ECM) and identify risk factors by screening our PC patients for mistreatment using two mistreatment screening tools validated among elderly: Elder Abuse Suspicion Index (EASI) and Caregiver Abuse Screen (CASE). 64 patients were screened over 30 days.  Eleven (17.19%) ECM . A significant relationship was found between PC diagnoses and ECM, [p = 0.01].  EASI question #2 (preventing access to resources/people/medical care, p=0.02), #3 (verbal shaming, p < 0.001) and CASE question #2 (caregiver shameful of actions, p=0.005), #4 (caregiver acting rough, p=0.02), #7 (caregiver exhaustion, p=0.006) were significant to ECM. The rate of PC patients who ECM is similar to other vulnerable populations. ECM risk factors included PC diagnoses; further risk factor identification was limited by small sample size and variable applicability of elderly-targeted validated scales. Larger scale studies are needed to identify risk factors for PC mistreatment, and develop validated PC mistreatment screening tools, ultimately improving patient-care for vulnerable PC patients and targeting risk factors.


  • Katie Stowers, DO
  • University of Texas Health Science Center San Antonio; University Health System
  • 7703 Floyd Curl Drive
  • San Antonio, TX 78231
  • (210) 358-0594


  • Heather Veeder
  • James Linden
  • Sandra Sanchez-Reilly MD
  • Shuko Lee MS

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