The Indicators of Abuse (IOA) checklist signals mistreatment of seniors. The IOA (pronounced Iowa) also helps sensitize the practitioner to important abuse issues. The IOA is practical for busy practitioners and useful in training intervenors and volunteers in cases of abuse to recognize the signs of abuse. The IOA is a summary of abuse high-risk signals. It is not, however, a substitute for becoming knowledgeable about abuse signs through education.
CAREGIVER AND CARE-RECEIVER INDICATORS OF ABUSE (IOA)
For Discriminating Abuse and Non-Abuse Cases Indicators of abuse are listed on the next two panels, in order of importance*. After a two–to three-hour home assessment (or other intensive assessment), rate each of the following items on a scale of 0 - 4 (as described below). Do not omit any items. Rate according to your current opinion.
Scale
0 = non-existent
1 = slight
2 = moderate
3 = probably/severe Caregiver Age years
4 = yes/severe
00 = not applicable
000 = don’t know
______ Has behaviour problems
______ Is financially dependent
______ Has mental/emotional difficulties
______ Has alcohol/substance abuse problem Has unrealistic expectations
______ Lacks understanding of medical condition Caregiving reluctancy
______ Has marital/family conflict
______ Has poor current relationship
______ Caregiving inexperience
______ Is a blamer
______ Had poor past relationship
______ Is financially dependent
______ Has unrealistic expectations
______ Has alcohol/medication problems Has poor current relationship
______ Has suspicious falls/injuries
______ Has mental/emotional difficulties Is a blamer
______ Is emotionally dependent
______ No regular doctor
______ Has been abused in the past
______ Has marital/family conflict
______ Lacks understanding of medical condition
______ Is socially isolated
______ Lacks social support
______ Has behaviour problems
SCORING THE IOA
Total the sum of ratings for all items (range: 0 - 108).
The abuse indicators are listed in rough order of importance. In general, the caregiver indicators carry more weight than care-receiver indicators. However, it is the total list of indicators together that signal abuse. Thus, the higher the total score (0 - 108), the more likely it is that abuse is occurring. Total scores close to 16 and higher are suggestive of abuse. Total scores of 4 or less indicate that there probably is no abuse.
Each indicator that is rated by the interviewer as being between 1 and 4 on the scale should be explored clinically. However, each individual indicator does not, by itself, indicate abuse.
Extracted from Myrna Reis and Daphne Nahmiash, When Seniors Are Abused (Toronto: Captus Press, 1995, pp. 15-26). Reproduced with permission.
