CHARACTERISTICS OF VIOLENT ELDERLY IN THE EMERGENCY DEPARTMENT

The objective of the study was to determine (1) the incidence of viole nt acts committed by elderly patients in an emergency department and ( 2) the characteristics of these violent elderly patients compared to n on-elderly violent patients. A 5-year retrospective review was underta ken of all dangerous behaviour incident reports (DBRs) in an urban Vet erans Affairs Medical Center. Information abstracted from DBRs include d descriptions of verbal or physical aggression, use of a weapon, inju ry to others and outcome of the incident. Demographic information, psy chiatric and medical diagnoses and frequency of medical center use wer e obtained by medical record review. Twenty-one violent elderly person s (age 60 years and over) were compared to 190 non-elderly violent per sons (under age 60). Eighty-one per cent of the aged patients had a ps ychiatric diagnosis, most commonly alcohol dependence or a psychotic d isorder. Old patients had more medical illness than young patients, bu t both groups were frequent users of medical services (mean 4.4 emerge ncy department visits or hospitalizations for elderly vs 3.7 for non-e lderly in the year before incident). There were no differences between the two age groups in characteristics of the perpetrators, nature of the violent episodes or outcomes. Violent elderly persons in the emerg ency department are likely to have both medical and psychiatric illnes s and use medical services frequently. They are not distinctly differe nt from younger violent patients.