The Strengthening Hospital Response to Family Violence (SHRFV) Program is pleased to announce the launch of the ‘Family Violence MARAM – Responding to Elder Abuse Training Module’.

The SHRFV Program has developed this supplementary training module to complement and build on our existing Family Violence MARAM Mandatory Training.  The module is designed to support clinicians to enhance their knowledge and understanding of elder abuse. It outlines the signs and risk factors specific to elder abuse and equips clinicians with further skills to identify and respond to older patients experiencing elder abuse.

A key focus of the module is the use of the MARAM Screening & Identification Tool with victim-survivors of elder abuse. It also outlines our legal and clinical responsibilities under the Multi-Agency Risk Assessment and Management (MARAM) Framework and the Family Violence Information Sharing Scheme (FVISS) and Child Information Sharing Scheme (CISS).

Elder abuse is a recognised form of family violence that encompasses physical, sexual, emotional, psychological, financial and social abuse and neglect. These forms of abuse rarely occur in isolation and are often cumulative, co-occurring, and embedded within relational dynamics, dependency and shifting roles across the life span. Presentations are often subtle, ambiguous and easily obscured by health conditions, cognitive impairment, assumptions about ageing or carer stress.

Tanya Ellis, SHRFV Program Manager, says, “While elder abuse can occur as a single incident, many cases reflect patterns of coercion, control, and exploitation that evolve over time. Consistent with the broader family violence evidence base, perpetrators are most often family members, with adult children accounting for a significant proportion. These situations involve complex interdependencies, including financial reliance, housing insecurity, mental health issues, substance use and histories of trauma within the family system. Gendered dynamics remain critical, with older women disproportionately affected, particularly in the context of patterns of violence across the lifespan”. 

The World Health Organisation describes elder abuse as a violation of human rights and a significant cause of illness, loss of productivity, isolation and despair. Elder abuse is a serious and prevalent health issue that has a profound impact on the psychological and physical wellbeing of victim-survivors. Victim-survivors are among our community and frequently present to our health service.

Elder abuse remains significantly underreported, influenced by barriers such as fear, shame, loyalty, social isolation and limited awareness of available supports. Systemic barriers including; ageism, fragmented service responses and thresholds for intervention further complicate identification, disclosure and risk assessment.  As populations continue to age, the prevalence and complexity of elder abuse is expected to increase. This highlights the need for ongoing education, collaborative practice and integrated service responses.

Dr Kim Jeffs, Geriatrician, Director Northern Doctors Education & Director of Training, Northern Training Alliance, Victorian Geriatric Medicine Training Program says, “Older people can be especially vulnerable to abuse and neglect. It is important for staff to look for signs of elder abuse, to sensitively inquire when it is suspected and to involve broader support such as social work and geriatricians. The MARAM Screening & Identification Tool assists with this process and is key to ensuring communication and handover within and between episodes of care. I have found the Tool invaluable when caring for patients experiencing elder abuse.”

Northern Health is committed to creating a safe environment and reducing barriers for victim- survivors to disclose elder abuse to their health professional and receive support and access to safety. In order to support this response, we have implemented a whole-of-hospital approach to address this serious health issue. A whole-of-hospital approach is essential to effectively identify and respond elder abuse, as disclosures can occur at any stage of a patient’s healthcare journey. This approach promotes collaborative, coordinated and consistent practice across the organisation. It also ensures that all staff – both clinical and non-clinical – understand their role and responsibilities under the MARAM Framework.

Northern Health is a family violence-informed health service where all of our staff members and volunteers receive mandatory training and we are proudly one of the most extensively MARAM trained hospitals in Victoria.

Tanya says, “We have significantly strengthened our response to elder abuse and family violence, but we are committed to continuing to build on our knowledge, skills, and capacity in this complex area to ensure we provide the highest standard of care to our patients who are at risk of violence”.

All clinicians working with older people are encouraged to complete this new module at their earliest convenience.  The training module is available on LMS: Elder Abuse MARAM Training.

The SHRFV Program is also available for specialist consultation and to deliver Elder Abuse MARAM Training across the organisation. Please contact the SHRFV Program or your Ward Social Worker if you need to consult or to organise education in your area.

As Northern Health continues to strengthen our response to family violence, elder abuse and child safety watch out for further supplementary training modules being released.

All clinicians are required to use the Family Violence MARAM Screening & Identification Tool  when they receive a disclosure of elder abuse or family violence or when it is suspected. This is trauma-informed, evidence-based, best practice for identifying and responding to all forms of elder abuse/family violence and is required for all patients including those with cognitive impairment or disability.  The Tool is located on EMR (AdHoc Forms Section) and PROMPT.

Elder Abuse Support Services:

• Safe Steps:(24/7) 1800 015 188
• Better Place: Ph: 1800 214 117
• Seniors Rights:Ph: 1300 368 821
• 1800 RESPECT:(24/7) Ph: 1800 737 732

Further Information on Elder Abuse:

Elder Abuse – Identification, Response & Referral Procedure

Family Violence MARAM Learning Hub

Pictured in featured image: 

Dr Kim Jeffs (Geriatrician, Director Northern Doctors Education & Director of Training, Northern Training Alliance, Victorian Geriatric Medicine Training Program and Tanya Ellis (SHRFV Program Manager).