Do medical examiners determine elder mistreatment as a cause of death?

This study examines the decision-making process of medical examiners in determining elder mistreatment in cases that present to the county morgue. Harris County Medical Examiners were surveyed about factors that influence the determination whether elder abuse or neglect was a contributor to the cause of death. At the time of the survey, all 11 Harris County Medical Examiners participated. Of these, 8 did not determine elder abuse or neglect as contributing to the cause of death in the 12 months prior to the survey, 6 reported that medical records were helpful "all the time", 3 reported "most of the time", and 2, indicated that the records were "some-times helpful". The survey also indicated that information that assists medical examiners in identifying the potential for abuse or neglect ranged from "present most of the time" to "never present". Multiple factors including autopsy findings, medical compliance, inconsistency in injury findings, and malnutrition were reported as helpful in determining elder abuse or neglect. Further studies are needed to determine additional factors that would provide medical examiners with the ability to more readily identify signs of elder abuse or neglect.