Understanding the Brief Abuse Screen for the Elderly (BASE)
The Brief Abuse Screen for the Elderly (BASE), developed in 1995, is a proprietary, 5-item screening tool for home-care workers to identify potential abuse and neglect in new clients aged 60 or over. It is designed as a quick assessment, taking about one minute to complete, and is based on the observations and interactions of a trained practitioner. Due to its proprietary nature, permission from the authors is needed for its use. BASE is intended for use with English-speaking care-receivers or caregivers.
How BASE Is Administered and Scored
Administering the BASE involves a trained healthcare professional completing a five-item questionnaire based on their observations. Extensive training in elder abuse is recommended before using the tool. Specific questions are not publicly available but generally relate to caregiver relationships and suspicion of abuse. Scoring typically uses a scale to indicate the likelihood of abuse, often simplified into categories like "abuse not likely" or "abuse likely". A positive result suggests the need for further investigation.
Comparing BASE with Other Elder Abuse Screens
BASE is one of several screening tools, each suited for different contexts. Here is a comparison:
| Feature | Brief Abuse Screen for the Elderly (BASE) | Elder Abuse Suspicion Index (EASI) | Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) |
|---|---|---|---|
| Target User | Home-care workers | Physicians | Professional (self-report or interview) |
| Setting | Home-care services | Primary care/ambulatory care | Emergency or outpatient setting |
| Number of Items | 5 | 6 (5 for patient, 1 for physician) | 15 (reduced from 105) |
| Format | Practitioner observation | Patient interview (for cognitively intact) and observation | Self-report or interview |
| Abuse Types | Physical, psychosocial, financial, neglect | Neglect, verbal, psychological, emotional, financial, physical, sexual | Predictive validity (abuse potential) |
| Key Features | Quick (1-minute) assessment; proprietary | Short (2-minute) screening; validated in primary care | Good cross-cultural adaptation |
| Proprietary | Yes | No | No |
Strengths and Limitations of Brief Screening
Brief screening tools like BASE offer efficiency and support early detection. However, they have limitations, including potential for false results and difficulty with cognitively impaired individuals. Brief screens may also not capture all forms of abuse, and signs can be confused with other conditions. Elders may also be reluctant to disclose abuse.
Conclusion
What is the brief abuse screen for the elderly? The Brief Abuse Screen for the Elderly (BASE) is a concise, proprietary tool for trained home-care workers to screen for potential elder abuse. While useful for initial assessment, it should be part of a broader approach to elder protection. Further evaluation by a multidisciplinary team is recommended for positive screens. Healthcare professionals must be aware of the limitations of brief screening and prioritize creating a safe environment for disclosure.
