The Role of Radiology in Detecting Elder Abuse

This September, Dr. Flege suffered his second hip fracture in less than a year. This injury occurred at the Kenwood by Senior Star. I had visited him for several days approximately a week before he presented to the ER. He was obviously drugged and I spoke with an executive at The Kenwood by Senior Star about his condition. She explained to me that a psychologist visits every two weeks and recommends drugs for the patients and asks the house doctor or the patient's PCP for a script...YIKES! She said this became necessary when the visiting psychiatrist quit. I expressed concern as to who is responsible for monitoring for drug side effects and pointed out that Dr. Flege was somnolent and unsteady. Dr. Flege's private caregivers repeatedly notified nursing staff of his condition following the administration of psychotropic drugs. The Kenwood staff had found the pills in question in the bed sheets. Dr. Flege obviously did not want to take this medication. He had been keeping it in his mouth and spitting it out after the nurse left. I observed the nurse, very stern with him, refusing to leave the bedside until she was satisfied he had swallowed the pills. Degrading. I also expressed concern, by email, to the psychologist who had recommended the drugs. Dr. Flege was at risk of injury. As it turns out, it would only be a matter of days. I did not observe Dr. Flege to be in pain at the time of my visit. Days prior to his presentation to the ER, visitors reported that he was adopting interesting positions on the floor with pillows to alleviate pain. I reported this to the admitting orthopedic surgeon. Did this fracture occur at an earlier date? Was there an attempt to cover up a serious injury? Radiologists can order and interpret studies with the suspicion of abuse in mind. I was not able to follow up with the admitting surgeon. He was quickly gagged.