investigators who have produced a modest body of knowledge concerning the phenomenology, magnitude, etiology, and consequences of elder mistreatment. Preventive and remedial interventions have been unsystematic, episodic, and poorly evaluated. In recognition of these deficiencies, the National Institute on Aging requested the National Research Council to commission this study as the first step in an effort to broaden and deepen knowledge about the mistreatment of elders. Support was also provided by the Office of Behavioral and Social Science Research on Women’s Health of the National Institutes of Health and the Agency for Health Care Research and Quality. This report presents a research agenda for consideration by the National Institute on Aging and other potential sponsors of research on elder mistreatment—a term we explain more fully in Chapter 2.

HISTORICAL AND SOCIAL CONTEXT

Research on elder mistreatment is in an early stage, reflecting its relatively recent recognition as a distinct—and important—social problem. The prevailing understanding of the problem, and the social response to it, have gradually emerged over the past half-century, shaped by evolving social responses to child protection and family violence as well as by an intensifying concern about neglect and victimization of vulnerable elderly people.

Family discord and mistreatment of its vulnerable members were outside the public domain for much of this country’s history. Responsibility for assisting families in need was assumed mainly by religious organizations and private charitable institutions. Although many states established asylums for people with mental illness during the 18th and 19th centuries, thereby providing some custodial protection for dependent or neglected adults, there was no legal basis for intervention into families until the late 19th century, when industrialization, immigration, and urbanization exacerbated family problems, including poverty and internal conflict, and also exposed them to public view—especially when its victims were children. The emergence of the juvenile court in the early part of the 20th century represented a significant assertion of collective responsibility for protecting and “saving” children who had become ungovernable by their parents; over the following decades, the jurisdiction of the juvenile courts gradually reached children who were neglected or abused by their parents (Platt, 1969).

The legal foundation for modern policies and programs for elder protection was put in place after World War II, particularly during a burst of national energy geared toward remediation of endemic social problems during the 1970s. Although the threads of child protection, adult protection, and family violence were intertwined in the history of that period, they are summarized separately below.



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