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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
Origins of Child Protection
The current system for protection of elders and other vulnerable adults grew from the child protection system, which itself is only about 40 years old in its modern form. The seminal event in the formation of the modern child protection system was the publication of an article in the Journal of the American Medical Association by a team of physicians at the University of Colorado, who proclaimed the existence of a “battered child syndrome” (Kempe et al., 1962). Pediatrician Henry Kempe, the leader of the group and founder of the International Society for Prevention of Child Abuse and Neglect, spearheaded a movement to adopt mandated reporting laws. These laws, which were quickly adopted in all 50 states, rested on the premise that the abused child was an aberrant problem (amounting to several hundred egregious cases each year in the United States), and on the belief that the problem could be solved if health professionals brought those cases to the attention of social service authorities. Although initial federal action did not occur until significantly later, with the adoption of the Child Abuse Prevention and Treatment Act of 1974 (Nelson, 1984), that legislation also required states to adopt mandated reporting and investigation as the primary strategy for protecting children.
Origins of Adult Protection
Drawing on their parens patriae authority to protect helpless citizens, a few states developed new public welfare programs during the 1940s and 1950s to protect adults who could not manage their own resources or protect themselves from harm. New adult protective services units were established not only to provide social services, but also to provide legal services, such as guardianship. Aroused by these state innovations, federal interest in the problem first appeared in the 1960s. Legislation was directed at all adults who were seen as defenseless and susceptible to being hurt by others. In 1962 Congress passed the Public Welfare Amendments to the Social Security Act, authorizing payments to the states to establish protective services for “persons with physical and/or mental limitations, who were unable to manage their own affairs . . . or who were neglected or exploited” (U.S. Department of Health, Education, and Welfare, 1966).
One of the demonstration projects funded by this new program was operated by a team at the Benjamin Rose Institute in Cleveland under Margaret Blenkner and her associates (Blenkner et al., 1974; Anetzberger et al., 2000). She matched a group of elders receiving protective services with a group from the community who were receiving traditional services, finding that those who were receiving protective services had a higher mortality rate and higher nursing home placement rate than those who were receiving