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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
mented. Specialization and interdisciplinary linkages also are more likely to lead to collaboration between practitioners and researchers and therefore to better design and evaluation of new interventions.
The panel strongly encourages government agencies and private sponsors of elder mistreatment programs to give priority to interventions that emphasize specialized professional training and interdisciplinary collaboration. Moreover, in the panel’s view, all new initiatives should include sufficient funding for evaluation.
INTERVENTIONS IN RESIDENTIAL CARE FACILITIES
Throughout this report, the panel has focused attention on general issues concerning the definition, identification, and prevention of mistreatment, regardless of setting. Although residential care facilities were not excluded from the panel’s view, family living settings have usually been emphasized. This section briefly addresses several specific research priorities pertaining to residential care settings. Current knowledge about mistreatment in nursing homes and other residential care settings is summarized by Hawes (this volume), and a recent report, Improving the Quality of Long-Term Care, by the Institute of Medicine (2001) provides a comprehensive review of the broader subject of quality improvement, of which patient safety (including avoidance of mistreatment and harm) is a core component.
Among the most important priorities identified in Improving the Quality of Long-Term Care concerns the need for uniform definitions and data elements for characterizing the components, processes, and outcomes of long-term care across different jurisdictions, populations, and settings of care (e.g., nursing homes, assisted living facilities, and home health care). The report envisions national systematic and comprehensive data bearing on the staffing and care provided in the various settings of long-term care. This panel endorses the Institute of Medicine committee’s recommendation, while emphasizing that uniform data elements relating to mistreatment (including subjective measures of security) should be included in the outcome measures, and that implementation of this recommendation would facilitate research on the effectiveness of interventions of any kind (whether initiated voluntarily or through regulatory action). Virtually nothing is now known, for example, about the nature and effectiveness of regulatory efforts relating to assisted living facilities and other residential care facilities other than nursing homes (Harrington et al., 2000).
Hawes (this volume) discusses the prevalence and demography of mistreatment among residents of long-term care facilities, as well as discusses the array of government and quasi-government agencies responsible for receiving and investigating complaints of elder mistreatment in nursing