and Okar, 1981), he stated that elder abuse was increasing and recommended that Congress act immediately to help the states identify and assist elder abuse victims. Again, however, Pepper’s plea was unheeded by the Congress. Finally, in 1989, Pepper succeeded in including creation of a national center on elder abuse as an amendment to the Older Americans Act. Although various versions of a national center followed, the current National Center on Elder Abuse was established in 1998.

In retrospect, it appears that elder mistreatment became identified as a national concern when it was conceptualized as an “aging” issue, rather than as an undifferentiated component of adult protection. This also helped to broaden the constituencies interested in research and program development to include gerontologists and the expanding network of service providers and advocates for the elderly. The Pepper hearings also cast the problem of elder abuse in a particular light—as a complication of caregiving. The emerging image was that of an impaired victim, usually an elderly parent being cared for by an adult caregiver who wasn’t able to manage the caregiving because of stresses in life, on the job, and in the family. Even though it is only a partial explanation of elder mistreatment, this picture seemed to resonate with Congress and the media (Wolfe, this volume).

Emerging Conceptions of Family Violence

The evolving understanding of elder mistreatment as a social problem has more recently been shaped by another image—the trapped victim of family violence. Spouse abuse and other varieties of intimate partner violence have received increasing professional and political attention since the 1980s, leading to a wide variety of interventions and a substantial investment in research (National Research Council, 1996; National Research Council and Institute of Medicine, 1998). Prevention, protection, and punishment are necessary components of a comprehensive social response, requiring the participation and coordination of a broad array of public agencies. As the consciousness of health professionals has been raised, family violence has been embraced as a public health problem, thereby recruiting researchers and advocates in injury prevention and public health to the field (Institute of Medicine, 1999). Many of the preventive and protective tools developed in the context of intimate partner violence have now been directed to violence against elders. Bringing elder mistreatment into the domain of family violence widens the angle of the lens and thereby brings new ideas about etiology and prevention into view. However, it also exposes some tensions between social services agencies, with their traditional helping orientation, and many family violence specialists, with their greater emphasis on criminalization and punishment of perpetrators.



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