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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
quality (easily extended to other human services), patient (or client) safety is one of the four components of quality in services (together with effectiveness, patient-centeredness, and timeliness) (Institute of Medicine, 2001). It is already understood that prevention of mistreatment is a core element of quality assurance in nursing home regulation. However, as noted earlier, 80 percent of vulnerable elderly persons live in community settings, not in nursing homes. Protecting elderly people in these settings, including their own homes, represents a parallel challenge for policy makers and an overlapping agenda for researchers aiming to understand the phenomenology, etiology, and consequences of mistreatment and the interventions that can reduce it. By viewing elder mistreatment through the prism of quality assurance (safety and security) in long-term care, it is possible to draw together the frameworks and methods of researchers studying the needs of, and services provided to, vulnerable elderly people in various long-term care settings, as well as those used by researchers studying power and conflict in human relationships (see Chapter 3).
BUILDING THE INFRASTRUCTURE
Researchers currently in the field indicate that the ability to attract new investigators is hampered by the lack of training funds. Both federal agencies and private foundations should make funds available for both predoctoral and postdoctoral training programs. Career advancement funding should be readily available to investigators who express an interest in pursuing careers in elder mistreatment research. Foundations supporting geriatric education in the professions should pay special attention to those seeking funding or support for careers in elder mistreatment research.
An adequate long-term funding commitment to research on elder mistreatment must be made by relevant federal, state, and private agencies to support research careers and to develop the next generation of investigators in the field.
To help develop the research infrastructure of the field, several steps are needed to remove barriers and create new opportunities:
The Office for Human Research Protections needs to work with both experts in elder mistreatment and experts on human subjects protection to arrive at useful guidelines concerning research participation.
Research funding is needed from agencies other than those already in the field. Most research on elder mistreatment has been supported by the National Institute on Aging, the Administration on Aging, and offices within the Department of Justice. Funding agencies with interests in aging or disabled or vulnerable populations, or in health care delivery (especially long-term care) and health/social policy research, should invest in research