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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
sexual abuse and severe physical abuse) has not adopted the “perpetrator-victim” model commonly embraced by advocates for battered women (Melton and Andrews, 2000). There are some signs of an uneasy rapprochement between the two systems (see, e.g., Schechter and Edleson, 1999), as some child protection authorities have adopted safety planning, a feature of victim empowerment in programs for battered women, as a potentially useful element of intervention in cases of child maltreatment.
Even this development, however, has illustrated the field’s vulnerability to unintended side effects. For example, a legislative determination in Minnesota that exposure of children to intimate partner violence is per se evidence of child neglect led to an immediate doubling of referrals to child protective services, a huge increase in expenditures, and increased stress and loss of confidentiality for women and their families living in shelters (Edleson, 2000). It was also speculated that this policy, soon retracted by the legislature, deterred some battered women from seeking protection for themselves and their children.
These tensions and policy adaptations in the field of child protection appear to be highly relevant to elder protection at this moment in the evolution of research and public policy in this nascent field. As discussed further in Chapter 6, adult protection services agencies grapple daily with the tensions between investigation and service, and prosecution and protection. Agency caseloads reflect the highly diverse problems within their jurisdictions, ranging from intentional partner violence to far more numerous cases of caregiver neglect (as well as problems not arising in child protection, such as financial exploitation). The recent history of child protection offers many lessons for specialists in elder mistreatment.
Prevailing conceptions of elder mistreatment draw on a diverse array of images (the forgotten and helpless nursing home resident, the battered granny, the stressed caregiver, the abusing spouse). Moreover, the system of adult protection that has emerged to respond to these varied problems (as well as other problems relating to adults with disabilities) is based on ideas and structures borrowed from policy and practice in child maltreatment and, more recently, intimate partner violence. Yet prevailing policies and practices in these adjacent domains are not fully applicable to elder mistreatment and have been controversial on their own terms. Repeatedly, National Research Council and Institute of Medicine panels have called attention to the need for sustained and aggressive research on the phenomenology, magnitude, etiology, and consequences of these problems and on the effects of interventions (National Research Council, 1993, 1996; National Research Council and Institute of Medicine, 1998). In so doing, they