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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
use lists of injuries to define physical elder abuse, such as cuts, fractures, bruises, and burns.
The development of better definitions of mistreatment of the elderly should be an extremely high priority for researchers. In particular, it is critical to differentiate among various types of mistreatment. Researchers must be clear and explicit regarding what is included and excluded from the category of elder abuse in order to conduct any meaningful meta-analyses. The panel addresses this problem in the next chapter.
Unclear and Inadequate Measures
Related to the definitional issue is that of measurement. This is an equally vexing problem, since the definitions of the varying elements of elder abuse must be operationalized through the design and administration of a research instrument. Many studies have not developed separate research instruments at all; instead, they have simply analyzed the forms used by agencies. These forms are not designed for research and rarely provide data of the type and quality to be of use to researchers. Or studies use as a “measure” of abuse whether a professional has identified an elderly person as “abused”—thereby embracing without further clarification the discretionary judgments of clinicians and caseworkers applying the ambiguous statutory definitions. Few attempts have been made to create reliable and valid instruments for the studies. Even when research instruments have been used, researchers have used highly varying approaches.
An example to illustrate this point may be in order. Researcher A includes physical abuse in her definition of elder abuse. She is using the Conflict Tactics Scale, which measures physical acting out in response to conflict. She then proceeds to define physical abuse as a single incident in which the elder is hit, bit, punched, kicked, threatened with a weapon, or has a weapon used on him or her. Researcher B also includes physical abuse in his definition of elder abuse. However, he has developed his own scale, similar to the Conflict Tactics Scale but more broadly constructed, so that it measures any assaultive behavior of hitting, biting, kicking, punching, threatening with a weapon, or using a weapon regardless of the reason for the behavior. Furthermore, he decides that there must be at least two episodes of this behavior for it to be called physical abuse except for those items dealing with weapons, in which case one incident is sufficient. Thus both researchers have included physical abuse in their studies—indeed, it may be the sole focus of each researcher’s study—but the measure of physical abuse differs across the two studies.
This problem arises for all of the types of elder mistreatment typically investigated, including neglect and financial exploitation. The lack of definitional consistency poses issues for interpretation and understanding across