studies, including determining prevalence and risk factors. However, even if researchers embraced a common set of definitions for the elements of elder mistreatment and operationalized them the same way, that would still leave the problem of determining whether the instruments actually measure what they purport to measure (validity) and whether they can be reliably administered. At the present time, no measure of elder mistreatment has been validated, nor has any instrument been embraced by the field as a definitive measure of mistreatment, even within a narrow sphere.

All this suggests that researchers, policy makers, and other consumers of research on elder mistreatment must pay careful attention to the definitions and measures of any studies on which they rely. In most cases, the measures will not be comparable.

Incompleteness of Professional Accounts

Since the earliest stages of elder abuse research, surveys of professionals have been used to shed light on the prevalence of elder abuse and on risk factors. Investigators typically mail surveys to professionals and paraprofessionals, asking them about contacts with cases of elder abuse or neglect during a given time period. To provide a typical example, in a survey on elder abuse funded by the Administration on Aging, a sample of professionals, including administrators and direct service workers from 16 types of agencies, was surveyed in each of Pennsylvania’s 67 counties. Overall, one-half of the responding agencies reported encountering elder abuse, ranging from over 90 percent of domestic violence agencies, to less than 30 percent for law enforcement, emergency services, medical clinics, and drug/alcohol agencies (Fiegener et al., 1989). Similarly, a survey of Alabama physicians and registered and licensed practical nurses found that 38 percent of the physicians and 53 percent of the nurses had seen cases of elder abuse in the previous year (Clark-Daniels et al., 1990).

At best, studies of professional experience provide impressionistic estimates and opinions about the prevalence, correlates, and consequences of elder mistreatment. Although such data may be useful for generating hypotheses for further research, they do not provide a sound basis for designing programs or formulating policies.

Elder mistreatment researchers have also relied on samples of cases that have come to the formal attention of a social agency or reporting authority. For example, records of patients at hospitals or social service agencies have been reviewed, and the percentage of elderly persons judged to have been abused is established. A more controlled version of this kind of study provides agency caseworkers or health professionals with a standardized assessment tool, which they are trained to fill out for clients. The “Three Model Projects on Elder Abuse,” funded by the Administration on Aging,



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