used such methods (Wolf et al., 1984). In both types of studies, however, researchers obtained data from professional accounts of mistreatment rather than from interviews with victims themselves.
It is widely recognized that reported cases are highly selective samples, and that there is a large reservoir of unreported and undetected cases of elder mistreatment about which very little is known. Although unreported cases may be similar to reported cases, they also may be quite different. Samples of reported cases may suggest common patterns and correlates of mistreatment, especially when paired with a control group, but the data must be interpreted with great care. Most important, the question of the extent of elder mistreatment cannot be answered by studies of reported cases. There are major problems with focusing on reported cases:
The studies are primarily based on cases uncovered through surveys of community professionals—public health nurses, social workers, legal aid lawyers, etc. They are thus cases that have come to public attention in one way or another. However, we know from other studies of family violence using nonclinical populations that only a fraction of cases involving serious mistreatment comes to public attention and that these cases are not necessarily representative of the problem at large. (In relation to child abuse, for example, see the 1995 Gallup Poll, finding that far more of America’s children are victims of physical and sexual abuse than officially reported—Gallup Poll, 1995.)
Similarly, in most cases, the research data on elder mistreatment have not come directly from victims, but instead from professionals and outside observers. Such secondhand knowledge may distort the actual dynamics of mistreatment by failing to present the problems and their effects, as the actual participants perceive them.
Case reports have little value in studying some forms of mistreatment that are rarely reported to adult protective services agencies, such as mistreatment in institutional settings.
Because elder mistreatment studies have relied so heavily on reports from professionals, crucial data about abuse situations have been missed. Community professionals in general do not collect data useful to researchers and policy makers. Thus, previous research using agency records has rarely been able to obtain detailed information about family history, attitudes, and consequences of mistreatment and other issues. Some researchers (e.g., Lachs et al., 1997a) have made effective use of these weak datasets by matching cases with higher-quality datasets.
In an effort to generate a national estimate of the occurrence of elder abuse and neglect based on case-identification by professional “sentinels,” the National Center of Elder Abuse, in conjunction with Westat, Inc.,