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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
problems, so psychopathology seems to be another way of explaining what takes place.
Several additional theories have been used to explain elder abuse:
the exchange theory, which describes how some of the dependencies that exist between a victim and a perpetrator relate to tactics and responses developed in family life, which continue into adulthood;
social learning theory, which brings in the whole issue of how abuse was learned and that spouse abuse among the elderly does exist; and
political economic theory, which focuses on the challenges faced by elders in a society that leaves people in poverty and takes away their importance in community life. Political economic theory addresses the marginalization of elders in society.
People in the field have come to realize that you can’t really explain such a complicated construct as elder abuse with one theory, and that perhaps what is needed is something that looks at factors across several domains. Heist has examined this issue in relation to child abuse, but it has subsequently been presented in a broader context by the Committee on Interventions of Family Violence (National Research Council and Institute of Medicine, 1998) as an ecological model that incorporates and links individual-level psychopathology and interpersonal relationships in the context of the overall sociocultural environment. That could be exchange dependency in the caregiver, for example, in the context of the elder community. For instance, are there services to take care of caregivers with alcohol problems? And it highlights some of the societal issues, such as the loss of the importance of older persons in transmitting values and traditions and certain cultural issues.
In the absence of an overarching theoretical framework, research has thus far focused on the characteristics of situations and victims and perpetrators that constitute risk factors for abuse. I will mention victim dependency, abuser dependence/deviance, social isolation, and living arrangements as examples.
There is no question that there are some people who are impaired and neglected, but is impairment necessary? There is a model of family violence in which victims are generally seen as people unable to leave the situation. When you think of a younger victim of what I will refer to as intimate partner violence, this represents the classic “battered woman syndrome.” When you look at those younger victims, you know that they find it very difficult to leave a situation. There is a concerted effort on the part of the