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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
and Dupree, 1994:374). Not only must assessors be trained to avoid ageist thinking or actions, but the assessment instrument itself must not be ageist in tone or content. Focusing on specific behaviors and events during assessment (e.g., using very clear, specific descriptions of behavioral events, rather than culturally or generationally defined phrases) appears to be an objective means by which to limit ageism, and, as illustrated below, is an important methodological strategy to increase sensitivity and accuracy of victimization assessment (Patterson and Dupree, 1994).
In addition, it is important to conduct some assessment of cognitive functioning in order to determine the best form of violence assessment, and whether or not assessment of the older adult is even appropriate. Greater susceptibility to fatigue and concentration problems related to disclosure of highly personal content make it advantageous to limit stress during interviews (Gurland et al., 1978). This is particularly the case when interview disclosures potentially affect the interviewee’s life, or at least such potential impact is perceived (e.g., disclosing abuse, which then might be reported, leading to social service intervention).
ASSESSMENT OF ELDER MISTREATMENT: EXISTING METHODS AND MEASURES
The following review summarizes specific measures of elder mistreatment and their advantages and disadvantages. Measures are categorized in terms of the five forms of elder mistreatment assessment methodology outlined above. In general, factors such as feasibility, sensitivity, reliability, validity, and cost guide overall conclusions and recommendations for each strategy and measure.
Agency Record Review
Agency records provide a readily available source of information regarding investigated and substantiated cases of elder abuse, neglect, and exploitation. These data are not collected for the purpose of epidemiological or preventive research, however, and the specific information is not always exactly what a particular researcher desires. Moreover, the criteria by which cases are designated substantiated or not and the definitions for particular forms of elder mistreatment vary widely across social service agency, county, and state.
The National Center on Elder Abuse (Tatara, 1997) collects and compiles into reports nationwide data from those social service agencies charged with protecting the health and welfare of older adults. Thus, these reports describe actual investigated and indicated cases of abuse and neglect in which family members were interviewed, households were visited, and in-