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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
and intimate partner abuse. It is to some extent the state of the art, but some elder mistreatment researchers do not seem to be aware of it.
It is very difficult to obtain access to perpetrators of mistreatment. In intimate partner studies, a number of researchers have used treatment programs for batterers as sources of research subjects. These do not exist for elder mistreatment.
The exclusion of some victims can seriously bias samples. The problem is most evident when residents of institutions are excluded altogether from population samples. However, even within the targeted study population (whether community dwelling or residing in institutions), exclusion criteria based on cognitive deficiencies can seriously skew the findings.
There is some anecdotal evidence that institutional review boards have interpreted the Common Rule (the governing regulations on research ethics) in an unduly restrictive fashion, impeding potentially valuable research on elder mistreatment (see Chapter 8).
Few investigators have been drawn to this field of inquiry. Reviews of the literature reflect the same small set of names time and again, with few new researchers selecting and remaining in this field. One of the reasons for this situation is that so little funding has been available for research on elder mistreatment. Although more outstanding investigators might have attracted more funding, dedicated funding also could attract more and better investigators. Although the total federal contribution to research on elder mistreatment is uncertain, expenditures by NIA, the lead agency for aging research, have totaled $10 million during the last 12 years (1990–2001). Annual expenditures have increased from less than $300,000 per year in 1990 to over $1.3 million in 2001; this is a modest sum even in comparison to the underfunded domain of child abuse research, on which federal agencies spend $3.8 million each year.
The existing body of research is largely descriptive and pragmatic, taking the concepts and definitions used in practice or in statutes as given, rather than deriving the concepts and measures from theoretical premises or hypotheses. The atheoretical nature of the research is reflected in the tendency to lump all forms of mistreatment within a single category.
Individuals who have attempted to conduct research on elder abuse report that they have sometimes been hindered by a lack of cooperation from agencies responsible for identifying and treating victims of mistreatment. Adult protective services programs and other elder abuse service programs have been characteristically reluctant to assist researchers in research activities, and especially research that involves interviews with victims and their families. Reasons for lack of agency cooperation include a desire to protect their clients’ privacy and to prevent additional disruption in their lives, fear of evaluation research, and a shortage of staff time to devote to research.