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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
Although every state has enacted a statute authorizing or directing intervention in cases involving vulnerable adults, including the elderly, these statutes vary widely in almost every respect (see Appendix B and tables in Chapter 2). They specify different ages or circumstance under which a victim is eligible for protective services, often differentiating between in-home and institutional abuse. They also vary in definitions of abuse, classification of abuse as civil or criminal, whether reporting is mandatory or voluntary, and the remedies or resources available when abuse is documented.
Each of the statutes defines conditions or circumstances that warrant intervention. The statutes typically define abuse or mistreatment as a series of broad categories, such as physical abuse, psychological or emotional abuse, sexual abuse or exploitation, and fiduciary abuse or exploitation, as well as neglect. However, not all states include all of these categories, and others are sometimes added. For example, some states do not include psychological abuse within the definition, while others add more specific forms of mistreatment such as “unreasonable confinement” or “abandonment.” Moreover, statutes sometimes distinguish between degrees of mistreatment according to the perpetrator’s culpability or state of mind; for example, the law may distinguish among willful infliction of physical abuse, negligently causing physical injury, and failure to prevent it.
In addition to variations in the types of mistreatment included in the statutory definition, the statutes also differ substantially in defining the common categories. For example, the definition of emotional abuse in several states includes “ridiculing or demeaning an infirm adult, making derogatory remarks to an infirm adult or cursing or threatening to inflict physical or emotional harm on an infirm adult,” whereas other states require proof of “extreme emotional distress or harm” (see Appendix B).
These statutory variations in definitions and obligations create innumerable opportunities for confusion and lack of comparability, especially if reported cases are being studied. When data are reported to some central repository, unless the repository has imposed a specific definition for each of the forms of abuse, the same statutory element will trigger reports in different categories of cases in different states. Interpretation of combined statistics is treacherous, even if the only objective is to compare trends across states.
OUTLINE OF REPORT
Keeping in mind the impediments to research identified in this chapter, the panel decided to concentrate its attention on the tasks that are most urgently needed to propel the field forward. Chapter 2 addresses the prob-