a much better understanding of the key elements of elder mistreatment, which in turn will facilitate the development of broadly accepted operational definitions and the development of research and clinical measures for these phenomena. Examples of such research include studies of: (1) the kinds of trust relationships that older persons enter into, the other parties involved in these relationships, the foundations of these relationships, and their association with different types of mistreatment; (2) the different types of harms that mistreated older persons may suffer, the interrelationship of the different harms (e.g., relationship of physical to emotional to financial), the severity of harms, their temporal characteristics, and their natural history; (3) the injurious conduct or omissions of other parties in trust relationships, how they manifest themselves, and their natural history; (4) the psychological effects of mistreatment, including types of psychological harm, their presentation, and their natural history; and (5) the circumstances under which harm is most likely to have been caused by the acts or omissions of another person.
Development of widely accepted operational definitions and validated and standardized measurement methods for the elements of elder mistreatment is urgently needed to move the field forward. The field must develop widely accepted operational definitions of the elements of elder mistreatment, its different forms, and associated risk factors and outcomes. The field must also develop a series of measures for these elements, with good (and known) reliability and validity. A menu of measures is necessary for each of the multiple contexts of research, including screening and case identification in clinical settings as well as studies of elder mistreatment in populations.
Population-based surveys of elder mistreatment occurrence are feasible and should be given a high priority by funding agencies. Preparatory funding should be provided to develop and test measures for identifying elder mistreatment. There is inadequate information on elder mistreatment occurrence among both community-dwelling and institutionalized elders. However, before embarking on such surveys, the aims and rationale for them should be clearly delineated, and the strengths and weaknesses of the survey methodology fully understood. Different methods and approaches may be required for various types of mistreatment, and multiple modes of case ascertainment should be considered and evaluated. Survey-acquired information could be enhanced by appropriately applied record linkage techniques. Complementary study of biomarkers that may enhance elder mistreatment case identification should be explored.
Funding agencies should give priority to the design and fielding of national prevalence and incidence studies of elder mistreatment. These studies should include both a large-scale, independent study of prevalence and modular add-ons to surveys of aging populations. Acquiring valid