ing types of mistreatment: (1) physical acts causing pain or injury; (2) conduct inflicting emotional distress or psychological harm; (3) sexual assault; (4) financial exploitation; and (5) neglect. Some states also include other conduct and conditions, such as “isolation” or “unreasonable confinement.” In most, but not all, states, abuse and neglect of elders fall under the general adult protection statute, whereas some states have enacted specific provisions for elder protection. In almost all states, protective interventions are authorized or required only if the adults (or elders) are mentally or physically impaired. In some contexts, the nature of the relationship between the elder person and the alleged perpetrator also matters. On one hand, “neglect” (by definition) usually is associated exclusively with persons who have a legal duty to provide care, but some states direct or authorize intervention in cases involving adults found to be neglecting their own basic needs (“self-neglect”). On the other hand, in most states, anyone, even a stranger, can be found to have committed “abuse.” The common statutory patterns in definitions of abuse, neglect, and financial exploitation are depicted in Figures 2-1, 2-2, and 2-3.

TOWARD A SCIENTIFIC VOCABULARY

The scientific vocabulary and measures that are used to study elder abuse and neglect must diverge from the legal definitions in three important respects: First, the conduct (by a perpetrator) and harms (to the elder) being studied must be objectively ascertainable based on observation, record review, or direct questioning of relevant parties. Second, although abuse and neglect represent dichotomous (yes/no) judgments from a legal standpoint, most of the underlying behaviors fall along a continuum and must be analyzed empirically as dimensional variables in terms of frequency, intensity, and severity (or riskiness)—even though the data may often be subjected to dichotomous judgments. Third, the range of conduct being measured should be more inclusive than the behaviors or harmful consequences that would indisputably amount to abuse or neglect under the applicable law.

In other words, researchers should investigate all the conduct and harms that could amount to abuse or neglect if the perpetrator had the necessary intention or culpability and if other statutory conditions are met. Some subset of this all-encompassing category could be disaggregated in data analysis to represent “core” cases of abuse or neglect, based on suppositions about the presence of the necessary intention and other conditions. The main point, however, is that the ideal empirical strategy would define the category of interest broadly in terms of conduct and harmful consequences, leaving further narrowing to the analytical and interpretive stages.



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement