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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
and comfortable and then isolated; and finally the perpetrator takes possession of assets by employing psychological abuse.
APPROPRIATENESS OF ADOPTING MODELS ADDRESSING CHILD AND SPOUSE ABUSE
Societal attention to child abuse and spouse abuse20 predated the attention given to elder abuse. The rising awareness of child abuse in the 1960s and that of spouse abuse in the 1970s have been cited as triggering societal awareness of the existence of elder abuse (Dessin, 2000).21
Preventive measures, reporting systems, and interventions designed to curtail child abuse frequently provided a model for efforts to address elder abuse (Capezuti et al., 1997; Gilbert, 1986; Kapp, 1995; Macolini, 1995; Nerenberg, 2000a; Wolf, 2000). As statutes were already in place that mandated child abuse reports and established service systems to redress such abuse when elder abuse was “discovered,” many states found it expedient to apply the same model to elder abuse as well (Anetzberger, 2000). One reason for using the same model is that child and elder abuse, whether physical or financial in nature, are difficult to detect because the victim may be reluctant or unable to report the abuse (Dessin, 2000), in part because the perpetrator is likely to be a family member (National Center on Elder Abuse, 1996). Also, the victims of both forms of abuse are frequently perceived as particularly vulnerable or sympathetic and in need of society’s
The phrase “spouse abuse” also encompasses actions associated with wife assault, partner abuse, battered women, and domestic violence; is intended to refer to abuse between adults who live together in intimate relationships, regardless of their marital relationship and the gender of the partners; and remains the terminology used in a number of reporting statutes.
Growing awareness of child abuse and the need for society to take steps to curtail it also led to increased efforts to address spouse abuse. Initially it was suggested that there were relatively direct parallels between child and spouse abuse in that in both the victims were relatively helpless captives of the abuser (a relationship sometimes suggested for elder abuse victims). Such a perspective led to legislation that mandates reporting by various individuals of suspected spouse abuse. However, this “infantilizing” of spouses has met considerable resistance. For example, the American Medical Association’s Council on Ethical and Judicial Affairs asserted that spouse abuse differs from child abuse in important respects and concluded that mandatory reporting of spouse abuse violated the ethical standards of confidentiality that physicians owe to their adult patients (Council on Ethical and Judicial Affairs, AMA, 1992). Rather than imposing mandatory reporting of spouse abuse, a number of other mandatory steps pertaining to spouse abuse have been suggested for treating physicians, including mandatory intensive domestic violence training for various specialties as part of medical education and requiring treatment plans and protocols that assist the medical team in identifying and responding to abuse (Council, 1992; Jecker, 1993).