addition, typically an agency is empowered to coordinate the provision of services for the elderly person determined to be at risk and to intervene to protect endangered individuals (Moskowitz, 1998b).

Sources of Reports

Third parties, not the victims themselves, are the most likely to report elder abuse in general (Choi and Mayer, 2000; Lavrisha, 1997; Moskowitz, 1998b; Tueth, 2000). The NEAIS review of substantiated APS reports in 1996 found that 25.7 percent of the reports came from hospitals, physicians, nurses, and clinics, 20 percent came from family members, 14.8 percent came from in-home or out-of-home service providers, 11.3 percent came from the police or sheriff, 9.1 percent came from friends or neighbors, and only 8.8 percent came from the victims (National Center on Elder Abuse, 1998). Most mandatory elder abuse reports appear to come from health-care providers, including home health-care providers, and family, friends, or neighbors of the victim (Rosenblatt et al., 1996; Wolf and Pillemer, 1989).37

For financial abuse, the NEAIS review found that the three most frequent reporters were friends and neighbors (15 percent), hospitals (14.2 percent), and family members (14 percent). Choi et al. (1999) found that two-thirds of the reports of suspected financial exploitation to an APS agency were made by social service or health care providers and one-third were made by other individuals, including relatives, friends, neighbors, landlords, law enforcement agencies, and banks. Choi and Mayer (2000) in a subsequent analysis determined that only 1.4 percent of the reports of elder abuse came from the victims, a figure that did not significantly vary when the focus was only financial exploitation cases.

It has been claimed that health care providers, particularly practitioners involved in the long-term care of the elderly, are in a unique position, perhaps the best position, to detect the financial abuse of the elderly (Bernatz et al., 2001; Hwang, 1996; Tueth, 2000). For example, it has been suggested that such practitioners may have the best opportunity to meet privately with the elder person outside the presence of a caregiver; may be asked for financial help or advice; may be likely to learn about an inability to pay for important services such as medical care; may learn that patients


But compare Shiferaw et al. (1994); in a study of all reports of elder abuse over a threeyear period to a county APS unit in North Carolina, the most referrals came from service agencies (32 percent), followed by family members (26 percent); Kleinschmidt (1997); “Physicians infrequently report elder abuse, despite being ‘in an ideal position to recognize, manage, and prevent elder mistreatment.’”

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