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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
have been forced to sign documents, provide loans or gifts, or sign documents they did not understand; may determine the elder person executed a power of attorney when the person lacked the mental capacity to do so; may notice suspicious companions and their relationship with the elder person; or may detect neglect that reflects financial abuse (Bernatz et al., 2001; Hwang, 1996; Lachs and Pillemer, 1995). It has been suggested that health care providers affirmatively ask patients whether they are being taken advantage of in any way (Bernatz et al., 2001; Lachs and Pillemer, 1995).
It has also been asserted that adding financial institutions to the list of mandatory reporters could “prove a valuable weapon against [financial] abuse” (Coker and Little, 1997:4). Similarly, lawyers have been identified as having a central role to play in identifying and preventing financial abuse of the elderly (Moskowitz, 1998a).
On the other hand, a report by the U.S. General Accounting Office concluded that increasing public and professional awareness of the existence of elder abuse was more important in identifying cases of elder abuse than reporting requirements and, although reporting laws are moderately effective in case identification, these laws were not effective in preventing first occurrences of elder abuse or treating substantiated cases (U.S. General Accounting Office, 1991). The U.S. General Accounting Office concluded that focusing the debate on the relative effectiveness of mandatory versus voluntary reporting was of questionable value (U.S. General Accounting Office, 1991). The U.S. General Accounting Office did not specifically address financial abuse, but it did include “material or financial exploitation” within its definition of elder abuse (U.S. General Accounting Office, 1991). In general, although not typically posed in the context of financial abuse, controversy has raged over whether elder abuse should be subject to mandatory reporting (Capezuti et al., 1997; Gilbert, 1986; Kapp, 1995; Kleinschmidt, 1997; Macolini, 1995; Moskowitz, 1998b; Podnieks, 1992; Roby and Sullivan, 2000).
Barriers to Reporting
As discussed, there is a wide consensus that elder abuse in general is greatly underreported (Coker and Little, 1997; Dessin, 2000; Marshall et al., 2000; Moskowitz, 1998b; National Center on Elder Abuse, 1996, 1998; Pillemer and Finkelhor, 1988; Wolf, 2000).38 Although little data are
But see Reis (2000), “It is also true that a seeming abuse is sometimes revealed as more benevolent when examined closely” (p. 13).