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. To the extent that dichotomous classifications of mistreatment are needed, agreement must be reached on what LEAD-type methodology will be used in place of a gold standard for such studies.

Agreement on operational definitions for research may provide a useful foundation for developing standard definitions and classification criteria for surveillance and reporting. It is conceivable that a consensus conference could be convened to propel this process forward, although such an effort may be premature in the absence of greater experience in the field developing the approach outlined in this chapter. Another possibility would be to initiate a consensus process in a more limited domain—such as defining mistreatment in the context of developing definitions and measures of quality in long-term care, as recommended in a recent report on this subject by the Institute of Medicine (2001). (see Chapter 7 for further discussion).



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