feel increased stress in his or her situation and become more likely to respond in an abusive manner to another challenge to his or her caregiving capabilities. In short, the overarching conception of the model is one of a time-dependent process with feedback loops that interact with the “independent” variables over time.
Such a conception highlights the critical need for longitudinal studies to gain a better understanding of the underlying dynamics. The clinically and forensically oriented literature often characterizes the issue as one of enhancing case identification methods so that “findings” of culpability can be established. But this leads to a focus on punishment and deterrence as the principal goals of intervention. A process-oriented account of elder mistreatment, in contrast, would lead to investigation of the reversibility of the process by providing a better understanding of the etiology of specific forms of elder mistreatment and therefore a better understanding of the preventive and remedial measures that could be undertaken.
Such a perspective would benefit from knowledge gained by qualitatively and phenomenally oriented research designed to flesh out the meanings of different forms of elder mistreatment. For example, how does spousal mistreatment differ from adult child mistreatment? What are the differences between one-shot or episodic mistreatment in response to a crisis situation that overwhelmed the caregiver and chronic or recurrent elder mistreatment in a long-term marriage characterized by recurrent physical conflict? We often speak of the heterogeneity of the phenomena of elder mistreatment, but there are literally no studies that attempt to explore the nature of that heterogeneity. At present, we are functioning at the level of commonsense classes, perhaps informed by legal distinctions rather than scientifically informed classification. Legal categories of elder mistreatment are highly heterogeneous in their phenomenal base and may thus arise from quite different etiologies, with correspondingly various implications for the kinds of interventions that might successfully be pursued. In regard to the potential opportunities and foci for prevention and intervention, the phenomena may be basically independent in cases of (a) battering by an intimate partner that persists as part of a long-term, even life-long pattern; (b) battering by an intimate partner that begins in late life (perhaps because of a transformation in the marital relationship as a result of changes in physical well-being or the social status and financial well-being of one or both spouses); (c) neglectful or abusive care by other kin who face a multiplicity of overwhelming care needs as well as other, perhaps unrelated problems; (d) neglectful or abusive care by employees of adult day programs, nursing homes, and hospitals; and (e) crimes of opportunity, in which dependent persons are exploited by caregivers who take advantage of access to financial resources.