various types of elder mistreatment occurrence are poorly understood, necessitating more longitudinal investigations, including follow-up studies of the clinical, social, and psychological outcomes of elder mistreatment cases detected. The existing research appears to lack depth and texture. This is not surprising in light of the field’s early stage of development and the emphasis thus far placed on occurrence of cases (in population-based surveys and in the clinical setting). If the field is to move forward, attention must be devoted to theory-driven efforts to identify the intersecting behaviors, relationships, and conditions that characterize mistreatment and to trace its clinical course.
Longitudinal studies are needed to explore the relationship among different forms of mistreatment, to place descriptive information about risk factors in context, to trace outcomes, to draw causal inferences, and to identify potential targets for intervention. For example, what are the individual and familial outcomes of elder mistreatment? What proportion of mistreatment cases result in emergency department visits? To what extent do persons who experience elder mistreatment develop post-traumatic stress disorder or other psychiatric conditions? Many elder mistreatment situations are recurrent and may have various incarnations over long periods, making the definition of an elder mistreatment “event” difficult to define. Thus, further work on the nature, periodicity, variation, and triggers for elder mistreatment is needed and will require longitudinal investigations. Such longitudinal studies could be enhanced by linkage of medical and social records, when feasible, to augment the range of available information.
The occurrence of elder mistreatment in institutional settings, including long-term care and assisted living situations, is all but uncharacterized and needs new study sampling and detection methods. Sampling and surveillance techniques may be different from community-based elder mistreatment detection, and considerable innovation may be required.