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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America (2003)

Chapter: Appendix A: Elder Mistreatment Measures and Studies

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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

APPENDIX
A
Elder Mistreatment Measures and Studies

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

TABLE A-1 Elder Mistreatment Measures

Measure

Summary

Characteristics

Properties

Pathophysiological signs and symptoms

Fulmer (1984)

Lachs and Fulmer (1993)

Dyer et al. (2000)

Haviland and O’Brien (1989)

O’Brien (1986)

Uses items such as unexplained bruising, dehydration, urine burns, fractures.

Subjective and objective clinical observations as documented by health care clinicians.

Poor sensitivity and specificity.

Conflict Tactic Scale

Straus (1978)

Perception of upsetting and injurious circumstances in a person’s life.

19-item self-report, e.g., “Has anyone threatened you with a knife or gun?”

Chronbach’s alpha reliability: 0.88. Content validity 0.80. Available in Spanish.

Elder Assessment Instrument

Fulmer (1984)

Provides information to clinicians to better inform judgments about risk of elder mistreatment.

40-item screening tool with both subjective and objective items to determine if an older person should be referred for suspected elder mistreatment.

Content validity 0.83. Interrater agreement 0.84. Available in Spanish.

The QUALCARE Scale

Phillips et al. (1990a, 1990b)

Assessment of six areas: physical, medical management, psychosocial, environmental, human rights, and financial.

53-item observational rating scale designed to quantify and qualify family caregiving.

Extensive psychometrics reported: Interrater agreement range: 0.79-0.88. Chronbach’s alpha: 0.81-0.95 on 6 subscales.

Hwalek-Sengstock Elder Abuse Screening Test

Neale et al. (1991)

Assessment of physical, financial, psychological, and neglectful situations.

15-item assessment screen for detecting suspected elder abuse and neglect.

Discriminant function analysis: 9 items identified 94% of cases. Three conceptual domains: violation of personal rights, characteristics of vulnerability, and potentially abusive situations.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Measure

Summary

Characteristics

Properties

Fulmer Restriction Scale

Fulmer and Gurland (1996)

Assessment of physical, psychological, and financial restriction of older adults.

34-item scale designed to elicit information regarding unnecessary restriction of the older adult.

Chronbach’s alpha: 0.78. Interrater agreement: 0.93. Available in Spanish.

Indicators of Abuse Screen

Reis and Nahmiash (1998)

Developed specifically for use by social service agency practitioners likely to visit the older adult in the home.

29-item set of indicators for use by social service agency practitioners to identify elder mistreatment.

Discriminant function analysis: 29 items identified 96.3% of cases. Factor analysis: no reliable pattern of variable clusters.

Adult Protective Service Reports

Intake forms used to document calls of suspected elder mistreatment from public hot lines and state agencies.

No specific format.

No psychometrics available.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

TABLE A-2 Elder Mistreatment Studies

Study

Methods

Selected Findings

Childs et al. (2000)

Design: Descriptive

Measure: (1) SVWS; (2) EAA BIS-R

Sample: Nonrandom: 422 young and 201 middle-aged adults

Theory: N/A

Middle-aged respondents viewed psychological behavior more harshly than younger respondent.s Both middle-aged women and young men were less tolerant of middle-aged perpetrators.

Data support relativistic nature of elder abuse.

Coyne et al. (1993)

Design: Descriptive survey

Measure: Demographics; Zarit Burden interview; Zung Self-Rating Depression Scale

Sample: 1,000 caregivers who called a telephone help line for dementia; 342 respondents

Mean age of caregiver 56.1; 54.5% were adult children caring for parents; 37.1% caring for spouses; 8.4% cared for other relatives. 11.9% reported they had been physically abusive toward dementia patients. Abusers had been providing care for more years; patients functioned at a lower level; caregivers had higher burden and depression scores.

Dyer et al. (2000)

Design: Case-control study

Intervention: Comprehensive geriatric assessment

Measure: Standard geriatric assessment tools

Sample: 47 older persons referred for neglect and 97 referred for other reasons

45 cases of abuse or neglect identified.

37 were self-neglect.

Elder mistreatment cases were more likely to be white and male.

Higher prevalence of depression and dementia.

Ertem et al. (2000)

Design: Descriptive

Method: Meta-analysis

Sample: 10 studies

10 studies: 4 cohort, 1 cross-sectional, and 5 case-control.

The RR of maltreatment in children of abused parents were significantly increased in 4 studies (RR 4.75-37.8). In 3 other studies the RR was less than 2.

Significant validity issues.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

Fulmer and Gurland (1996)

Design: Descriptive

Measure: CTS, FRS and NMAP Survey, Beck Depression Scale, BDBS

Sample: 125 elder-caregiver dyads; 51 dyads with cognitive impairment and 74 dyads with no cognitive impairment; mean age of the elder 78 years

Theory: Risk and vulnerability

Cognitive impairment risk factor for elder mistreatment.

CTS higher for CI patients.

FRS higher for CI patients.

CI patients more dependent.

CI patients had higher BDBS.

CI patients had higher Zarit Burden scores.

Fulmer et al. (1999)

Design: Descriptive

Method: Analysis of a probability sample of ADHC clients in New York State. Social workers served as informants.

Sample: 9 sites drawn through random sampling

Prevalence of elder mistreatment 12.3%.

Apprehensive behavior was highest reported behavior; with this item removed, prevalence 3.6%.

Social workers noted concern regarding elders who appeared frightened in the presence of their home caregiver.

Fulmer et al. (2000)

Design: Descriptive

Measure: EAI, MMSE

Sample: 180 emergency department patients over the age of 70 with MMSE of 18 or greater

36 patients eligible for study.

7 patients screened positive for neglect.

Nurses were able to screen for elder neglect with greater than 70% accuracy; true positive 71%, false positive 7%.

Huber et al. (2001)

Design: Descriptive

Method: Analysis of cross-sectional 6-state ombudsman database

Sample: 23,787 complaints

5 most frequent complaints were (1) loss of dignity and respect; (2) accidents; (3) physical abuse; (4) call lights unanswered; (5) poor personal hygiene.

Race and gender differences noted.

Hudson (1991)

Design: Descriptive

Measure: 3-round Delphi survey

Sample: 63 elder mistreatment experts

Agreement on a 5-level taxonomy.

11 theoretical definitions proposed by panel.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

Hwalek et al. (1996)

Design: Descriptive

Method: Database analysis

Measure: Risk of Future Abuse instrument

Sample: State of Illinois Abuse, Neglect and Exploitation Tracking System; 2,577 cases from October 1989 to December 1991. 552 substantiated reports used for this study

73% of victims were women.

Mean age 77 (60-99).

Caucasian 73%; widowed 54%; living at home 76%.

Caregiver substance abuse more likely to involve physical or emotional abuse.

Jogerst et al. (2000)

Design: Descriptive

Method: Analysis of county-level data between 1984 and 1993 to test association between county characteristics and rates of elder abuse

Sample: 99 counties in Iowa

Analysis: univariate correlational analysis and stagewise linear regression

Community characteristics that had a positive association with rates of reported or substantiated elder mistreatment were: (1) population density; (2) children in poverty; (3) reported child abuse.

Jones et al. (1997)

Design: Descriptive

Method: Random sample survey

Sample: 3,000 members of the American College of Emergency Physicians; 705 completed surveys (response rate 24%)

52% of respondents described elder mistreatment as prevalent but less than spouse or child abuse.

Respondents evaluated a mean of 4 ± 8 suspected cases of elder mistreatment in the last 12 months; 50% were reported.

Lachs et al. (1994)

Design: Prospective cohort study

Method: Case matching with adult protective services database

Sample: 329 elders investigated in 1985 and 1986

Analysis: Relative risk calculations

68 (2.4%) of database cohort members received ombudsman investigation. Risk factors for elder mistreatment investigation using logistic regression included requiring assistance with feeding OR 3.5, being a minority elder OR 2.3, over age 75 at cohort inception OR 1.9, and poor social networks OR 1.7.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

Lachs et al. (1997a)

Design: Prospective cohort study

Method: Case matching with adult protective services database

Sample: 184 cohort members

Analysis: Pooled logistic regression

47 cohort members were seen for elder mistreatment (prevalence 1.6%).

Age, race, poverty, functional disability, and cognitive impairment were identified as risk factors for reported elder mistreatment, with ORs reported.

The onset of new cognitive impairment was also associated with abuse and neglect.

The influence of race and poverty is likely to be overestimated due to reporting bias.

Lachs et al. (1997b)

Design: Prospective cohort study

Method: 7-year longitudinal database with identification of 182 victims of elder abuse

Sample: 114 elders seen in 2 emergency departments

114 individuals accounted for 628 visits (median 3, range 1-46).

30.6% resulted in hospital admission.

66% had at least one visit that resulted in an injury-related chief complaint.

Lachs et al. (1998)

Design: Prospective cohort study

Measure: mortality among elders for whom protective services were used to corroborate mistreatment and elderly persons for whom protective services were used for self-neglect

Sample: 176 adult protective services elders

Cohort members seen for elder mistreatment at any time during follow up had poorer survival (9%) than others.

Reported and corroborated elder mistreatment and self-neglect are associated with shorter survival after adjusting for other factors associated with increased mortality in older adults.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

Moody et al. (2000)

Design: Descriptive

Measure: H-S/EAST

Sample: 100 black, Hispanic, and white elders living in public housing

Principal components FA of 15-item instrument supported the 3-factor structure for a total of 10 items explaining 38% of the variance.

Discriminant function analysis showed that 6 items were as effective as the 9-item model in classifying cases as abused (71.4%).

National Center on Elder Abuse at the American Public Human Services Association [formerly American Public Welfare Association] in collaboration with Westat, Inc. (1998)

Design: Descriptive study

Method: Incidence study using sentinel agency reports

Sample: 20 counties in 15

states: nationally representative sample

551,000 elder mistreatment cases in 1996.

Female elders are abused at higher rates than males.

The oldest elders (80 years and older) are abused and neglected at 2-3 times their proportion in the elderly population.

In almost 90% of elder mistreatment cases, the perpetrator is a family member and 2/3 are adult children or spouses.

Victims of self-neglect are usually depressed, confused, or extremely frail.

O’Malley et al. (1984)

Design: Descriptive

Measure: Case analysis using OARS

Sample: 24 cases from primary care clinic

Cases divided into three categories: (1) extremely impaired who receive care from individuals responsible for abuse and neglect (N = 4); (2) impaired elders who receive inadequate or intermittent care (N = 9); (3) involved independent elders whose only care needs resulted from threats or violence from relatives (N = 11).

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

STudy

Methods

Selected Findings

Paveza et al. (1992)

Design: Descriptive

Measure: CTS

Sample: Purposive sample from Alzheimer’s disease

registry: 184 patients

Severe family violence as measured by the CTS was a significant problem: overall prevalence 17.4%.

15.8% of patients had been violent since diagnosis.

5.4% of caregivers reported being violent toward the patient.

Violence by the Alzheimer’s disease patient against the caregiver was serious problem.

Pavlik et al. (2001)

Design: Descriptive

Method: Analysis of Texas Department of Protective and Regulatory Services, Adult Protective Services

Sample: 62,258 allegations of elder mistreatment in 1997

Neglect accounted for 80% of allegations.

The incidence of being reported to adult protective services increased sharply after age 65.

Prevalence was 1,310 over 100,000 = 65 years of age.

Phillips and Rempusheski (1985)

Design: Descriptive

Method: Interviews with grounded theory analysis

Sample: 29 health care providers (16 nurses and 13 social workers)

4-stage model describing decisions of health care providers about elder abuse.

Model identifies 3 types of decisions: diagnostic, value, and intervention.

Complexity of decision processes is revealed via 5 pathways.

Phillips et al. (1990a)

Design: Adaptation of the QUALPACS

Method: Instrument development

Sample: Piloted with 8 data collectors (4 in each of 2 sites) who interviewed 4 elder-caregiver dyads. A total of 29 elder-caregiver dyads were interviewed

QUALCARE Scale contains six subscales and 53 items. Included in 6 subscales: environmental, physical, medical maintenance, psychological, human rights, and financial.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

Phillips et al. (1990b)

Design: Descriptive correlational study

Measure: QUALCARE

Sample: Convenient sample of 249 elder-caregiver dyads

Interrater reliability for 55 observations ranged from 79% to 88%.

Internal consistency: alpha = .097.

Conceptual structure: confirmatory factor analysis indicated 6 significant factors accounting for 64.4% of the variance.

Criterion validity: all correlations between criteria variables and QUALCARE were in correct direction and p = 0.05 level.

Construct validity: 8 of 9 correlations in the predicted direction.

Pillemer and Finkelhor (1988)

Design: Descriptive

Method: Stratified random sample survey

Sample: 2,020 community-dwelling elders in metropolitan Boston

63 elder persons were maltreated.

Rate of 32 per 1,000.

95% confidence interval of 25-39 per 1,000.

No minority differences or age differences.

Those in poor health were 3 to 4 times likely to be abused.

Males were more likely to be abused than females.

Pillemer and Finkelhor (1989)

Design: Descriptive

Method: Case control

Sample: 46 abuse or neglect victims and 215 random controls

Factors associated with elder mistreatment included abuser factors of deviance, dependence on victim, and life stress.

Victim factors included court help, disability, dependence on abuser, and conflictual relationship (spouse only).

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

Pillemer and Moore (1989)

Design: Descriptive

Measure: CTS

Sample: 577 nursing personnel from 31 nursing homes in New Hampshire

36% of the sample had seen at least one incident of physical abuse in the preceding year.

Most frequent abuse observed was excessive restraint.

Second most frequent type was physical abuse.

81% observed at least one psychologically abusive incident in the preceding year.

10% of respondents reported committing physical abuse.

40% of respondents reported committing psychological abuse.

Pillemer and Suitor (1992)

Design: Descriptive

Method: Analysis of quantitative and qualitative data

Sample: 236 family caregivers for dementia victims

Characteristics predictive of violent feelings in caregivers included physical aggression by elder, disruptive behaviors, and a shared living situation.

Structural relationship and caregiver age were related to actual violence: spouses were more likely to be violent than other relatives, as were older individuals.

Violence by elder was positively related to caregiver violence.

Rosenblatt et al. (1996)

Design: Descriptive

Method: Analysis of State of Michigan records of reported cases of suspected elder abuse 1989–1993

Sample: 27,371 cases of possible elder mistreatment

17,238 of cases were older than age 65.

Physicians reported only 2% of cases.

Physician reporting rates did not increase over a 5-year period.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

Shaw (1998)

Design: Descriptive

Method: Grounded theory

Sample: 21 semistructured interviews conducted with six abuse investigators and 15 nursing home staff

The two types of abusive nursing home staff were identified as reactive sadistic.

Wolf (1986)

Design: Descriptive

Method: Analysis of cases from an elder mistreatment intervention project

Sample: 59 elder mistreatment cases compared with 49 cases randomly selected from nonabuse caseload

Victims and nonabuse clients were similar in age, sex, and health status.

Caretakers for both groups were similar in age and health status.

More perpetrators were males.

A majority of elder mistreatment cases resided with family members versus nonabused persons living alone.

Victims and perpetrators had more psychological and emotional health problems.

Abused elders did not appear to be more dependent.

Wolf and Pillemer (1997)

Design: Descriptive

Measure: ADLs, IADLs, CTS

Sample: 73 older women: 22 victimized by husbands and 51 victimized by adult children

Wives more likely to be dependent on husbands for IADLs.

Adult children more likely to be dependent on mothers for housing and finances.

Husbands more likely to use physical violence against wives than adult children

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Study

Methods

Selected Findings

 

 

against mothers.

Wolf and Li (1999)

Design: Descriptive

Measure: DV was number of reports per 1,000 persons age 60 years and older during 1994

Sample: 27 geographical areas in Massachusetts

Rate of reports varied from a low of 2.41 per 1,000 through 9.31 per 1,000.

Higher rates of reporting were associated with lower socioeconomic status, more community training, higher agency service rating scores, lower community agency relationship score.

 

SOURCE: Adapted from Fulmer (2002).

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

REFERENCES

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Ertem, I.O., J.M. Leventhal, and S. Dobbs 2000 Intergenerational continuity of child physical abuse: How good is the evidence? Lancet 356(9232):814-9.


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Fulmer, T., and B. Gurland 1996 Restriction as elder mistreatment: Differences between caregiver and elder perceptions. Journal of Mental Health and Aging 2:89-98.

Fulmer, T., G. Paveza, I. Abraham, and S. Fairchild 2000 Elder neglect assessment in the emergency department. Journal of Emergency Nursing 26(5):436-443.

Fulmer, T., M. Ramirez, S. Fairchild, D. Holmes, M.J. Koren, and J. Teresi 1999 Prevalence of elder mistreatment as reported by social workers in a probability sample of adult day health care clients. Journal of Elder Abuse and Neglect 11(3):25-36.


Haviland, S., and J. O’Brien 1989 Physical abuse and neglect of the elderly: Assessment and intervention. Orthopedic Nursing 8(4):11-19.

Huber, R., K. Borders, F.E. Netting, and H.W. Nelson 2001 Data from long-term care ombudsman programs in six states: The implications of collecting resident demographics. The Gerontologist 41(1):61-68.

Hudson, M.F. 1991 Elder mistreatment: A taxonomy with definitions by Delphi. Journal of Elder Abuse and Neglect 3(2):1-20.

Hwalek, M., A. Neale, C. Goodrich, and K. Quinn 1996 The association of elder abuse and substance abuse in the Illinois Elder Abuse System. The Gerontologist 36(5):694-700.


Jogerst, G.J., J.D. Dawson, A. J. Hartz, J.W. Ely, and L.A. Schweitzer 2000 Community characteristics associated with elder abuse. Journal of the American Geriatrics Society 48(5):513-518.

Jones, J.S., T.R. Veenstra, J.P. Seamon, and J. Krohmer 1997 Elder mistreatment: National survey of emergency physicians. Annals of Emergency Medicine 30(4):473-479.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Lachs, M.S., L. Berkman, T. Fulmer, and R. Horwitz 1994 A prospective community-based pilot study of risk factors for the investigation of elder mistreatment. Journal of the American Geriatrics Society 42(2):169-73.

Lachs, M.S., and T. Fulmer 1993 Recognizing elder abuse and neglect. Clinical Geriatric Medicine 9(3):665-81.

Lachs, M.S., C. Williams, S. O’Brien, L. Hurst, and R.I. Horwitz 1997a Risk factors for reported elder abuse and neglect: A nine-year observational cohort study. The Gerontologist 37(4):469-474.

Lachs, M.S., C.S.Williams, S. O’Brien, L. Hurst, A. Kossack, A. A. Siegal, and M.E. Tinetti 1997b ED use by older victims of family violence. Annals of Emergency Medicine 30(4):448-454.

Lachs, M. S., C.S. Williams, S. O’Brien, K.A. Pillemer, and M.E. Charlson 1998 The mortality of elder mistreatment. Journal of the American Medical Association 280(5):428-432.


Moody, L. E., A. Voss, and C.A. Lengacher 2000 Assessing abuse among the elderly living in public housing. Journal of Nursing Measurement 8(1):61-70.


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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Pillemer, K.A., and D.W. Moore 1989 Abuse of patients in nursing homes: Findings from a survey of staff. The Gerontologist 29(3):314-320.

Pillemer, K. A., and J.J. Suitor 1992 Violence and violent feelings: What causes them among family caregivers? Journal of Gerontological Nursing 47(4):S165-S172.

Reis, M., and D. Nahmiash 1998 Validation of the indicators of abuse (IOA) screen. The Gerontologist 38(4):471-480.

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Shaw, M.M.C. 1998 Nursing home resident abuse by staff: Exploring the dynamics. Journal of Elder Abuse and Neglect 9(4):1-21.

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Tatara, T 1993 Understanding the nature and scope of domestic elder abuse with the use of state aggregate data: Summaries of key findings of a national survey of state APS and aging agencies. Journal of Elder Abuse and Neglect 5:35-57.


Wolf, R.S. 1986 Major findings from three model projects on elderly abuse. In Elder Abuse: Conflict in the Family, K.A. Pillemer and R.S. Wolf, eds. Dover MA: Auburn House Publishing.

Wolf, R.S., and D. Li 1999 Factors affecting the rate of elder abuse reporting to a state protective services program. The Gerontologist 39(2):222-228.

Wolf, R.S., and K.A. Pillemer 1997 The older battered woman: wives and mothers compared. Journal of Mental Health & Aging 3(3):325-336.

Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Page 178
Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Suggested Citation:"Appendix A: Elder Mistreatment Measures and Studies." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
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Next: Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law »
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Since the late 1970s when Congressman Claude Pepper held widely publicized hearings on the mistreatment of the elderly, policy makers and practitioners have sought ways to protect older Americans from physical, psychological, and financial abuse. Yet, during the last 20 years fewer than 50 articles have addressed the shameful problem that abusers—and sometimes the abused themselves—want to conceal.

Elder Mistreatment in an Aging America takes a giant step toward broadening our understanding of the mistreatment of the elderly and recommends specific research and funding strategies that can be used to deepen it. The book includes a discussion of the conceptual, methodological, and logistical issues needed to create a solid research base as well as the ethical concerns that must be considered when working with older subjects. It also looks at problems in determination of a report’s reliability and the role of physicians, EMTs, and others who are among the first to recognize situations of mistreatment.

Elder Mistreatment in an Aging America will be of interest to anyone concerned about the elderly and ways to intervene when abuse is suspected, including family members, caregivers, and advocates for the elderly. It will also be of interest to researchers, research sponsors, and policy makers who need to know how to advance our knowledge of this problem.

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