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

Chapter: Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law

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Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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APPENDIX
B
Analysis of Elder Abuse and Neglect Definitions Under State Law

Lora Flattum Hamp

ALABAMA: Code of Ala. § 38-9-2 (2001)

Abuse” means the infliction of physical pain, injury, willful deprivation by a caregiver or other person of services necessary to maintain mental and physical health.

Defined separately: Emotional abuse is the willful or reckless infliction of emotional or mental anguish or the use of a physical or chemical restraint, medication or isolation as punishment or as a substitute for treatment or care of any protected person. Sexual abuse includes any conduct that is a crime as defined in § 13A-6-60 to § 13A-6-70 of the Code of Alabama.

“Neglect” means the failure of a caregiver to provide food, shelter, clothing, medical services, or health care for the person unable to care for self; or the failure of person to provide these needs for self as result of mental or physical inability.

“Exploitation” means expenditure, diminution, use of property, assets, or resources of protected person without the express voluntary consent of that person or that person’s legally authorized representative.

“Adult in need of protective services” means a person 18 years of age or older whose behavior indicates that he or she is mentally incapable of

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

adequately caring for himself or herself and his or her interests without serious consequences to himself or herself or others, or who, because of physical or mental impairment, is unable to protect himself or herself from abuse, neglect, exploitation, sexual abuse, or emotional abuse by others, and who has no guardian, relative, or other appropriate person able, willing, and available to assume the kind and degree of protection and supervision required under the circumstances.

“Caregiver” means an individual who has the responsibility for care of a protected person as a result of family relationship or who has assumed the responsibility for care of the person voluntarily by contract or as a result of the ties of friendship.

ALASKA: Alaska Stat. § 47.24.900 (2001)

Abuse” means willful, intentional, reckless, nonaccidental, and nontherapeutic infliction of physical pain injury or mental distress or sexual assault.

Neglect” means the intentional failure by a caregiver to provide essential care or services necessary to maintain the physical and mental health of the vulnerable adult. Self-neglect includes an act or omission by a vulnerable adult that results or could result in the deprivation of essential services necessary to maintain minimal mental, emotional, or physical health and safety.

Exploitation” means the unjust or improper use of another person or another person’s resources for one’s own profit or advantage.

Vulnerable adult” means a person 18 years of age or older who, because of physical or mental impairment, is unable to meet person’s own needs or to seek help without assistance.

Caregiver” means a person providing care to a vulnerable adult as a result of family relationship; or who has assumed responsibility for the care of a vulnerable adult voluntarily, by contract, or by court order; or an employee of an out-of-home care facility who provides care to one or more vulnerable adults.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

ARIZONA: A.R.S. § 46-451 (2000); A.R.S. § 13-3623 (2001)

Abuse” under § 46-451 and § 13-3623 means the intentional infliction of physical harm; injury caused by negligent acts or omissions; unreasonable confinement; sexual abuse or sexual assault.

Defined separately under § 13-3623: Emotional abuse means a pattern of ridiculing or demeaning a vulnerable adult, making derogatory remarks to a vulnerable adult, verbally harassing a vulnerable adult, or threatening to inflict physical or emotional harm on a vulnerable adult. Physical injury means the impairment of physical condition and includes any skin bruising, pressure sores, bleeding, failure to thrive, malnutrition, dehydration, burns, fracture of any bone, subdural hematoma, soft tissue swelling, injury to any internal organ, or any physical condition that imperils health or welfare.

Neglect” under § 46-451 means a pattern of conduct without the person’s informed consent resulting in deprivation of food, water, medication, medical services, shelter, cooling, heating, or other services necessary to maintain minimum physical or mental health.

Exploitation” under § 46-451 means the illegal or improper use of an incapacitated or vulnerable adult or his resources for another’s profit or advantage.

Vulnerable adult” under § 46-451 and § 13-3623 means an individual who is 18 years of age or older who is unable to protect himself from abuse, neglect, or exploitation by others because of a physical or mental impairment.

ARKANSAS: A.C.A. § 5-28-101 (2001)

Abuse” means any intentional or unnecessary physical act which inflicts pain on or causes injury to endangered or impaired adult, including sexual abuse; or any intentional or demeaning act which subjects an endangered or impaired adult to ridicule; or psychological injury in manner likely to provoke fear or harm.

Defined separately: Sexual abuse means deviate sexual activity, sexual contact, or sexual intercourse, as those terms are defined in § 5-14-101, with another person who is not the actor’s spouse and who is incapable of

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

consent because he or she is mentally defective, mentally incapacitated, or physically helpless, as those terms are defined in § 5-14-101.

Neglect” means acts or omissions by an endangered adult; for example, self-neglect or intentional acts or omissions by a caregiver responsible for the care and supervision of an endangered or impaired adult constituting: (a) Negligently failing to provide necessary treatment, rehabilitation, care, food, clothing, shelter, supervision, or medical services to an endangered or impaired adult; (b) Negligently failing to report health problems or changes in health problems or changes in the health condition of an endangered or impaired adult to the appropriate medical personnel; or (c) Negligently failing to carry out a prescribed treatment plan.

Exploitation” means the illegal use or management of endangered or impaired adult’s funds, assets, or property, or the use of an endangered or impaired adult’s person, power of attorney, or guardianship for the profit or advantage of himself, herself, or another.

Endangered adult” means an adult 18 years of age or older who is found to be in a situation or condition which poses an imminent risk of death or serious bodily harm to that person and who demonstrates a lack of capacity to comprehend the nature and consequences of remaining in that situation or condition; or a resident 18 years of age or older of a long-term care facility which is required to be licensed under § 20-10-224, who is found to be in a situation or condition which poses imminent risk of death or serious bodily harm to the person and who demonstrates the lack of capacity to comprehend the nature and consequences of remaining in that situation or condition. “Impaired adult” means a person 18 years or older who, as a result of mental or physical impairment, is unable to protect himself or herself from abuse, sexual abuse, neglect, or exploitation, and as a consequence thereof is endangered.

Caregiver” means a related or unrelated person, owner, agent, high managerial agent of a public or private organization, or public or private organization that has responsibility for protection, care, or custody of an endangered or impaired adult as a result of assuming the responsibility voluntarily, by contract, through employment, or by order of the court.

CALIFORNIA: Cal. Wel. & Inst. Code §§ 15610.07, 15610.30, 15610.57 (2001); Cal. Pen. Code § 368 (2001)

Abuse of an elder or dependent adult” under § 15610.07 includes physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

treatment with resulting physical harm or pain or mental suffering; the deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering.

“Abuse” under Cal. Pen. Code § 368 occurs when any person who, under circumstances or conditions likely to produce great bodily harm or death, willfully causes or permits any elder or dependent adult, with knowledge that he or she is an elder or a dependent adult, to suffer, or inflicts thereon unjustifiable physical pain or mental suffering, or having the care or custody of any elder or dependent adult, willfully causes or permits the person or health of the elder or dependent adult to be injured, or willfully causes or permits the elder or dependent adult to be placed in a situation in which his or her person or health is endangered.

Neglect” under § 15610.17 includes (1) negligent failure of any person having the care or custody of elder of a dependent adult to exercise that degree of care that a reasonable person in a like position would exercise; (2) negligent failure of person themselves to exercise that degree of care that a reasonable person in a like position would exercise.

Financial abuse” under § 15610.30 occurs when a person or entity does any of the following: (1) Takes, secretes, appropriates, or retains real or personal property of an elder or dependent adult to a wrongful use or with intent to defraud, or both; (2) assists in taking, secreting, appropriating, or retaining real or personal property of an elder or dependent adult to a wrongful use or with intent to defraud, or both.

Elder” under Cal. Pen. Code § 368 means any person residing in this state, 65 years of age or older.

Dependent adult” under Cal. Pen. Code § 368 means any person residing in this state, between the ages of 18 and 64 years, who has physical or mental limitations that restrict his or her ability to carry out normal activities or to protect his or her rights including, but not limited to, persons who have physical or developmental disabilities or whose physical or mental abilities have diminished because of age; includes any person between the ages of 18 and 64 who is admitted as an inpatient to a 24-hour health facility, as defined in Sections 1250, 1250.2, and 1250.3 of the Health and Safety Code.

Caretaker” under Cal. Pen. Code § 368 means any person who has the care, custody, or control of, or who stands in a position of trust with, an elder or a dependent adult.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

COLORADO: C.R.S. §§ 18-6.5-102, 26-3.1-101 (2001)

Mistreatment” under § 26-3.1-101 means an act or omission which threatens health, safety, or welfare of an at-risk adult…or which exposes the adult to a situation or condition that poses an imminent risk of death, serious bodily injury or bodily injury to the adult. Includes but is not limited to (a) Abuse which occurs: (I) Where there is infliction of physical pain or injury, as demonstrated by, but not limited to, substantial or multiple skin bruising, bleeding, malnutrition, dehydration, burns, bone fractures, poisoning, subdural hematoma, soft tissue swelling, or suffocation; (II) Where unreasonable confinement or restraint is imposed; or (III) Where there is subjection to nonconsensual sexual conduct or contact classified as a crime under the “Colorado Criminal Code” title 18, C.R.S; (b) Caretaker neglect which occurs when adequate food, clothing, shelter, psychological care, physical care, medical care, or supervision is not secured for the at-risk adult or is not provided by a caretaker in a timely manner and with the degree of care that a reasonable person in the same situation would exercise; except that the withholding of artificial nourishment in accordance with the “Colorado Medical Treatment Decision Act,” article 18 of title 15, C.R.S., shall not be considered as abuse; (c) Exploitation which is the illegal or improper use of an at-risk adult for another person’s advantage.

Caretaker neglect” under § 26-3.1-101 and § 18-6.5-102 occurs when adequate food, clothing, shelter, psychological care, physical care, medical care, or supervision is not secured for the at-risk adult or is not provided by a caretaker in a timely manner and with degree of care that a reasonable person in the same situation would exercise. Self-neglect (defined separately): act or failure to act whereby an at-risk adult substantially endangers the adult’s health, safety, welfare, or life by not seeking or obtaining services necessary to meet the adult’s essential human needs. Choice of lifestyle or living arrangements shall not, by itself, be evidence of self-neglect:

Exploitation” under § 26-3.1-101 means the illegal or improper use of an at-risk adult for another person’s advantage.

At-risk adult” under § 26-3.1-101 means an individual 18 years of age or older who is susceptible to mistreatment …or self-neglect as such term is defined because individual is unable to perform or obtain services necessary for individual’s health, safety, or welfare or lacks sufficient understanding or capacity to make or communicate responsible decisions concerning the individual’s person or affairs. “At-risk adult” under § 18-6.5-102 means any person who is 60 years of age or older or any person who is 18 years of age or older and is a person with a disability.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Caretaker” under § 26-3.1-101 means a person who is responsible for care of at-risk adult as a result of family or legal relationship or who has assumed responsibility for the care of an at-risk adult.

CONNECTICUT: Conn. Gen. Stat. § 17b-450 (2001)

Abuse” includes, but is not limited to, willful infliction of physical pain, injury, or mental anguish, or the willful deprivation by a caretaker of services which are necessary to maintain physical or mental health.

Neglect” refers to an elderly person who is either living alone and not able to provide for oneself the services which are necessary to maintain physical and mental health or is not receiving the said necessary services from the responsible caretaker.

Exploitation” refers to the act or process of taking advantage of an elderly person by another person or caretaker whether for monetary, personal, or other benefit, gain, or profit.

Elderly person” means a resident of Connecticut who is 60 years of age or older.

Caretaker” means a person who has the responsibility for the care of an elderly person as a result of a family relationship or who has assumed the responsibility for the care of the elderly voluntarily, by contract, or by order of a court of competent jurisdiction.

DELAWARE: 31 Del. C. § 3902 (2000); 16 De. C. § 1131 (2000)

Abuse” under § 3902 includes physical abuse by unnecessarily inflicting pain or injury on an infirm adult; or a pattern of emotional abuse, which includes, but is not limited to, ridiculing or demeaning an infirm adult, making derogatory remarks to an infirm adult, or cursing or threatening to inflict physical or emotional harm on an infirm adult.

INSTITUTIONAL ABUSE: “Abuse” under § 1131 includes (a) physical abuse by unnecessarily inflicting pain or injury to a patient or resident. This includes, but is not limited to hitting, kicking, . . . sexual molestation; (b) emotional abuse which includes, but is not limited to, ridiculing or demeaning a patient or resident, making derogatory remarks to a patient or resident, or cursing directed toward

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

patient or resident, or threatening to inflict physical or emotional harm on a patient. Mistreatment shall include the inappropriate use of meds, isolation, or physical or chemical restraints on or of a patient or resident.

Neglect” under § 3902 includes (a) lack of attention by a caregiver to physical needs of an infirm adult including but not limited to toileting, bathing, meals, and safety; (b) failure by a caregiver to carry out a treatment plan prescribed by a health care professional for an infirm adult; or (c) intentional and permanent abandonment or desertion in any place of an infirm adult by a caregiver who does not make reasonable efforts to ensure that essential services, as defined in this section, will be provided for said infirm adult.

INSTITUTIONAL NEGLECT: “Neglect” under § 1131 means (a) lack of attention to physical needs of the patient or resident including, but not limited to toileting, bathing, meals, and safety; (b) failure to report patient or resident health problems or changes in health problems or changes in health condition to an immediate supervisor or nurse; (c) failure to carry out a prescribed treatment plan for a patient or resident; (d) a knowing failure to provide adequate staffing which results in a medical emergency to any patient or resident where there has been documented history of at least 2 prior cited instances of such inadequate staffing within the past 2 years in violation of minimum maintenance of staffing levels as required by statute or regulations promulgated by the Department, all so as to evidence a willful pattern of such neglect.

“Exploitation” under both § 3902 and § 1131: Illegal or improper use or abuse of an infirm person, the infirm person’s resources or the infirm person’s rights, by another person, whether for profit or other advantage.

“Infirm adult” under § 3902: Any person 18 years of age or over who, because of physical or mental disability, is substantially impaired in the ability to provide adequately for the person’s own care and custody.

“Caregiver” under § 3902 means any adult who has assumed the permanent or temporary care, custody, or responsibility for the supervision of an infirm adult.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

DISTRICT OF COLUMBIA: D.C. Code § 6-2501 (2001)

Abuse” means intentional or reckless infliction of serious physical pain or injury; use or threatened use of violence to force participation in sexual conduct; repeated intentional imposition of unreasonable confinement, resulting in severe mental distress; repeated use of threats or violence, resulting in shock or an intense, expressed fear for one’s life or of serious physical injury; or intentional or deliberately indifferent deprivation of essential food, shelter, or health care in violation of a caregiver’s responsibilities, when that deprivation constitutes a serious threat to one’s life or physical health.

Neglect” includes (a) the repeated, careless infliction of serious physical pain or injury; (b) the repeated failure of a caregiver to take reasonable steps, within the purview of his or her responsibilities, to protect against acts of abuse; (c) the repeated, careless imposition of unreasonable confinement, resulting in severe mental distress; or (d) the careless deprivation of essential food, shelter, or health care in violation of a caregiver’s responsibilities, when that deprivation constitutes a serious threat to one’s life or physical health.

Exploitation” means the unlawful appropriation or use of another’s property for one’s own benefit or that of a third person.

Adult in need of protective services” means an individual aged 18 or older who is: highly vulnerable to abuse, neglect, or exploitation, because of a physical or mental impairment; being or has recently been abused, neglected, or exploited by another; and likely to continue being abused, neglected, or exploited by others because he or she has no one willing and able to provide adequate protection.

Caregiver” means a person that, by law, contract, court order, or voluntary action, is charged with or has assumed the responsibility for an adult’s essential food, shelter, or health care needs.

FLORIDA: Fla. Stat. § 415.102 (2000); Fla. Stat. § 825.102 (2001)

Abuse” under § 415.102: Willful act or threatened act that causes or is likely to cause significant impairment to a vulnerable adult’s physical, mental, or emotional health. Abuse includes acts and omissions.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Defined separately: Sexual abuse defined separately: means acts of a sexual nature committed in the presence of a vulnerable adult without that person’s informed consent. Sexual abuse includes, but is not limited to, the acts defined in § 794.011(1)(h), fondling, exposure of a vulnerable adult’s sexual organs, or the use of a vulnerable adult to solicit for or engage in prostitution or sexual performance. Sexual abuse does not include any act intended for a valid medical purpose or any act that may reasonably be construed to be normal caregiving action or appropriate display of affection.

Abuse” under § 825.102: (a) Intentional infliction of physical or psychological injury upon an elderly person or disabled adult; (b) An intentional act that could reasonably be expected to result in physical or psychological injury to an elderly person or disabled adult; or (c) Active encouragement of any person to commit an act that results or could reasonably be expected to result in physical or psychological injury to an elderly person or disabled adult.

Neglect” under § 415.102 and § 825.102: Failure or omission on the part of the caregiver to provide the care, supervision, and services necessary to maintain the physical and mental health of the vulnerable adult, including, but not limited to, food, clothing, medicine, shelter, supervision, and medical services, that a prudent person would consider essential for the well-being of a vulnerable adult. The term “neglect” also means the failure of a caregiver to make a reasonable effort to protect a vulnerable adult from abuse, neglect, or exploitation by others. “Neglect” is repeated conduct or a single incident of carelessness which produces or could reasonably be expected to result in serious physical or psychological injury or a substantial risk of death.

Exploitation” under § 415.102 occurs when a person who: 1. Stands in a position of trust and confidence with a vulnerable adult and knowingly, by deception or intimidation, obtains or uses, or endeavors to obtain or use, a vulnerable adult’s funds, assets, or property with the intent to temporarily or permanently deprive a vulnerable adult of the use, benefit, or possession of the funds, assets, or property for the benefit of someone other than the vulnerable adult; or 2. Knows or should know that the vulnerable adult lacks the capacity to consent, and obtains or uses, or endeavors to obtain or use, the vulnerable adult’s funds, assets, or property with the intent to temporarily or permanently deprive the vulnerable adult of the use, benefit, or possession of the funds, assets, or property for the benefit of someone other than the vulnerable adult; “Exploitation” may include, but is not limited to: 1. Breaches of fiduciary relationships, such as the misuse of a

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

power of attorney or the abuse of guardianship duties, resulting in the unauthorized appropriation, sale, or transfer of property; 2. Unauthorized taking of personal assets; 3. Misappropriation, misuse, or transfer of moneys belonging to a vulnerable adult from a personal or joint account; or 4. Intentional or negligent failure to effectively use a vulnerable adult’s income and assets for the necessities required for that person’s support and maintenance.

Vulnerable adult” under § 415.102 means a person 18 years of age or older whose ability to perform the normal activities of daily living or to provide for his or her own care or protection is impaired due to a mental, emotional, physical, or developmental disability or dysfunctioning, or brain damage, or the infirmities of aging.

Caregiver” under § 415.102 means a person who has been entrusted with or has assumed the responsibility for frequent and regular care of or services to a vulnerable adult on a temporary or permanent basis and who has a commitment, agreement, or understanding with that person or that person’s guardian that a caregiver role exists. “Caregiver” includes, but is not limited to, relatives, household members, guardians, neighbors, and employees and volunteers of facilities as defined in subsection (8). For the purpose of departmental investigative jurisdiction, the term “caregiver” does not include law enforcement officers or employees of municipal or county detention facilities or the Department of Corrections while acting in an official capacity.

GEORGIA: O.C.G.A. §§ 30-5-3, 31-8-81 (2000)

Abuse” under § 30-5-3 means willful infliction of physical pain, physical injury, mental anguish, unreasonable confinement, or the willful deprivation of essential services to a disabled adult or elder person.

INSTITUTIONAL ABUSE “Abuse” under § 31-8-81 means any intentional or grossly negligent act or series of acts or intentional or grossly negligent omission to act which causes injury to a resident, including, but not limited to, assault or battery, failure to provide treatment or care, or sexual harassment of the resident.

Neglect” under § 30-5-3 means absence or omission of essential services to the degree that it harms or threatens with harm the physical or emotional health of a disabled adult or elder person.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Exploitation” under § 30-5-3 means illegal or improper use of a disabled adult or elder person or that person’s resources for another’s profit or advantage.

Elder person” under § 30-5-3 means a person 65 years of age or older who is not a resident of a long-term care facility as defined in Article 4 of Chapter 8 of Title 31.

Caretaker” under § 30-5-3 means a person who has the responsibility for the care of a disabled adult or elder person as a result of family relationship, contract, voluntary assumption of that responsibility, or by operation of law.

HAWAII: HRS § 346-222 (2000)

Abuse” means actual or imminent physical injury, psychological abuse or neglect, sexual abuse, financial exploitation, negligent treatment, or maltreatment as further defined in this chapter.

“Neglect” includes the failure to exercise that degree of care toward a dependent adult which a reasonable person with the responsibility of a caregiver would exercise, including, but not limited to, failure to: (A) Assist in personal hygiene; (B) Provide necessary food, shelter, and clothing; (C) Provide necessary health care, access to health care, or prescribed medication; (D) Protect a dependent adult from health and safety hazards.

“Financial and economic exploitation” means the wrongful or negligent taking, withholding, misappropriation, or use of a dependent adult’s money, real property, or personal property; includes but is not limited to: (A) Breaches of fiduciary relationships such as the misuse of a power of attorney or the abuse of guardianship privileges, resulting in the unauthorized appropriation, sale, or transfer of property; (B) The unauthorized taking of personal assets; (C) The misappropriation, misuse, or transfer of moneys belonging to the dependent adult from a personal or joint account; or (D) The intentional or negligent failure to effectively use a dependent adult’s income and assets for the necessities required for the person’s support and maintenance. The exploitation may involve coercion, manipulation, threats, intimidation, misrepresentation, or exertion of undue influence. Protect against acts of abuse by third parties.

Dependent adult” means any adult who, because of mental or physical

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

impairment is dependent upon another person, a care organization, or a care facility for personal health, safety, or welfare.

IDAHO: Idaho Code §§ 18-1505, 39-5302 (2000)

Abuse” under § 39-5302 and § 18-1505 means intentional or negligent infliction of physical pain, injury, or mental injury.

Neglect” under § 39-5302 includes self-neglect and means the failure of a caretaker to provide food, clothing, shelter, or medical care reasonably necessary to sustain the life and health of a vulnerable adult, or the failure of a vulnerable adult to provide those services for himself.

Neglect” under § 18-1505 means failure of a caretaker to provide food, clothing, shelter, or medical care to a vulnerable adult, in such a manner as to jeopardize the life, health and safety of the vulnerable adult.

Exploitation” under § 39-5302 and § 18-1505 means an action which may include, but is not limited to, the misuse of a vulnerable adult’s funds, property, or resources by another person for profit or advantage.

Vulnerable adult” under § 39-5302 and § 18-1505 means a person 18 years of age or older who is unable to protect himself from abuse, neglect ,or exploitation due to physical or mental impairment which affects the person’s judgment or behavior to the extent that he lacks sufficient understanding or capacity to make or communicate or implement decisions regarding his person.

Caretaker” under § 39-5302 and § 18-1505 means any individual or institution that is responsible by relationship, contract, or court order to provide food, shelter, or clothing, medical or other life-sustaining necessities to a vulnerable adult.

ILLINOIS: 320 ILCS 20/2 (2001); 320 ILCS 15/2 (2001); 210 ILCS 30/3 (2001); 210 ILCS 45/1-103 (2001); 720 ILCS 5/12-19 (2001)

Abuse” under 320 ILCS 20/2 means causing any physical, mental, or sexual injury to an eligible adult, including exploitation of such adult’s financial resources.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Abuse” under 320 ILCS 15/2 means intentionally or knowingly causing any physical injury or exploiting the resources of an elderly individual.

INSTITUTIONAL ABUSE: “Abuse” under 210 ILCS 30/3 means any physical injury, sexual abuse, or mental injury inflicted on a resident other than by accidental means.

Abuse” under 210 ILCS 45/1-103 means any physical or mental injury or sexual assault inflicted on a resident other than by accidental means in a facility.

Abuse” under 720 ILCS 5/12-19 means intentionally or knowingly causing any physical or mental injury or committing any sexual offense set forth in this Code.

Neglect” under 320 ILCS 20/2 means another individual’s failure to provide an eligible adult with or willful withholding from an eligible adult the necessities of life including, but not limited to, food, clothing, shelter, or medical care. This subsection does not create any new affirmative duty to provide support to eligible adults. Nothing in this Act shall be construed to mean that an eligible adult is a victim of neglect because of health care services provided or not provided by licensed health care professionals.

INSTITUTIONAL NEGLECT: “Neglect” under 210 ILCS 30/3, 210 ILCS 45/1-117, and 720 ILCS 5/12-19 means a failure in a long-term care facility to provide adequate medical or personal care or maintenance, which failure results in physical or mental injury to a resident or in the deterioration of a resident’s physical or mental condition.

Gross Neglect” under 720 ILCS 5/12-19 means recklessly failing to provide adequate medical or personal care or maintenance, which failure results in physical or mental injury or the deterioration of a physical or mental condition.

Eligible adult” under 320 ILCS 20/2 means a person 60 years of age or older who resides in a domestic living situation and is, or is alleged to be, abused, neglected, or financially exploited by another individual.

Elderly Individual” under 320 ILCS 15/2 means a person 60 years of age or older.

Resident” under 210 ILCS 30/3 means a person residing in and receiving personal care from a long-term care facility, or residing in a mental health

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

facility or developmental disability facility as defined in the Mental Health and Developmental Disabilities Code.

Caregiver” under 320 ILCS 20/2 means a person who either as a result of a family relationship, voluntarily, or in exchange for compensation has assumed responsibility for all or a portion of the care of an eligible adult who needs assistance with activities of daily living.

INDIANA: Burns Ind. Code Ann. § 12-10-3-2 (2000); Burns Ind. Code Ann. § 35-46-1-12 (2001)

Exploitation of endangered adult” under § 35-46-1-12 occurs when a person who recklessly, knowingly, or intentionally exerts unauthorized use of personal services or the property of an endangered adult for the person’s own profit or advantage or for the profit or advantage of another person.

Endangered adult” under § 12-10-3-2 means an individual who is: (1) at least 18 years of age; (2) incapable by reason of mental illness, mental retardation, dementia, habitual drunkenness, excessive use of drugs, or other physical or mental incapacity of managing or directing the management of the individual’s property or providing or directing the provision of self-care; and (3) harmed or threatened with harm as a result of: (A) neglect; (B) battery; or (C) exploitation of the individual’s personal services or property.

IOWA: Iowa Code §§ 235B.2, 726.7, 726.8 (2001)

Dependent adult abuse” under § 235B.2 means: (1) Any of the following as a result of the willful or negligent acts or omissions of a caretaker: (a) Physical injury to, or injury which is at a variance with the history given of the injury, or unreasonable confinement, unreasonable punishment, or assault of a dependent adult. (b) The commission of a sexual offense under chapter 709 or section 726.2 with or against a dependent adult. (c) Exploitation of a dependent adult which means the act or process of taking unfair advantage of a dependent adult or the adult’s physical or financial resources for one’s own personal or pecuniary profit, without the informed consent of the dependent adult, including theft, by the use of undue influence, harassment, duress, deception, false representation, or false pretenses. (d) The deprivation of the minimum food, shelter, clothing, supervision, physical or mental health care, or other care necessary to maintain a dependent adult’s life or health. (2) The deprivation of the minimum food, shel-

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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ter, clothing, supervision, physical or mental health care, and other care necessary to maintain a dependent adult’s life or health as a result of the acts or omissions of the dependent adult. (3) Sexual exploitation of a dependent adult who is a resident of a health care facility, as defined in section 135C.1, by a caretaker providing services to or employed by the health care facility, whether within the health care facility or at a location outside of the health care facility.

Defined separately: Sexual exploitation means any consensual or nonconsensual sexual conduct with a dependent adult for the purpose of arousing or satisfying the sexual desires of the caretaker or dependent adult, which includes but is not limited to kissing; touching of the clothed or unclothed inner thigh, breast, groin, buttock, anus, pubes, or genitals; or a sex act, as defined in section 702.17. Sexual exploitation does not include touching which is part of a necessary examination, treatment, or care by a caretaker acting within the scope of the practice or employment of the caretaker; the exchange of a brief touch or hug between the dependent adult and a caretaker for the purpose of reassurance, comfort, or casual friendship; or touching between spouses.

Neglect” under § 235B.2 is defined within “abuse” definition.

Wanton neglect or nonsupport of a dependent adult” under § 726.8 occurs when a caretaker knowingly acts in a manner likely to be injurious to the physical, mental, or emotional welfare of a dependent adult.

INSTITUTIONAL NEGLECT: “Wanton neglect of a resident of a health care facility” under § 726.7 occurs when a person knowingly acts in a manner likely to be injurious to the physical or mental welfare of a resident of a health care facility as defined in § 135C.1.

“Exploitation” under § 235B.2 is defined within “abuse” definition.

Dependent adult” means a person 18 years of age or older who is unable to protect the person’s own interests or unable to adequately perform or obtain services necessary to meet essential human needs, as a result of a physical or mental condition which requires assistance from another, or as defined by departmental rule.

Caretaker” means a related or nonrelated person who has the responsibility for the protection, care, or custody of a dependent adult as a result of

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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assuming the responsibility voluntarily, by contract, through employment, or by order of the court.

KANSAS: K.S.A. §§ 39-1401, 39-1430 (2000)

Abuse” under § 39-1430 and § 39-1401 means any act or failure to act performed intentionally or recklessly that causes or is likely to cause harm to an adult, including: (1) Infliction of physical or mental injury; (2) any sexual act with an adult when the adult does not consent or when the other person knows or should know that the adult is incapable of resisting or declining consent to the sexual act due to mental deficiency or disease or due to fear of retribution or hardship; (3) unreasonable use of a physical restraint, isolation, or medication that harms or is likely to harm an adult; (4) unreasonable use of a physical or chemical restraint, medication, or isolation as punishment, for convenience, in conflict with a physician’s orders or as a substitute for treatment, except where such conduct or physical restraint is in furtherance of the health and safety of the adult; (5) a threat or menacing conduct directed toward an adult that results or might reasonably be expected to result in fear or emotional or mental distress to an adult; (6) fiduciary abuse; or (7) omission or deprivation by a caretaker or another person of goods or services which are necessary to avoid physical or mental harm or illness.

“Neglect” under § 39-1430 and § 39-1401 means the failure or omission by one’s self, caretaker, or another person to provide goods or services which are reasonably necessary to ensure safety and well-being and to avoid physical or mental harm or illness.

“Exploitation” under § 39-1430 and § 39-1401 means misappropriation of an adult’s property or intentionally taking unfair advantage of an adult’s physical or financial resources for another individual’s personal or financial advantage by the use of undue influence, coercion, harassment, duress, deception, false representation or false pretense by a caretaker or another person. (e) “Fiduciary abuse” means a situation in which any person who is the caretaker of, or who stands in a position of trust to, an adult, takes, secretes, or appropriates their money or property, to any use or purpose not in the due and lawful execution of such person’s trust.

Adult” under § 39-1430 means an individual 18 years of age or older alleged to be unable to protect their own interest and who is harmed or threatened with harm through action or inaction by either another individual or through their own action or inaction when (1) such person is

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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residing in such person’s own home, the home of a family member or the home of a friend, (2) such person resides in an adult family home as defined in K.S.A. § 39-1501 and amendments thereto, or (3) such person is receiving services through a provider of community services and affiliates thereof operated or funded by the department of social and rehabilitation services or the department on aging or a residential facility licensed pursuant to K.S.A. § 75-3307b and amendments thereto. Such term shall not include persons to whom K.S.A. § 39-1401 et seq. and amendments thereto apply.

“Resident” under § 39-1401 means (1) Any resident, as defined by K.S.A. § 39-923 and amendments thereto; or (2) any individual kept, cared for, treated, boarded or otherwise accommodated in a medical care facility; or (3) any individual, kept, cared for, treated, boarded or otherwise accommodated in a state psychiatric hospital or state institution for the mentally retarded.

Caretaker” under § 39-1430 means a person who has assumed the responsibility for an adult’s care or financial management or both.

“Caretaker” under § 39-1401 means a person or institution who has assumed the responsibility for the care of the resident voluntarily, by contract or by order of a court of competent jurisdiction.

KENTUCKY: KRS §§ 209.020, 508.090 (2001)

Abuse” under § 209.020 means the infliction of physical pain, mental injury, or injury of an adult.

Abuse” under § 508.090 means the infliction of physical pain, injury, or mental injury, or the deprivation of services by a person which are necessary to maintain the health and welfare of a person, or a situation in which an adult, living alone, is unable to provide or obtain for himself the services which are necessary to maintain his health or welfare.

“Neglect” under § 209.020 means a situation in which an adult is unable to perform or obtain for himself the services which are necessary to maintain his health or welfare, or the deprivation of services by a caretaker which are necessary to maintain the health and welfare of an adult, or a situation in which a person deprives his spouse of reasonable services to maintain health and welfare.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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“Exploitation” under § 209.020 means the improper use of an adult or an adult’s resources by a caretaker or other person for the profit or advantage of the caretaker or other person.

“Adult” under § 209.020 means: (a) A person 18 years of age or older, who, because of mental or physical dysfunctioning, is unable to manage his own resources or carry out the activity of daily living or protect himself from neglect, or a hazardous or abusive situation without assistance from others, and who may be in need of protective services; or (b) a person without regard to age who is the victim of abuse and neglect inflicted by a spouse.

Caretaker” under § 209.020 means an individual or institution who has the responsibility for the care of the adult as a result of family relationship, or who has assumed the responsibility for the care of the adult person voluntarily, or by contract, or agreement.

LOUISIANA: La. R.S. §§ 14:403.2, 46:61 (2001)

Abuse” under La. R.S. § 14:403.2 is the infliction of physical or mental injury on an adult by other parties, including but not limited to such means as sexual abuse, abandonment, isolation, exploitation, or extortion of funds or other things of value, to such an extent that his health, self-determination, or emotional well-being is endangered.

Defined separately: Abandonment is the desertion or willful forsaking of an adult by anyone having care or custody of that person under circumstances in which a reasonable person would continue to provide care and custody. Isolation includes: (a) Intentional acts committed for the purpose of preventing, and which do serve to prevent, an adult from having contact with family, friends, or concerned persons. This shall not be construed to affect a legal restraining order. (b) Intentional acts committed to prevent an adult from receiving his mail or telephone calls. (c) Intentional acts of physical or chemical restraint of an adult committed for the purpose of preventing contact with visitors, family, friends, or other concerned persons. (d) Intentional acts which restrict, place, or confine an adult in a restricted area for the purposes of social deprivation or preventing contact with family, friends, visitors, or other concerned persons. However, medical isolation prescribed by a licensed physician caring for the adult shall not be included in this definition.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Elderly abuse” under § 46:61 means abuse of any person 60 years of age or older and shall include the abuse of any infirm person residing in a state licensed facility.

Neglect” under § 14:403.2 is the failure, by a caregiver responsible for an adult’s care or by other parties, to provide the proper or necessary support or medical, surgical, or any other care necessary for his well-being. No adult who is being provided treatment in accordance with a recognized religious method of healing in lieu of medical treatment shall for that reason alone be considered to be neglected or abused.

Exploitation” under § 14:403.2 is the illegal or improper use or management of an aged person’s or disabled adult’s funds, assets, or property, or the use of an aged person’s or disabled adult’s power of attorney or guardianship for one’s own profit or advantage.

Adult” under § 14:403.2 is any person 60 years of age or older, any disabled person 18 years of age or older, or an emancipated minor.

Caregiver” under § 14:403.2 is any person or persons, either temporarily or permanently, responsible for the care of an aged person or a physically or mentally disabled adult. Caregiver includes but is not limited to adult children, parents, relatives, neighbors, day care personnel, adult foster home sponsors, personnel of public and private institutions and facilities, adult congregate living facilities, and nursing homes which have voluntarily assumed the care of an aged person, or disabled adult, have assumed voluntary residence with an aged person or disabled adult, or have assumed voluntary use or tutelage of an aged or disabled person’s assets, funds, or property, and specifically shall include city, parish, or state law enforcement agencies.

MAINE: 22 M.R.S. § 3472 (2000)

Abuse” means the infliction of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical harm or pain or mental anguish; sexual abuse or exploitation; or the willful deprivation of essential needs.

Defined separately: Sexual abuse or exploitation means contact or interaction of a sexual nature involving an incapacitated or dependent adult without that adult’s consent.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Neglect” means a threat to an adult’s health or welfare by physical or mental injury or impairment, deprivation of essential needs or lack of protection from these.

Exploitation” means the illegal or improper use of an incapacitated or dependent adult or his resources for another’s profit or advantage.

Dependent adult” means any adult who is wholly or partially dependent upon one or more other persons for care or support, either emotional or physical, and who would be in danger if that care or support were withdrawn.

Caretaker” means any individual or institution who has or assumes the responsibility for the care of an adult.

MARYLAND: Md. Family Law Code Ann. § 14-101 (2001); Md. Ann. Code Art. 27, § 35D (2001); Md. Health General Code Ann. § 19-347 (2001)

Abuse” under § 14-101 means the sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by any person.

Abuse” under Art. 27, § 35D means (i) the sustaining of any physical pain or injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by a caregiver, a parent, or other person who has permanent or temporary care or custody or responsibility for the supervision of a vulnerable adult, or by any household or family member under circumstances that indicate that the vulnerable adult’s health or welfare is harmed or threatened. (ii) Abuse” includes the sexual abuse of a vulnerable adult. (iii) “Abuse” does not include the performance of an accepted medical or behavioral procedure ordered by a health care provider acting within the scope of the health care provider’s practice.

INSTITUTIONAL ABUSE: “Abuse” under § 19-347 means the nontherapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce or resulting in mental or emotional distress; “Abuse” does not include the performance of an accepted medical procedure that a physician orders.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Neglect” under § 14-101 means the willful deprivation of a vulnerable adult of adequate food, clothing, essential medical treatment or rehabilitative therapy, shelter, or supervision.

Neglect” under Art. 27, § 35D means intentional failure to provide necessary assistance and resources for the physical needs of the vulnerable adult, including food, clothing, toileting, essential medical treatment, shelter, or supervision.

Exploitation” under § 14-101 means any action which involves the misuse of a vulnerable adult’s funds, property, or person.

Vulnerable adult” under § 14-101 and Art. 27, § 35D means an adult who lacks the physical or mental capacity to provide for the adult’s daily needs.

Caregiver” under Art. 27, § 35D means a person under a duty to care for a vulnerable adult because of a contractual undertaking to provide care.

MASSACHUSETTS: Mass. Ann. Laws Ch. 19A § 14 (2001); Mass. Ann. Laws Ch. 111 § 72F (2001)

Abuse” under Ch. 19A § 14 means an act or omission which results in serious physical or emotional injury to an elderly person or financial exploitation of an elderly person; provided, however, that no person shall be considered to be abused or neglected for the sole reason that such person is being furnished or relies upon treatment in accordance with the tenets and teachings of a church or religious denomination by a duly accredited practitioner thereof.

INSTITUTIONAL ABUSE: “Abuse” under Ch. 111 § 72F means the willful infliction of injury, unreasonable confinement, intimidation, including verbal or mental abuse, or punishment with resulting physical harm, pain, or mental anguish or assault and battery; provided, however, that verbal or mental abuse shall require a knowing and willful act directed at a specific person.

INSTITUTIONAL NEGLECT: “Neglect” under Ch. 111 § 72F means failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness.

“Financial exploitation” under Ch. 19A § 14 means an act or omission by another person, which causes a substantial monetary or property loss to an

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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elderly person, or causes a substantial monetary or property gain to the other person, which gain would otherwise benefit the elderly person but for the act or omission of such other person; provided, however, that such an act or omission shall not be construed as financial exploitation if the elderly person has knowingly consented to such act or omission unless such consent is a consequence of misrepresentation, undue influence, coercion or threat of force by such other person; and, provided further, that financial exploitation shall not be construed to interfere with or prohibit a bona fide gift by an elderly person or to apply to any act or practice in the conduct of any trade or commerce declared unlawful by section two of chapter ninety-three A.

Elderly person” under Ch. 19A § 14 means an individual who is 60 years of age or over.

“Resident” under Ch. 111 § 72F means an individual who resides in a long-term care facility licensed under section 71.

“Caretaker” under Ch. 19A § 14 means the person responsible for the care of an elderly person, which responsibility may arise as the result of a family relationship, or by a voluntary or contractual duty undertaken on behalf of an elderly person, or may arise by a fiduciary duty imposed by law.

MICHIGAN: MCLS §§ 400.11, 400.586k, 750.145n (2001)

Abuse” under § 400.11 means harm or threatened harm to an adult’s health or welfare caused by another person. Abuse includes, but is not limited to, nonaccidental physical or mental injury, sexual abuse, or maltreatment.

Abuse of older persons” under § 400.586k includes the following types of abuse involving an older person: physical abuse, emotional or social abuse, financial abuse, or environmental abuse.

Vulnerable adult abuse” under MCLS § 750.145n: (1) A caregiver is guilty of vulnerable adult abuse in the first degree if the caregiver intentionally causes serious physical harm or serious mental harm to a vulnerable adult. (2) A caregiver or other person with authority over the vulnerable adult is guilty of vulnerable adult abuse in the second degree if the reckless act or reckless failure to act of the caregiver or other person with authority over the vulnerable adult causes serious physical harm or serious mental harm to a vulnerable adult. (3) A caregiver is guilty of vulnerable adult

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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abuse in the third degree if the caregiver intentionally causes physical harm to a vulnerable adult. (4) A caregiver or other person with authority over the vulnerable adult is guilty of vulnerable adult abuse in the fourth degree if the reckless act or reckless failure to act of the caregiver or other person with authority over a vulnerable adult causes physical harm to a vulnerable adult.

Neglect” under § 400.11 means harm to an adult’s health or welfare caused by the inability of the adult to respond to a harmful situation or by the conduct of a person who assumes responsibility for a significant aspect of the adult’s health or welfare. Neglect includes the failure to provide adequate food, clothing, shelter, or medical care. A person shall not be considered to be abused, neglected, or in need of emergency or protective services for the sole reason that the person is receiving or relying upon treatment by spiritual means through prayer alone in accordance with the tenets and practices of a recognized church or religious denomination, and this act shall not require any medical care or treatment in contravention of the stated or implied objection of that person.

Exploitation” under § 400.11 means an action that involves the misuse of an adult’s funds, property, or personal dignity by another person.

Adult in need of protective services” or “adult” under § 400.11 means a vulnerable person not less than 18 years of age who is suspected of being or believed to be abused, neglected, or exploited. “Vulnerable” means a condition in which an adult is unable to protect himself or herself from abuse, neglect, or exploitation because of a mental or physical impairment or because of advanced age.

Vulnerable adult” under § 750.145 means 1 or more of the following: (i) An individual age 18 or over who, because of age, developmental disability, mental illness, or physical disability requires supervision or personal care or lacks the personal and social skills required to live independently. (ii) An adult as defined in section 3(1)(b) of the adult foster care facility licensing act, MCL 400.703. (iii) An adult as defined in section 11(b) of the social welfare act, MCL 400.11.

Caregiver” under § 750.145 means an individual who directly cares for or has physical custody of a vulnerable adult.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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MINNESOTA: Minn. Stat. § 626.5572 (2000)

Abuse” means: (a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate, or aiding and abetting a violation of: (1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224; (2) the use of drugs to injure or facilitate crime as defined in section 609.235; (3) the solicitation, inducement, and promotion of prostitution as defined in section 609.322; and (4) criminal sexual conduct in the first through fifth degrees as defined in sections 609.342 to 609.3451. A violation includes any action that meets the elements of the crime, regardless of whether there is a criminal proceeding or conviction. (b) Conduct which is not an accident or therapeutic conduct as defined in this section, which produces or could reasonably be expected to produce physical pain or injury or emotional distress including, but not limited to, the following: (1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable adult; (2) use of repeated or malicious oral, written, or gestured language toward a vulnerable adult or the treatment of a vulnerable adult which would be considered by a reasonable person to be disparaging, derogatory, humiliating, harassing, or threatening; (3) use of any aversive or deprivation procedure, unreasonable confinement, or involuntary seclusion, including the forced separation of the vulnerable adult from other persons against the will of the vulnerable adult or the legal representative of the vulnerable adult; and (4) use of any aversive or deprivation procedures for persons with developmental disabilities or related conditions not authorized under section 245.825. (c) Any sexual contact or penetration as defined in section 609.341, between a facility staff person or a person providing services in the facility and a resident, patient, or client of that facility. (d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the vulnerable adult’s will to perform services for the advantage of another. (e) For purposes of this section, a vulnerable adult is not abused for the sole reason that the vulnerable adult or a person with authority to make health care decisions for the vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section 253B.03 or 525.539 to 525.6199, refuses consent or withdraws consent, consistent with that authority and within the boundary of reasonable medical practice, to any therapeutic conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition of the vulnerable adult or, where permitted under law, to provide nutrition and hydration parenterally or through intubation. This paragraph does not enlarge or diminish rights otherwise held under law by: (1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an involved family member, to consent to or refuse consent for therapeutic conduct; or (2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct. (f) For

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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purposes of this section, a vulnerable adult is not abused for the sole reason that the vulnerable adult, a person with authority to make health care decisions for the vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care, provided that this is consistent with the prior practice or belief of the vulnerable adult or with the expressed intentions of the vulnerable adult. (g) For purposes of this section, a vulnerable adult is not abused for the sole reason that the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional dysfunction or undue influence, engages in consensual sexual contact with: (1) a person, including a facility staff person, when a consensual sexual personal relationship existed prior to the caregiving relationship; or (2) a personal care attendant, regardless of whether the consensual sexual personal relationship existed prior to the caregiving relationship.

Neglect” means (a) The failure or omission by a caregiver to supply a vulnerable adult with care or services, including but not limited to, food, clothing, shelter, health care, or supervision which is: (1) reasonable and necessary to obtain or maintain the vulnerable adult’s physical or mental health or safety, considering the physical and mental capacity or dysfunction of the vulnerable adult; and (2) which is not the result of an accident or therapeutic conduct. (b) The absence or likelihood of absence of care or services, including but not limited to, food, clothing, shelter, health care, or supervision necessary to maintain the physical and mental health of the vulnerable adult which a reasonable person would deem essential to obtain or maintain the vulnerable adult’s health, safety, or comfort considering the physical or mental capacity or dysfunction of the vulnerable adult.

Financial exploitation” means: (a) In breach of a fiduciary obligation recognized elsewhere in law, including pertinent regulations, contractual obligations, documented consent by a competent person, or the obligations of a responsible party under section 144.6501, a person: (1) engages in unauthorized expenditure of funds entrusted to the actor by the vulnerable adult which results or is likely to result in detriment to the vulnerable adult; or (2) fails to use the financial resources of the vulnerable adult to provide food, clothing, shelter, health care, therapeutic conduct or supervision for the vulnerable adult, and the failure results or is likely to result in detriment to the vulnerable adult. (b) In the absence of legal authority a person: (1) willfully uses, withholds, or disposes of funds or property of a vulnerable adult; (2) obtains for the actor or another the performance of services by a third person for the wrongful profit or advantage of the actor or another to the detriment of the vulnerable adult; (3) acquires possession or control of, or an interest in, funds or property of a vulnerable adult through the use of

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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undue influence, harassment, duress, deception, or fraud; or (4) forces, compels, coerces, or entices a vulnerable adult against the vulnerable adult’s will to perform services for the profit or advantage of another. (c) Nothing in this definition requires a facility or caregiver to provide financial management or supervise financial management for a vulnerable adult except as otherwise required by law.

Vulnerable adult” means any person 18 years of age or older who: (1) is a resident or inpatient of a facility; (2) receives services at or from a facility required to be licensed to serve adults under sections 245A.01 to 245A.15, except that a person receiving outpatient services for treatment of chemical dependency or mental illness, or one who is committed as a sexual psychopathic personality or as a sexually dangerous person under chapter 253B, is not considered a vulnerable adult unless the person meets the requirements of clause (4); (3) receives services from a home care provider required to be licensed under section 144A.46; or from a person or organization that exclusively offers, provides, or arranges for personal care assistant services under the medical assistance program as authorized under sections 256B.04, subdivision 16, 256B.0625, subdivision 19a, and 256B.0627; or (4) regardless of residence or whether any type of service is received, possesses a physical or mental infirmity or other physical, mental, or emotional dysfunction: (i) that impairs the individual’s ability to provide adequately for the individual’s own care without assistance, including the provision of food, shelter, clothing, health care, or supervision; and (ii) because of the dysfunction or infirmity and the need for assistance, the individual has an impaired ability to protect the individual from maltreatment.

Caregiver” means an individual or facility who has responsibility for the care of a vulnerable adult as a result of a family relationship, or who has assumed responsibility for all or a portion of the care of a vulnerable adult voluntarily, by contract, or by agreement.

MISSISSIPPI: Miss. Code Ann. § 43-47-5 (2001)

Abuse” shall mean the willful or nonaccidental infliction of physical pain, injury, or mental anguish on a vulnerable adult, the unreasonable confinement of a vulnerable adult, or the willful deprivation by a caretaker of services which are necessary to maintain the mental and physical health of a vulnerable adult. “Abuse” shall include sexual abuse. “Abuse” shall not mean conduct which is a part of the treatment and care of, and in furtherance of the health and safety of a patient or resident of a care facility. “Abuse” includes, but is not limited to, a single incident.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Neglect” shall mean either the inability of a vulnerable adult who is living alone to provide for himself the food, clothing, shelter, health care or other services which are necessary to maintain his mental and physical health, or failure of a caretaker to supply the vulnerable adult with the food, clothing, shelter, health care, supervision or other services which a reasonably prudent person would do to maintain the vulnerable adult’s mental and physical health. “Neglect” includes, but is not limited to, a single incident.

Exploitation” shall mean the illegal or improper use of a vulnerable adult or his resources for another’s profit or advantage with or without the consent of the vulnerable adult. “Exploitation” includes, but is not limited to, a single incident.

Vulnerable adult” shall mean a person 18 years of age or older or any minor whose ability to perform the normal activities of daily living or to provide for his or her own care or protection is impaired due to a mental, emotional, physical, or developmental disability or dysfunction, or brain damage or the infirmities of aging. The term “vulnerable adult” shall also include all residents or patients, regardless of age, in a care facility for the purposes of Sections 43-47-19 and 43-47-37 only. The department shall not be prohibited from investigating, and shall have the authority and responsibility to fully investigate, in accordance with the provisions of this chapter, any allegation of abuse, neglect, and/or exploitation regarding a patient in a care facility, if the alleged abuse, neglect, and/or exploitation occurred at a private residence.

Caretaker” shall mean an individual, corporation, partnership, or other organization which has assumed the responsibility for the care of a vulnerable adult, but shall not include the Division of Medicaid, a licensed hospital, or a licensed nursing home within the state.

MISSOURI: § 660.250 R.S. Mo. (2000); § 565.180 R.S. Mo. (2000); § 565.182 R.S. Mo. (2000); § 565.184 R.S. Mo. (2000); § 198.006 R.S.Mo. (2000)

Abuse” under § 660.250 means the infliction of physical, sexual, or emotional injury or harm including financial exploitation by any person, firm, or corporation.

Elder abuse” under § 565.180 occurs when a person attempts to kill, knowingly causes or attempts to cause serious physical injury, as defined in § 565.002, to any person 60 years of age or older or an eligible adult as

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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defined in § 660.250. It occurs under § 565.182 when a person (1) Knowingly causes, attempts to cause physical injury to any person 60 years of age or older or an eligible adult, as defined in § 660.250 by means of a deadly weapon or dangerous instrument; or (2) Recklessly and purposely causes serious physical injury, as defined in § 565.002, to a person 60 years of age or older or an eligible adult as defined in § 660.250. It occurs under § 565.184 when a person (1) Knowingly causes or attempts to cause physical contact with any person 60 years of age or older or an eligible adult as defined in § 660.250, knowing the other person will regard the contact as harmful or provocative; or (2) Purposely engages in conduct involving more than one incident that causes grave emotional distress to a person 60 years of age or older or an eligible adult, as defined in § 660.250. The course of conduct shall be such as would cause a reasonable person age 60 years of age or older or an eligible adult, as defined in § 660.250, to suffer substantial emotional distress; or (3) Purposely or knowingly places a person 60 years of age or older or an eligible adult, as defined in § 660.250 in apprehension of immediate physical injury; or (4) Intentionally fails to provide care, goods or services to a person 60 years of age or older or an eligible adult, as defined in § 660.250. The cause of the conduct shall be such as would cause a reasonable person age 60 or older or an eligible adult, as defined in § 660.250, to suffer physical or emotional distress; or (5) Knowingly acts or knowingly fails to act in a manner which results in a grave risk to the life, body, or health of a person 60 years of age or older or an eligible adult, as defined in § 660.250.

INSTITUTIONAL ABUSE: “Abuse” under § 198.006 means the infliction of physical, sexual, or emotional injury or harm.

Neglect” under § 660.250 means the failure to provide services to an eligible adult by any person, firm or corporation with a legal or contractual duty to do so, when such failure presents either an imminent danger to the health, safety, or welfare of the client or a substantial probability that death or serious physical harm would result.

INSTITUTIONAL NEGLECT: “Neglect” under § 198.006 means the failure to provide, by those responsible for the care, custody, and control of a resident in a facility, the services which are reasonable and necessary to maintain the physical and mental health of the resident, when such failure presents either an imminent danger to the health, safety, or welfare of the resident or a substantial probability that death or serious physical harm would result.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Eligible adult” under § 660.250 means a person 60 years of age or older or an adult with a handicap, as defined in § 660.053, between the ages of 18 and 59 who is unable to protect his own interests or adequately perform or obtain services which are necessary to meet his essential human needs.

Resident” under § 198.006 means a person who by reason of aging, illness, disease, or physical or mental infirmity receives or requires care and services furnished by a facility and who resides or boards in or otherwise kept, cared for, treated or accommodated in such facility for a period exceeding 24 consecutive hours.

MONTANA: Mont. Code Anno. § 52-3-803 (2001)

Abuse” means: (a) the infliction of physical or mental injury; or (b) the deprivation of food, shelter, clothing, or services necessary to maintain the physical or mental health of an older person or a person with a developmental disability without lawful authority. A declaration made pursuant to 50-9-103 constitutes lawful authority.

Defined separately: Sexual abuse means the commission of sexual assault, sexual intercourse without consent, indecent exposure, deviate sexual conduct, or incest.

Neglect” means the failure of a person who has assumed legal responsibility or a contractual obligation for caring for an older person or a person with a developmental disability or who has voluntarily assumed responsibility for the person’s care, including an employee of a public or private residential institution, facility, home, or agency, to provide food, shelter, clothing, or services necessary to maintain the physical or mental health of the older person or the person with a developmental disability.

Exploitation” means: (a) the unreasonable use of an older person or a person with a developmental disability or of a power of attorney, conservatorship, or guardianship with regard to an older person or a person with a developmental disability to obtain control of or to divert to the advantage of another the ownership, use, benefit, or possession of the person’s money, assets, or property by means of deception, duress, menace, fraud, undue influence, or intimidation with the intent or result of permanently depriving the older person or person with a developmental disability of the ownership, use, benefit, or possession of the person’s money, assets, or property; (b) an act taken by a person who has the trust and confidence of an older person or a person with a developmental disability to obtain control of or

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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to divert to the advantage of another the ownership, use, benefit, or possession of the person’s money, assets, or property by means of deception, duress, menace, fraud, undue influence, or intimidation with the intent or result of permanently depriving the older person or person with a developmental disability of the ownership, use, or benefit of the person’s money, assets, or property.

Older person” means a person who is at least 60 years of age. For purposes of prosecution under 52-3-825(2), the person 60 years of age or older must be unable to provide personal protection from abuse, sexual abuse, neglect, or exploitation because of a mental or physical impairment or because of frailties or dependencies brought about by advanced age. “Person with a developmental disability” means a person 18 years of age or older who has a developmental disability.

NEBRASKA: R.R.S. Neb. §§ 28-351, 28-353, 28-355, 28-358, 28-371 (2001)

Abuse” means any knowing, intentional, or negligent act or omission on the part of a caregiver, a vulnerable adult, or any other person which results in physical injury, unreasonable confinement, cruel punishment, sexual abuse, exploitation, or denial of essential services to a vulnerable adult.

Denial of essential services” under § 28-355 shall mean that essential services are denied or neglected to such an extent that there is actual physical injury to a vulnerable adult or imminent danger of the vulnerable adult suffering physical injury or death.

Exploitation” under § 28-358 shall mean the taking of property of a vulnerable adult by means of undue influence, breach of a fiduciary relationship, deception, or extortion or by any unlawful means.

Vulnerable adult” under § 28-371 shall mean any person 18 years of age or older who has a substantial mental or functional impairment or for whom a guardian has been appointed under the Nebraska Probate Code.

Caregiver” under § 28-353 shall mean any person or entity which has assumed the responsibility for the care of a vulnerable adult voluntarily, by express or implied contract, or by order of a court of competent jurisdiction.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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NEVADA: Nev. Rev. Stat. Ann. §§ 41.1395, 200.5092 (2001)

Abuse” under § 41.1395 means willful and unjustified: (1) Infliction of pain, injury or mental anguish; or (2) Deprivation of food, shelter, clothing or services which are necessary to maintain the physical or mental health of an older person or a vulnerable person.

Abuse” under § 200.5092 means willful and unjustified: (a) Infliction of pain, injury or mental anguish on an older person; or (b) Deprivation of food, shelter, clothing, or services which are necessary to maintain the physical or mental health of an older person.

Neglect” under § 41.1395 means the failure of a person who has assumed legal responsibility or a contractual obligation for caring for an older person or a vulnerable person, or who has voluntarily assumed responsibility for his care, to provide food, shelter, clothing, or services within the scope of his responsibility or obligation, which are necessary to maintain the physical or mental health of the older person or vulnerable person. For the purposes of this paragraph, a person voluntarily assumes responsibility to provide care for an older or vulnerable person only to the extent that he has expressly acknowledged his responsibility to provide such care.

Neglect” under § 200.5092 means the failure of: (a) A person who has assumed legal responsibility or a contractual obligation for caring for an older person or who has voluntarily assumed responsibility for his care to provide food, shelter, clothing, or services which are necessary to maintain the physical or mental health of the older person; or (b) An older person to provide for his own needs because of inability to do so.

Exploitation” under § 41.1395 and § 200.5092 means any act taken by a person who has the trust and confidence of an older person or a vulnerable person or any use of the power of attorney or guardianship of an older person or a vulnerable person to obtain control, through deception, intimidation, or undue influence, over the money, assets or property of the older person or vulnerable person with the intention of permanently depriving the older person or vulnerable person of the ownership, use, benefit, or possession of his money, assets, or property. As used in this paragraph, “undue influence” does not include the normal influence that one member of a family has over another.

Older person” under § 41.1395 and § 200.5092 means a person who is 60 years of age or older. ”Vulnerable person” means a person who: (1) Has a physical or mental impairment that substantially limits one or more of the

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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major life activities of the person; and (2) Has a medical or psychological record of the impairment or is otherwise regarded as having the impairment.

NEW HAMPSHIRE: RSA 161-F:43 (2000)

Abuse” means any act or omission by a person which is not accidental and harms or threatens to harm an incapacitated adult’s physical, mental, or emotional health or safety. The term abuse includes the following: (a) “Emotional abuse” means the misuse of power, authority, or both, verbal harassment, or unreasonable confinement which results or could result in the mental anguish or emotional distress of an incapacitated adult. (b) “Physical abuse” means the use of physical force which results or could result in physical injury to an incapacitated adult. (c) “Sexual abuse” means contact or interaction of a sexual nature involving an incapacitated adult who is being used without his or her informed consent.

Neglect” means an act of omission which results or could result in the deprivation of essential services necessary to maintain the minimum mental, emotional, or physical health and safety of an incapacitated adult. “Self-neglect” is defined separately at §161-F:43(VII).

Exploitation” means the illegal use of an incapacitated adult’s person or property for another person’s profit or advantage, or the breach of a fiduciary relationship through the use of a person or a person’s property for any purpose not in the proper and lawful execution of a trust, including, but not limited to, situations where a person obtains money, property, or services from an incapacitated adult through the use of undue influence, harassment, duress, deception, or fraud.

Adult” means any person who is 18 years of age or older who is thought to manifest a degree of incapacity by reason of limited mental or physical function which may result in harm or hazard to himself or others or who is a person unable to manage his estate.

NEW JERSEY: N.J. Stat. §§ 52:27D-407, 30:1A-3 (2001)

Abuse” under § 52:27D-407 means the willful infliction of physical pain, injury, or mental anguish, unreasonable confinement, or the willful deprivation of services which are necessary to maintain a person’s physical and mental health.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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INSTITUTIONAL ABUSE: “Abuse” under § 30:1A-3 means the willful infliction of physical pain, injury, or mental anguish; unreasonable confinement; or, the willful deprivation of services which are necessary to maintain a person’s physical and mental health.

“Neglect” under § 52:27D-407 means an act or failure to act by a vulnerable adult or his caretaker which results in the inadequate provision of care or services necessary to maintain the physical and mental health of the vulnerable adult, and which places the vulnerable adult in a situation which can result in serious injury or which is life-threatening.

Exploitation” under § 52:27D-407 means the act or process of illegally or improperly using a person or his resources for another person’s profit or advantage.

INSTITUTIONAL EXPLOITATION: “Exploitation” under § 30:1A-3 means the act or process of using a person or his resources for another person’s profit or advantage.

Vulnerable adult” under § 52:27D-407 means a person 18 years of age or older who resides in a community setting and who, because of a physical or mental illness, disability, or deficiency, lacks sufficient understanding or capacity to make, communicate, or carry out decisions concerning his well-being and is the subject of abuse, neglect ,or exploitation. A person shall not be deemed to be the subject of abuse, neglect, or exploitation or in need of protective services for the sole reason that the person is being furnished nonmedical remedial treatment by spiritual means through prayer alone or in accordance with a recognized religious method of healing in lieu of medical treatment, and in accordance with the tenets and practices of the person’s established religious tradition.

Caretaker” under § 52:27D-407 means a person who has assumed the responsibility for the care of a vulnerable adult as a result of family relationship or who has assumed responsibility for the care of a vulnerable adult voluntarily, by contract, or by order of a court of competent jurisdiction, whether or not they reside together.

NEW MEXICO: N.M. Stat. Ann. §§ 27-7-16, 30-47-3 (2001)

Abuse” under § 27-7-16 means: (1) knowingly, intentionally or negligently and without justifiable cause inflicting physical pain, injury, or mental anguish; or (2) the intentional deprivation by a caretaker or other per-

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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son of services necessary to maintain the mental and physical health of an adult;

INSTITUTIONAL ABUSE: “Abuse” under § 30-47-3 means any act or failure to act performed intentionally, knowingly or recklessly that causes or is likely to cause harm to a resident, including: (1) physical contact that harms or is likely to harm a resident of a care facility; (2) inappropriate use of a physical restraint, isolation, or medication that harms or is likely to harm a resident; (3) inappropriate use of a physical or chemical restraint, medication, or isolation as punishment or in conflict with a physician’s order; (4) medically inappropriate conduct that causes or is likely to cause physical harm to a resident; (5) medically inappropriate conduct that causes or is likely to cause great psychological harm to a resident;(6) an unlawful act, a threat, or menacing conduct directed toward a resident that results and might reasonably be expected to result in fear or emotional or mental distress to a resident.

Neglect” under § 27-7-16 means failure of the caretaker of an adult to provide basic needs such as clothing, food, shelter, supervision, and care for the physical and mental health for that adult or failure by an adult to provide such basic needs for himself.

INSTITUTIONAL NEGLECT: “Neglect” under § 30-47-3 means, subject to the resident’s right to refuse treatment and subject to the caregiver’s right to exercise sound medical discretion, the grossly negligent: (1) failure to provide any treatment, service, care, medication, or item that is necessary to maintain the health or safety of a resident; (2) failure to take any reasonable precaution that is necessary to prevent damage to the health or safety of a resident; or (3) failure to carry out a duty to supervise properly or control the provision of any treatment, care, good, service, or medication necessary to maintain the health or safety of a resident.

Exploitation” under § 27-7-16 means an unjust or improper use of an adult’s money or property for another person’s profit or advantage, pecuniary or otherwise.

Adult” under § 27-7-16 means a person 18 years of age or older.

Caretaker” under § 27-7-16 means an individual or institution that has assumed the responsibility for the care of an adult.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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NEW YORK: NY CLS Soc. Serv. § 473 (2001); NY CLS Penal §§ 260.30, 260.32, 260.34 (2001)

Physical abuse” means the nonaccidental use of force that results in bodily injury, pain or impairment, including but not limited to, being slapped, burned, cut, bruised, or improperly physically restrained. (b) ”Sexual abuse” means nonconsensual sexual contact of any kind, including but not limited to, forcing sexual contact or forcing sex with a third party. (c) ”Emotional abuse” means willful infliction of mental or emotional anguish by threat, humiliation, intimidation, or other abusive conduct, including but not limited to, frightening or isolating an adult.

Endangering the welfare of a vulnerable elderly person” occurs under NY CLS Penal § 260.32 when, being a caregiver for a vulnerable elderly person: 1. With intent to cause physical injury to such person, he or she causes such injury to such person; or 2. He or she recklessly causes physical injury to such person; or 3. With criminal negligence, he or she causes physical injury to such person by means of a deadly weapon or a dangerous instrument; or 4. He or she subjects such person to sexual contact without the latter’s consent. “Endangering the welfare of a vulnerable elderly person” under NY CLS Penal § 260.34 occurs when, being a caregiver for a vulnerable elderly person: 1. With intent to cause physical injury to such person, he or she causes serious physical injury to such person; or 2. He or she recklessly causes serious physical injury to such person.

Active neglect” under NY CLS Soc. Serv. § 473 means willful failure by the caregiver to fulfill the care-taking functions and responsibilities assumed by the caregiver, including but not limited to, abandonment, willful deprivation of food, water, heat, clean clothing and bedding, eyeglasses or dentures, or health-related services. “Passive neglect” under NY CLS Soc. Serv. § 473 means nonwillful failure of a caregiver to fulfill care-taking functions and responsibilities assumed by the caregiver, including but not limited to, abandonment or denial of food or health-related services because of inadequate caregiver knowledge, infirmity, or disputing the value of prescribed services. “Self-neglect” defined separately.

Financial exploitation” means improper use of an adult’s funds, property, or resources by another individual, including but not limited to, fraud, false pretenses, embezzlement, conspiracy, forgery, falsifying records, coerced property transfers, or denial of access to assets.

Vulnerable elderly person” under NY CLS Penal § 260.30 means a person 60 years of age or older who is suffering from a disease or infirmity associ-

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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ated with advanced age and manifested by demonstrable physical, mental, or emotional dysfunction to the extent that the person is incapable of adequately providing for his or her own health or personal care.

Caregiver” under NY CLS § 260.30 means a person who (i) assumes responsibility for the care of a vulnerable elderly person pursuant to a court order; or (ii) receives monetary or other valuable consideration for providing care for a vulnerable elderly person.

NORTH CAROLINA: N.C. Gen. Stat. §§ 14-32.3, 108A-101, 131D-2 (2000)

Abuse” under § 108A-101 means the willful infliction of physical pain, injury ,or mental anguish, unreasonable confinement, or the willful deprivation by a caretaker of services which are necessary to maintain mental and physical health.

Abuse” under § 14-32.3 occurs when a person is a caretaker of a disabled or elder adult who is residing in a domestic setting and, with malice aforethought, knowingly and willfully: (i) assaults, (ii) fails to provide medical or hygienic care, or (iii) confines or restrains the disabled or elder adult in a place or under a condition that is cruel or unsafe, and as a result of the act or failure to act the disabled or elder adult suffers mental or physical injury.

INSTITUTIONAL ABUSE: “Abuse” under § 131D-2 means the willful or grossly negligent infliction of physical pain, injury, or mental anguish, unreasonable confinement, or the willful or grossly negligent deprivation by the administrator or staff of an adult care home of services which are necessary to maintain mental and physical health.

“Neglect” under § 108A-101 refers to a disabled adult who is either living alone and not able to provide for himself the services which are necessary to maintain his mental or physical health or is not receiving services from his caretaker. A person is not receiving services from his caretaker if, among other things and not by way of limitation, he is a resident of one of the State-owned hospitals for the mentally ill, centers for the mentally retarded or North Carolina Special Care Center he is, in the opinion of the professional staff of that hospital or center, mentally incompetent to give his consent to medical treatment, he has no legal guardian appointed pursuant to Chapter 35A, or guardian as defined in G.S. 122C-3(15), and he needs medical treatment. “Neglect” occurs under § 14-32.3 when a person is a caretaker of a disabled or elder adult who is residing in a domestic setting

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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and, wantonly, recklessly, or with gross carelessness: (i) fails to provide medical or hygienic care, or (ii) confines or restrains the disabled or elder adult in a place or under a condition that is unsafe, and as a result of the act or failure to act the disabled or elder adult suffers mental or physical injury.

INSTITUTIONAL NEGLECT: “Neglect” under § 131D-2 means the failure to provide the services necessary to maintain a resident’s physical or mental health.

Exploitation” under § 108A-101 means the illegal or improper use of a disabled adult or his resources for another’s profit or advantage. “Exploitation” under § 14-32.3 occurs when a person is a caretaker of a disabled or elder adult who is residing in a domestic setting, and knowingly, willfully, and with the intent to permanently deprive the owner of property or money: (i) makes a false representation, (ii) abuses a position of trust or fiduciary duty, or (iii) coerces, commands, or threatens, and, as a result of the act, the disabled or elder adult gives or loses possession and control of property or money.

INSTITUTIONAL EXPLOITATION: “Exploitation” under § 131D-2 means the illegal or improper use of an aged or disabled resident or his resources for another’s profit or advantage.

Disabled adult” under § 108A-101 shall mean any person 18 years of age or over or any lawfully emancipated minor who is present in the State of North Carolina and who is physically or mentally incapacitated due to mental retardation, cerebral palsy, epilepsy, or autism; organic brain damage caused by advanced age or other physical degeneration in connection therewith; or due to conditions incurred at any age which are the result of accident, organic brain damage, mental or physical illness, or continued consumption or absorption of substances.

Disabled adult” under § 14-32.3 means a person 18 years of age or older or a lawfully emancipated minor who is present in the State of North Carolina and who is physically or mentally incapacitated as defined in G.S. 108A-101(d).

“Elder adult” under § 14-32.3 means a person 60 years of age or older who is not able to provide for the social, medical, psychiatric, psychological, financial, or legal services necessary to safeguard the person’s rights and resources and to maintain the person’s physical and mental well-being.

“Resident” under § 131D-2 means a person living in an assisted living

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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residence for the purpose of obtaining access to housing and services provided or made available by housing management.

“Caretaker” under § 108A-101 and § 14-32.3 shall mean an individual who has the responsibility for the care of the disabled adult as a result of family relationship or who has assumed the responsibility for the care of the disabled adult voluntarily or by contract.

NORTH DAKOTA: N.D. Cent. Code § 50-25.2-01 (2001)

“Abuse” means any willful act or omission of a caregiver or any other person, which results in physical injury, mental anguish, unreasonable confinement, sexual abuse or exploitation, or financial exploitation to or of a vulnerable adult.

“Neglect” means the failure of a caregiver to provide essential services necessary to maintain the physical and mental health of a vulnerable adult, or the inability or lack of desire of the vulnerable adult to provide essential services necessary to maintain and safeguard the vulnerable adult’s own physical and mental health.

“Financial exploitation” means the taking or misuse of property or resources of a vulnerable adult by means of undue influence, breach of a fiduciary relationship, deception, harassment, criminal coercion, theft, or other unlawful or improper means.

“Vulnerable adult” means an adult who has a substantial mental or functional impairment.

“Caregiver” means any person who has assumed the legal responsibility or a contractual obligation for the care of a vulnerable adult or has voluntarily assumed responsibility for the care of a vulnerable adult. The term includes a facility operated by any public or private agency, organization, or institution which provides services to, and has assumed responsibility for the care of, a vulnerable adult.

OHIO: ORC Ann. §§ 2903.33, 3721.21, 3722.12, 5101.60 (2001)

Abuse” under § 5101.60 means the infliction upon an adult by self or others of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical harm, pain, or mental anguish.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Abuse” under § 2903.33 means knowingly causing physical harm or recklessly causing serious physical harm to a person by physical contact with the person or by the inappropriate use of a physical or chemical restraint, medication, or isolation on the person.

INSTITUTIONAL ABUSE: “Abuse” under § 3721.21 means knowingly causing physical harm or recklessly causing serious physical harm to a resident by physical contact with the resident or by use of physical or chemical restraint, medication, or isolation as punishment, for staff convenience, excessively, as a substitute for treatment, or in amounts that preclude habilitation and treatment.

Abuse” under § 3722.12 means the unreasonable confinement or intimidation of a resident, or the infliction of injury or cruel punishment upon a resident, resulting in physical harm, pain, or mental anguish.

“Neglect” under § 5101.60 means the failure of an adult to provide for self the goods or services necessary to avoid physical harm, mental anguish, or mental illness or the failure of a caretaker to provide such goods or services.

Gross neglect” under § 2903.33 means knowingly failing to provide a person with any treatment, care, goods, or service that is necessary to maintain the health or safety of the person when the failure results in physical harm or serious physical harm to the person. “Neglect” means recklessly failing to provide a person with any treatment, care, goods, or service that is necessary to maintain the health or safety of the person when the failure results in serious physical harm to the person.

INSTITUTIONAL NEGLECT: “Neglect” under § 3721.21 means recklessly failing to provide a resident with any treatment, care, goods, or service necessary to maintain the health or safety of the resident when the failure results in serious physical harm to the resident. “Neglect” does not include allowing a resident, at the resident’s option, to receive only treatment by spiritual means through prayer in accordance with the tenets of a recognized religious denomination.

Neglect” under § 3722.12 means failure to provide a resident with goods or services necessary to prevent physical harm, mental anguish, or mental illness.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

Exploitation” under § 5101.60 means the unlawful or improper act of a caretaker using an adult or an adult’s resources for monetary or personal benefit, profit, or gain.

INSTITUTIONAL MISAPPROPRIATION: “Misappropriation” under § 3721.21 means depriving, defrauding, or otherwise obtaining the real or personal property of a resident by any means prohibited by the Revised Code, including violations of Chapter 2911 or 2913 of the Revised Code.

“Exploitation” under § 3722.12 means the unlawful or improper utilization of an adult resident or his resources for personal or monetary benefit, profit, or gain.

Adult” under § 5101.60 means any person 60 years of age or older within this state who is handicapped by the infirmities of aging or who has a physical or mental impairment which prevents the person from providing for the person’s own care or protection, and who resides in an independent living arrangement. An “independent living arrangement” is a domicile of a person’s own choosing, including, but not limited to, a private home, apartment, trailer, or rooming house. Except as otherwise provided in this division, “independent living arrangement” includes a community alternative home licensed pursuant to § 3724.03 of the Revised Code but does not include other institutions or facilities licensed by the state, or facilities in which a person resides as a result of voluntary, civil, or criminal commitment. “Independent living arrangement” does include adult care facilities licensed pursuant to Chapter 3722 of the Revised Code.

Caretaker” under § 5101.60 means the person assuming the responsibility for the care of an adult on a voluntary basis, by contract, through receipt of payment for care, as a result of a family relationship, or by order of a court of competent jurisdiction.

OKLAHOMA: 43A Okl. St. § 10-103 (2000); 63 Okl. St. § 1-1902 (2000); 63 Okl. St. § 1-820 (2000)

Abuse” under § 10-103 means the intentional infliction of physical pain, injury, sexual abuse, or mental anguish or the deprivation of food, clothing, shelter, or medical care to a vulnerable adult by a caretaker or other person responsible for providing these services.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

INSITUTIONAL ABUSE: “Abuse” under § 1-1902 and § 1-820 means the willful infliction of injury, unreasonable confinement, intimidation or punishment, with resulting physical harm, impairment or mental anguish.

Neglect” under § 10-103 means the failure to provide protection for a vulnerable adult who is unable to protect the person’s own interest; or the failure to provide adequate shelter or clothing; or the harming or threatening with harm through action or inaction by either another individual or through the person’s own action or inaction because of a lack of awareness, incompetence, or incapacity, which has resulted or may result in physical or mental injury.

INSTITUTIONAL NEGLECT: “Neglect” under § 1-1902 and § 1-820 means failure to provide goods and/or services necessary to avoid physical harm, mental anguish, or mental illness.

Exploitation” or “exploit” under § 10-103 means an unjust or improper use of the resources of a vulnerable adult for the profit or advantage, pecuniary or otherwise, of a person other than the vulnerable adult through the use of undue influence, coercion, harassment, duress, deception, false representation or false pretense.

Vulnerable adult” under § 10-103 means an individual who is an incapacitated person or who, because of physical or mental disability, incapacity, or other disability, is substantially impaired in the ability to provide adequately for the care or custody of self, or is unable to manage his or her property and financial affairs effectively, or to meet essential requirements for mental or physical health or safety, or to protect self from abuse, neglect, or exploitation without assistance from others.

Resident” under § 1-1902 means a person residing in a facility due to illness, physical or mental infirmity, or advanced age.

Caretaker” under § 10-103 means a person who has: a. the responsibility for the care of the person or financial management of the resources of the vulnerable adult as a result of a family relationship, b. assumed the responsibility for the care of the vulnerable adult voluntarily, by contract, or as a result of the ties of friendship, or c. been appointed a guardian, limited guardian, or conservator pursuant to the Oklahoma Guardianship and Conservatorship Act.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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OREGON: ORS §§ 124.005, 441.630 (1999)

Abuse” under § 124.005 means one or more of the following: (a) Any physical injury caused by other than accidental means, or that appears to be at variance with the explanation given of the injury. (b) Neglect that leads to physical harm through withholding of services necessary to maintain health and well-being. (c) Abandonment, including desertion or willful forsaking of an elderly or disabled person or the withdrawal or neglect of duties and obligations owed an elderly or disabled person by a caregiver or other person. (d) Willful infliction of physical pain or injury. (e) Use of derogatory or inappropriate names, phrases, or profanity, ridicule, harassment, coercion, threats, cursing, intimidation or inappropriate sexual comments of such a nature as to threaten significant physical or emotional harm to the elderly or disabled person. (f) Causing any sweepstakes promotion to be mailed to an elderly, disabled, or incapacitated person who had received sweepstakes promotional material in the United States mail, spent more than $500 in the preceding year on any sweepstakes promotions, or any combination of sweepstakes promotions from the same service, regardless of the identities of the originators of the sweepstakes promotion and who represented to the court that the person felt the need for the court’s assistance to prevent the person from incurring further expense.

INSTITUTIONAL ABUSE: “Abuse” under § 441.630 means: (a) Any physical injury to a resident of a long-term care facility which has been caused by other than accidental means. (b) Failure to provide basic care or services, which failure results in physical harm or unreasonable discomfort or serious loss of human dignity. (c) Sexual contact with a resident caused by an employee, agent, or other resident of a long-term care facility by force, threat, duress ,or coercion. (d) Illegal or improper use of a resident’s resources for the personal profit or gain of another person. (e) Verbal or mental abuse as prohibited by federal law. (f) Corporal punishment. (g) Involuntary seclusion for convenience or discipline.

Elderly person” under § 124.005 means any person 65 years of age or older who is not subject to the provisions of ORS 441.640 to 441.665.

PENNSYLVANIA: 35 P.S. § 10225.103 (2001); 63 P.S. § 672 (2001)

Abuse” under § 10225.103 and § 672 means the occurrence of one or more of the following acts: (1) The infliction of injury, unreasonable confinement, intimidation or punishment with resulting physical harm, pain,

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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or mental anguish. (2) The willful deprivation by a caretaker of goods or services which are necessary to maintain physical or mental health. (3) Sexual harassment, rape or abuse, as defined in the act of October 7, 1976 (P.L. 1090, No. 218), known as the Protection From Abuse Act. No older adult shall be found to be abused solely on the grounds of environmental factors which are beyond the control of the older adult or the caretaker, such as inadequate housing, furnishings, income, clothing, or medical care.

“Neglect” under § 10225.103 means the failure to provide for oneself or the failure of a caretaker to provide goods or services essential to avoid a clear and serious threat to physical or mental health. No older adult who does not consent to the provision of protective services shall be found to be neglected solely on the grounds of environmental factors which are beyond the control of the older adult or the caretaker, such as inadequate housing, furnishings, income, clothing, or medical care.

“Exploitation” under § 10225.103 means an act or course of conduct by a caretaker or other person against an older adult or an older adult’s resources, without the informed consent of the older adult or with consent obtained through misrepresentation, coercion, or threats of force, that results in monetary, personal or other benefit, gain or profit for the perpetrator or monetary or personal loss to the older adult.

Older adult” under § 10225.103 means a person within the jurisdiction of the Commonwealth who is 60 years of age or older. “Older adult in need of protective services” means an incapacitated older adult who is unable to perform or obtain services that are necessary to maintain physical or mental health, for whom there is no responsible caretaker and who is at imminent risk of danger to his person or property.

Caretaker” under § 10225.103 means an individual or institution that has assumed the responsibility for the provision of care needed to maintain the physical or mental health of an older adult. This responsibility may arise voluntarily, by contract, by receipt of payment for care, as a result of family relationship, or by order of a court of competent jurisdiction. It is not the intent of this act to impose responsibility on any individual if such responsibility would not otherwise exist in law.

RHODE ISLAND: R.I. Gen. Laws §§ 23-17.8-1, 42-66-4.1 (2001)

Abuse” under § 42-66-4.1 means the subjection of an elderly person to the willful infliction of physical pain, or willful deprivation of services by a

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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caretaker or other person with a duty of care for the elderly person. Abuse also includes neglect, abandonment, and exploitation.

INSTITUTIONAL ABUSE: “Abuse” under § 23-17.8-1 means: (i) Any assault as defined in chapter 5 of title 11, including, but not limited to, hitting, kicking, pinching, slapping, or the pulling of hair, provided, however, unless such is required as an element of the offense charged, it shall not be necessary to prove that the patient or resident was injured thereby, or; (ii) Any assault as defined in chapter 37 of title 11, or; (iii) Any offense under chapter 10 of title 11, or; (iv) Any conduct which harms or is likely to physically harm the patient or resident except where the conduct is a part of the care and treatment, and in furtherance of the health and safety of the patient or resident, or (v) Intentionally engaging in a pattern of harassing conduct which causes or is likely to cause emotional or psychological harm to the patient or resident, including but not limited to, ridiculing or demeaning a patient or resident, making derogatory remarks to a patient or resident or cursing directed towards a patient or resident, or threatening to inflict physical or emotional harm on a patient or resident.

Mistreatment” under § 23-17.8-1 means the inappropriate use of medications, isolation, or use of physical or chemical restraints (1) as punishment, (2) for staff convenience, (3) as a substitute for treatment or care, (4) in conflict with a physician’s order, (5) or in quantities which inhibit effective care or treatment, which harms or is likely to harm the patient or resident.

Neglect” under § 42-66-4.1 means the willful refusal to provide services necessary to maintain physical and mental health on the part of a caretaker or other person with a duty of care.

INSTITUTIONAL NEGLECT: “Neglect” under § 23-17.8-1 means the intentional failure to provide treatment, care, goods, and services necessary to maintain the health and safety of the patient or resident, or the intentional failure to carry out a plan of treatment or care prescribed by the physician of the patient or resident, or the intentional failure to report patient or resident health problems or changes in health problems or changes in health conditions to an immediate supervisor or nurse, or the intentional lack of attention to the physical needs of a patient or resident including, but not limited to toileting, bathing, meals, and safety. Provided, however, no person shall be considered to be neglected for the sole reason that he or she relies on

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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or is being furnished treatment in accordance with the tenets and teachings of a well recognized church or denomination by a duly accredited practitioner thereof.

“Exploitation” under § 42-66-4.1 means an act or process of taking pecuniary advantage of an elderly person by use of undue influence, harassment, duress, deception, false representation, or false pretenses.

SOUTH CAROLINA: S.C. Code Ann. § 43-35-10 (2000)

Abuse” means physical abuse or psychological abuse. “Physical abuse” means intentionally inflicting or allowing to be inflicted physical injury on a vulnerable adult by an act or failure to act. Physical abuse includes, but is not limited to, slapping, hitting, kicking, biting, choking, pinching, burning, actual or attempted sexual battery as defined in Section 16-3-651, use of medication outside the standards of reasonable medical practice for the purpose of controlling behavior, and unreasonable confinement. Physical abuse also includes the use of a restrictive or physically intrusive procedure to control behavior for the purpose of punishment except that a therapeutic procedure prescribed by a licensed physician or other qualified professional or that is part of a written plan of care by a licensed physician or other qualified professional is not considered physical abuse. Physical abuse does not include altercations or acts of assault between vulnerable adults. “Psychological abuse” means deliberately subjecting a vulnerable adult to threats or harassment or other forms of intimidating behavior causing fear, humiliation, degradation, agitation, confusion, or other forms of serious emotional distress.

“Neglect” means the failure or omission of a caregiver to provide the care, goods, or services necessary to maintain the health or safety of a vulnerable adult including, but not limited to, food, clothing, medicine, shelter, supervision, and medical services. Neglect may be repeated conduct or a single incident which has produced or can be proven to result in serious physical or psychological harm or substantial risk of death. Noncompliance with regulatory standards alone does not constitute neglect. Neglect includes the inability of a vulnerable adult, in the absence of a caretaker, to provide for his or her own health or safety which produces or could reasonably be expected to produce serious physical or psychological harm or substantial risk of death.

“Exploitation” means: (a) causing or requiring a vulnerable adult to engage in activity or labor which is improper, illegal, or against the reasonable

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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and rational wishes of the vulnerable adult. Exploitation does not include requiring a vulnerable adult to participate in an activity or labor which is a part of a written plan of care or which is prescribed or authorized by a licensed physician attending the patient; or (b) an improper, illegal, or unauthorized use of the funds, assets, property, power of attorney, guardianship, or conservatorship of a vulnerable adult by a person for the profit or advantage of that person or another person.

“Vulnerable adult” means a person 18 years of age or older who has a physical or mental condition which substantially impairs the person from adequately providing for his or her own care or protection. This includes a person who is impaired in the ability to adequately provide for the person’s own care or protection because of the infirmities of aging including, but not limited to, organic brain damage, advanced age, and physical, mental, or emotional dysfunction. A resident of a facility is a vulnerable adult.

“Caregiver” means a person who provides care to a vulnerable adult, with or without compensation, on a temporary or permanent or full or part-time basis and includes, but is not limited to, a relative, household member, day care personnel, adult foster home sponsor, and personnel of a public or private institution or facility.

SOUTH DAKOTA: S.D. Codified Laws § 22-46-1 (2001)

Abuse” means physical harm, bodily injury, or attempt to cause physical harm or injury, or the infliction of fear of imminent physical harm or bodily injury on a disabled adult.

Neglect” means harm to a disabled adult’s health or welfare, without reasonable medical justification, caused by the conduct of a person responsible for the adult’s health or welfare, within the means available for the disabled adult, including the failure to provide adequate food, clothing, shelter, or medical care. If a disabled adult is under treatment solely by spiritual means, the court may, upon good cause shown, order that medical treatment be provided for that disabled adult.

Exploitation” means the wrongful taking or exercising of control over property of a disabled adult with intent to defraud him of it.

Disabled adult” means a person eighteen years of age or older who suffers from a condition of mental retardation, infirmities of aging as manifested by organic brain damage, advanced age, or other physical dysfunctioning to

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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the extent that the person is unable to protect himself or provide for his own care.

TENNESSEE: Tenn. Code Ann. § 71-6-102 (2001)

Abuse or neglect” means the infliction of physical pain, injury, or mental anguish, or the deprivation of services by a caretaker which are necessary to maintain the health and welfare of an adult or a situation in which an adult is unable to provide or obtain the services which are necessary to maintain that person’s health or welfare. Nothing in this part shall be construed to mean a person is abused or neglected or in need of protective services for the sole reason that the person relies on or is being furnished treatment by spiritual means through prayer alone in accordance with a recognized religious method of healing in lieu of medical treatment; further, nothing in this part shall be construed to require or authorize the provision of medical care to any terminally ill person if such person has executed an unrevoked living will in accordance with the provisions of the Tennessee Right to Natural Death Law, compiled in title 32, chapter 11, and if the provisions of such medical care would conflict with the terms of such living will.

Exploitation” means the improper use by a caretaker of funds which have been paid by a governmental agency to an adult or to the caretaker for the use or care of the adult.

Adult” means a person 18 years of age or older who because of mental or physical dysfunctioning or advanced age is unable to manage such person’s own resources, carry out the activities of daily living, or protect such person from neglect, hazardous or abusive situations without assistance from others and who has no available, willing, and responsibly able person for assistance and who may be in need of protective services.

Advanced age” means 60 years of age or older.

Caretaker” means an individual or institution who has the responsibility for the care of the adult as a result of family relationship, or who has assumed the responsibility for the care of the adult person voluntarily, or by contract, or agreement.

TEXAS: Tex. Hum.Res. Code § 48.002 (2000)

Abuse” means: (A) the negligent or willful infliction of injury, unreason-

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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able confinement, intimidation, or cruel punishment with resulting physical or emotional harm or pain to an elderly or disabled person by the person’s caretaker, family member, or other individual who has an ongoing relationship with the person; or (B) sexual abuse of an elderly or disabled person, including any involuntary or nonconsensual sexual conduct that would constitute an offense under Section 21.08, Penal Code (indecent exposure) or Chapter 22, Penal Code (assaultive offenses), committed by the person’s caretaker, family member, or other individual who has an ongoing relationship with the person.

Neglect” means the failure to provide for one’s self the goods or services, including medical services, which are necessary to avoid physical or emotional harm or pain or the failure of a caretaker to provide such goods or services.

Exploitation” means the illegal or improper act or process of a caretaker, family member, or other individual who has an ongoing relationship with the elderly or disabled person using the resources of an elderly or disabled person for monetary or personal benefit, profit, or gain without the informed consent of the elderly or disabled person.

Elderly person” means a person 65 years of age or older.

Disabled person” means a person with a mental, physical, or developmental disability that substantially impairs the person’s ability to provide adequately for the person’s care or protection and who is: (A) 18 years of age or older; or (B) under 18 years of age and who has had the disabilities of minority removed.

UTAH: Utah Code Ann. §§ 62A-3-301, 76-5-111 (2001)

Abuse” under § 62A-3-301 means: (a) attempting to cause, or intentionally or knowingly causing physical harm or intentionally placing another in fear of imminent physical harm; (b) physical injury caused by criminally negligent acts or omissions; (c) unlawful detention or unreasonable confinement; (d) gross lewdness; or (e) deprivation of life-sustaining treatment, except: (i) as provided in Title 75, Chapter 2, Part 11, Personal Choice and Living Will Act; or (ii) when informed consent, as defined in Section 76-5-111, has been obtained.

Elder abuse” under § 62A-3-301 means abuse, neglect, or exploitation of an elder adult. “Emotional or psychological abuse” means deliberate con-

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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duct that is directed at a disabled or elder adult through verbal or nonverbal means, and that causes the disabled or elder adult to suffer emotional distress or to fear bodily injury, harm, or restraint.

Abuse” under § 76-5-111 means: (i) attempting to cause, or causing physical harm; (ii) placing another in fear of imminent physical harm; (iii) physical injury caused by acts or omissions; (iv) unlawful detention or unreasonable confinement; (v) gross lewdness; or (vi) deprivation of life-sustaining treatment, except: (A) as provided in Title 75, Chapter 2, Part 11, Personal Choice and Living Will Act; or (B) when informed consent has been obtained.

“Neglect” under § 62A-3-301 means: (a) the failure of a caretaker to provide habilitation, care, nutrition, clothing, shelter, supervision, or medical care; (b) a pattern of conduct by a caretaker, without the disabled or elder adult’s informed consent, resulting in deprivation of food, water, medication, medical services, shelter, cooling, heating, or other services necessary to maintain minimum physical or mental health; or (c) the failure or inability of a disabled adult to provide those services for himself.

“Exploitation” under § 62A-3-301 means exploitation of a disabled or elder adult as that offense is described in Subsection 76-5-111(4).

“Elder adult” under § 62A-3-301 means a person 65 years of age or older.

“Caretaker” under § 62A-3-301 means any person, corporation, or public institution that has assumed by relationship, contract, or court order the responsibility to provide food, shelter, clothing, medical, and other necessities to a disabled or elder adult.

VERMONT: 33 V.S.A. § 6902 (2001)

Abuse” means: (A) Any treatment of an elderly or disabled adult which places life, health, or welfare in jeopardy or which is likely to result in impairment of health; (B) Any conduct committed with an intent or reckless disregard that such conduct is likely to cause unnecessary harm, unnecessary pain or unnecessary suffering to an elderly or disabled adult; (C) Unnecessary confinement or unnecessary restraint of an elderly or disabled adult; (D) Any sexual activity with an elderly or disabled adult by a caregiver, either, while providing a service for which he or she receives financial compensation, or at a caregiving facility or program; (E) Any

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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pattern of malicious behavior which results in impaired emotional well-being of an elderly or disabled adult.

“Neglect” means the lack of subsistence, medical or other care necessary for well-being.

“Exploitation” means: (A) Willfully using, withholding, or disposing of funds or property of an elderly or disabled adult without legal authority for the wrongful profit or advantage of another; (B) Acquiring possession or control of or an interest in funds or property of an elderly or disabled adult through the use of undue influence, harassment, duress, or fraud; (C) The act of forcing or compelling an elderly or disabled adult against his or her will to perform services for the profit or advantage of another; (D) Any sexual activity with an elderly or disabled adult when the elderly or disabled adult does not consent or when the actor knows or should know that the elderly or disabled adult is incapable of resisting or declining consent to the sexual activity due to age or disability or due to fear of retribution or hardship.

“Elderly adult” means an individual who is 60 years of age or older.

“Caregiver” means a person, agency, facility, or other organization with responsibility for providing subsistence or medical or other care to an elderly or disabled adult, who has assumed the responsibility voluntarily, by contract or by an order of the court; or a person providing care including but not limited to medical care, custodial care, personal care, mental health services, rehabilitative services, or any other kind of care provided which is required because of another’s age or disability.

VIRGINIA: Va. Code Ann. §§ 18.2-369, 63.1-55.2 (2001)

“Abuse” under § 63.1-55.2 means the willful infliction of physical pain, injury, or mental anguish or unreasonable confinement.

“Abuse” under §18.2-369 means (i) knowing and willful conduct that causes physical injury or pain or (ii) knowing and willful use of physical restraint, including confinement, as punishment, for convenience or as a substitute for treatment, except where such conduct or physical restraint, including confinement, is a part of care or treatment and is in furtherance of the health and safety of the incapacitated person.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Neglect” under § 63.1-55.2 means that an adult is living under such circumstance that he is not able to provide for himself or is not being provided such services as are necessary to maintain his physical and mental health and that the failure to receive such necessary services impairs or threatens to impair his well-being. “Neglect” under §18.2-369 means the knowing and willful failure by a responsible person to provide treatment, care, goods or services which results in injury to the health or endangers the safety of an incapacitated adult.

Exploitation” under § 63.1-55.2 means the illegal use of an incapacitated adult or his resources for another’s profit or advantage.

Incapacitated person” under § 63.1-55.2 and § 18.2-369 means any adult (18 or older) who is impaired by reason of mental illness, mental retardation, physical illness or disability, advanced age or other causes to the extent that the adult lacks sufficient understanding or capacity to make, communicate or carry out responsible decisions concerning his or her well-being.

Responsible person” under § 18.2-369 means a person who has responsibility for the care, custody or control of an incapacitated person by operation of law or who has assumed such responsibility voluntarily, by contract or in fact.

WASHINGTON: Rev. Code Wash. (ARCW) §§ 70.124.020, 74.34.020 (2001)

Abuse” under § 74.34.020 means the willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult. In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish. Abuse includes sexual abuse, mental abuse, physical abuse, and exploitation of a vulnerable adult, which have the following meanings: (a) “Sexual abuse” means any form of nonconsensual sexual contact, including but not limited to unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual abuse includes any sexual contact between a staff person, who is not also a resident or client, of a facility or a staff person of a program authorized under chapter 71A.12 RCW, and a vulnerable adult living in that facility or receiving service from a program authorized under chapter 71A.12 RCW, whether or not it is consensual. (b) “Physical abuse” means the willful

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, prodding, or the use of chemical restraints or physical restraints unless the restraints are consistent with licensing requirements, and includes restraints that are otherwise being used inappropriately. (c) “Mental abuse” means any willful action or inaction of mental or verbal abuse. Mental abuse includes, but is not limited to, coercion, harassment, inappropriately isolating a vulnerable adult from family, friends, or regular activity, and verbal assault that includes ridiculing, intimidating, yelling, or swearing. “Exploitation” means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another.

INSTITUTIONAL ABUSE/ NEGLECT: “Abuse or neglect” or “patient abuse or neglect” under § 70.124.020 means the nonaccidental physical injury or condition, sexual abuse, or negligent treatment of a state hospital patient under circumstances which indicate that the patient’s health, welfare, or safety is harmed thereby.

Neglect” under § 74.34.020 means (a) a pattern of conduct or inaction by a person or entity with a duty of care to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that avoids or prevents physical or mental harm or pain to a vulnerable adult; or (b) an act or omission that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult’s health, welfare, or safety.

Exploitation” under § 74.34.020 means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another. “Financial exploitation” means the illegal or improper use of the property, income, resources, or trust funds of the vulnerable adult by any person for any person’s profit or advantage.

Vulnerable adult” under § 74.34.020 includes a person: (a) 60 years of age or older who has the functional, mental, or physical inability to care for himself or herself; or (b) Found incapacitated under chapter 11.88 RCW; or (c) Who has a developmental disability as defined under RCW 71A.10.020; or (d) Admitted to any facility; or (e) Receiving services from home health,

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW; or (f) Receiving services from an individual provider.

WEST VIRGINIA: W.Va. Code §§ 9-6-1, 61-2-29 (2001)

Abuse” under § 9-6-1 means the infliction or threat to inflict physical pain or injury on or the imprisonment of any incapacitated adult or facility resident.

Abuse” under § 61-2-29 means infliction or threat to inflict physical pain or injury on an incapacitated adult.

Neglect” under § 9-6-1 means: (A) The failure to provide the necessities of life to an incapacitated adult or facility resident with intent to coerce or physically harm the incapacitated adult or resident; and (B) the unlawful expenditure or willful dissipation of the funds or other assets owned or paid to or for the benefit of an incapacitated adult or resident. “Neglect” under § 61-2-29 means (i) the failure to provide the necessities of life to an incapacitated adult or (ii) the unlawful expenditure or willful dissipation of the funds or other assets owned or paid to or for the benefit of an incapacitated adult.

Incapacitated adult” under § 9-6-1 and § 61-2-29 means any person who by reason of physical, mental, or other infirmity is unable to independently carry on the daily activities of life necessary to sustaining life and reasonable health.

Caregiver” under § 61-2-29 means an adult who has or shares actual physical possession or care of an incapacitated adult on a full-time or temporary basis, regardless of whether such person has been designated as a guardian of such adult by any contract, agreement, or legal proceeding. Caregiver includes health care providers, family members, and any person who otherwise voluntarily accepts a supervisory role towards an incapacitated adult.

WISCONSIN: Wis. Stat. §§ 46.90, 55.01, 940.285, 940.295 (2000)

Abuse” under § 46.90 means the willful infliction on an elder person of physical pain or injury or unreasonable confinement.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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Abuse” under § 55.01 means any of the following: (a) An act, omission, or course of conduct by another that is inflicted intentionally or recklessly and that does at least one of the following: 1. Results in bodily harm or great bodily harm to a vulnerable adult. 2. Intimidates, humiliates, threatens, frightens, or otherwise harasses a vulnerable adult. (b) The forcible administration of medication to a vulnerable adult, with the knowledge that no lawful authority exists for the forcible administration. (c) An act that constitutes first degree, second degree, third degree, or fourth degree sexual assault as specified under § 940.225.

Maltreatment” under § 940.285 includes any of the following conduct: 1. Conduct that causes or could reasonably be expected to cause bodily harm or great bodily harm. 2. Restraint, isolation, or confinement that causes or could reasonably be expected to cause bodily harm or great bodily harm or mental or emotional damage, including harm to the vulnerable adults psychological or intellectual functioning that is exhibited by severe anxiety, depression, withdrawal, regression, or outward aggressive behavior or a combination of these behaviors. This subdivision does not apply to restraint, isolation, or confinement by order of a court or other lawful authority. 3. Deprivation of a basic need for food, shelter, clothing or personal or health care, including deprivation resulting from the failure to provide or arrange for a basic need by a person who has assumed responsibility for meeting the need voluntarily or by contract, agreement, or court order.

Neglect” under § 55.01means an act, omission, or course of conduct that, because of the failure to provide adequate food, shelter, clothing, medical care or dental care, creates a significant danger to the physical or mental health of a vulnerable adult.

INSTITUTIONAL NEGLECT: “Neglect” under § 940.295 means an act, omission, or course of conduct by another that, because of the failure to provide adequate food, shelter, clothing, medical care or dental care, creates a significant danger to the physical or mental health of a patient or resident.

Material abuse” under § 46.90 means the misuse of an elder persons property or financial resources.

Misappropriation of property” under § 55.01 means any of the following: (a) The intentional taking, carrying away, use, transfer, concealment, or retention of possession of the property of a vulnerable adult without the vulnerable adult’s informed consent and with intent to deprive the vulner-

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

able adult of possession of the property. (b) Obtaining the property of a vulnerable adult by intentionally deceiving the vulnerable adult with a representation that is known to be a false representation, is made with intent to defraud, and does defraud the vulnerable adult.

Elder person” under § 46.90 means a person who is age 60 or older or who is subject to the infirmities of aging.

Vulnerable adult” under § 940.285 means any person 18 years of age or older who either is a developmentally disabled person or has infirmities of aging, mental illness, or other like incapacities and who is: 1. Substantially mentally incapable of providing for his or her needs for food, shelter, clothing or personal or health care; or 2. Unable to report cruel maltreatment without assistance.

Caretaker” under § 55.01 means the person, if any, who takes care of a vulnerable adult voluntarily or under a contract for care.

WYOMING: Wyo. Stat. § 35-20-102 (2001)

Abuse” means the willful infliction, whether by another person or self-inflicted, of physical pain, injury, unreasonable confinement or deprivation, which conduct threatens the welfare and well being of a disabled adult.

Defined separately: Abandonment means leaving a disabled adult without financial support or the means or ability to obtain food, clothing, shelter, or health care.

Neglect” means the deprivation, including self-deprivation, of the minimum food, shelter, clothing, supervision, physical and mental health care, and other care necessary to maintain a disabled adult’s life or health, or which may result in a life-threatening situation. The withholding of health care from a disabled adult is not neglect if: (A) Treatment is given in good faith by spiritual means alone, through prayer, by a duly accredited practitioner in accordance with the tenets and practices of a recognized church or religious denomination; or (B) The withholding of health care is in accordance with a declaration executed pursuant to W.S. 35-22-101 through 35-22-109.

Exploitation” means taking advantage of a disabled adult or of his physical or financial resources for personal or pecuniary profit by the use of

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." National Research Council. 2003. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington, DC: The National Academies Press. doi: 10.17226/10406.
×

undue influence, harassment, duress, deception, false representation, or false pretenses.

Disabled adult” means any person 18 years of age or older who is unable unassisted to properly manage and take care of himself or his property as a result of the infirmities of advanced age, physical or mental disability, or the use of alcohol or controlled substances.

Caretaker” means any person or agency responsible for the day to day care of a disabled adult because of: (A) A family relationship; (B) Voluntary assumption of responsibility for day to day care; (C) Court ordered responsibility or placement; (D) Rendering services on adult workshop or adult residential programs; or (E) Rendering services in an institution or in community-based programs.

Suggested Citation:"Appendix B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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 B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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 B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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 B: Analysis of Elder Abuse and Neglect Definitions Under State Law." 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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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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