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Suggested Citation:"References." Institute of Medicine and National Research Council. 2014. Elder Abuse and Its Prevention: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18518.
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known regarding the impact of such forms of abuse. It would be desirable to compare the impacts of culturally specific forms of abuse with traditional types of abuse.

Another observation is that studies using older persons or caregivers as informants found much higher rates than those using clinicians as informants. While older persons subjected to physical violence and neglect may present with physical injuries or other observable characteristics, such as malnutrition or dehydration, those who suffered emotional abuse or financial abuse may have no presenting symptoms at all. This may also be the reason why physical violence is overrepresented in clinician-identified cases. Contrary to the common perception that perpetrators are unwilling to admit to abusive behaviors, several studies using caregivers as informants found prevalence rates comparable to those of victim reports. Further research should compare the prevalence rates of reports from different informants in order to achieve a comprehensive picture of the actual rates of abuse.

Cultural sensitivity is essential for research into elder abuse in Asia. It goes beyond using culturally sensitive instruments that measure cultural-specific types of abuse. As discussed earlier, many older Asians may be reluctant to report their own abusive experience to a person outside of their families. In conducting research, special attention should be paid in building rapport with participants in the data collection process. Studies that employed indirect estimates, for example, by asking participants to report abuse incidents that they have heard of or witnessed, may be an alternative to traditional research that directly asks participants about their abusive experience.

Research into elder abuse in Asia remains underrepresented in the literature. Part of the reason is that scholars seldom publish in international journals. In searching the literature, the author was aware that a sizable amount of work in elder abuse in Asia was published as research reports in Korean and Japanese. Scholars conducting research on elder abuse in Asia should be encouraged to publish in international English journals to disseminate their knowledge.

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Elder Abuse and Its Prevention is the summary of a workshop convened in April 2013 by the Institute of Medicine's Forum on Global Violence Prevention. Using an ecological framework, this workshop explored the burden of elder abuse around the world, focusing on its impacts on individuals, families, communities, and societies. Additionally, the workshop addressed occurrences and co-occurrences of different types of abuse, including physical, sexual, emotional, and financial, as well as neglect. The ultimate objective was to illuminate promising global and multisectoral evidence-based approaches to the prevention of elder maltreatment. While the workshop covered scope and prevalence and unique characteristics of abuse, the intention was to move beyond what is known about elder abuse to foster discussions about how to improve prevention, intervention, and mitigation of the victims' needs, particularly through collaborative efforts. The workshop discussions included innovative intervention models and opportunities for prevention across sectors and settings.

Violence and related forms of abuse against elders is a global public health and human rights problem with far-reaching consequences, resulting in increased death, disability, and exploitation with collateral effects on well-being. Data suggest that at least 10 percent of elders in the United States are victims of elder maltreatment every year. In low- and middle-income countries, where the burden of violence is the greatest, the figure is likely even higher. In addition, elders experiencing risk factors such as diminishing cognitive function, caregiver dependence, and social isolation are more vulnerable to maltreatment and underreporting. As the world population of adults aged 65 and older continues to grow, the implications of elder maltreatment for health care, social welfare, justice, and financial systems are great. However, despite the magnitude of global elder maltreatment, it has been an underappreciated public health problem. Elder Abuse and Its Prevention discusses the prevalence and characteristics of elder abuse around the world, risk factors for abuse and potential adverse health outcomes, and contextually specific factors, such as culture and the role of the community.

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