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Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America
Index
A
Abandonment, 36, 184, 188, 199, 216, 222, 225, 236, 357
screening and case identification, 112-113
Abrasions and lacerations, 54, 118, 119, 340, 344-345, 359, 360, 361, 372, 449, 454
Abuse, see Child abuse and neglect;
Definitional issues;
Domestic violence;
Emotional abuse;
Exploitation;
Financial abuse;
Self-abuse/self-neglect;
Sexual abuse
Academic research, 6, 13, 60, 139, 521
Acierno, Ronald, 77, 78, 79, 81, 255, 261-302
Activities of daily living (ADLs), 10, 11, 98
adult protective services, 125
nursing homes, 452, 479
residential care facilities, 466, 469, 479
screening and case identification, 105, 270-271
Administration on Aging, 21-22, 132, 151, 246, 266-267
National Center on Elder Abuse, 15, 22-23, 132, 265-266, 385, 389-390
Administration on Developmental Disabilities and Rehabilitation Research, 7, 150, 152
Adult children of elderly persons, 11, 91, 95, 96-97, 168, 274, 293-302 (passim), 401
intergenerational transmission of mistreatment, 99
Adult Protective Service Reports, 167
Adult protective services, 6, 22, 23, 24-25, 27, 32, 42, 50, 80, 82, 101, 245, 332, 505
cost factors, 126, 239
criminal justice system and, 124-125, 126, 127-128, 129
evaluation of effectiveness, 6, 32, 122, 124-127, 139, 506
financial abuse, 390, 394, 405(n.25), 417, 436, 437
funding, 14, 126, 239, 240, 418-419
gender factors, 96
historical perspectives, 13-15, 17, 238-240, 506
legislation, 27, 28, 115, 124, 181-182, 185, 189, 411-412, 418-419, 505, 506-507
nursing homes and, 456-460
racial/ethnic factors, 97
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reporting practices, 27, 28, 115, 122, 167, 261, 267, 383-384, 411-412, 417, 456-460
residential care facilities, 465
response time, 124, 129-130
risk factors, 96, 97, 98
screening and case identification, 104, 105-106, 115-116, 124, 167, 261 267, 277, 365
self-abuse and neglect, 126-127
theoretical models, 60, 65
Advisory Board on Child Abuse and Neglect, 16
Advocacy, 14, 15, 17, 130, 136, 239, 251, 256, 316, 356, 388, 418, 419, 422, 423, 429, 430, 489, 490, 505-506, 516
African Americans, 97, 269, 390-391, 466
Age Discrimination in Employment Act, 42
Age factors, 171, 175, 176, 268-269
attitudes about aging and the elderly, 63, 168, 242, 264-265, 271-272, 276, 296, 299, 400, 406
definitional issues, 41-42, 43, 90, 115, 124, 181-237 (passim), 246
financial abuse, perpetrators, 401
forensics, 341, 344-360 (passim)
long-term care settings, 447
nursing homes, 452
perceptions of behavior, 168
population, aging of, xiii, 9-10, 78, 152
screening and case identification, 115, 294
state legislation, 27, 28, 115, 124, 181-182, 185
vulnerability, general, 41-42, 43
Agency for Healthcare Research and Quality, 12, 152
AIDS, 69
Alabama, 21, 181-182, 394, 424
Alaska, 182
Alcohol abuse, 21, 91, 94, 95, 242, 270, 282, 293, 294, 296, 299, 355, 357, 398
Alzheimer’s disease, see Dementia American College of Emergency Response, 170
American Medical Association (AMA), 104, 109, 342, 365, 402
Arizona, 183, 433
Arkansas, 183-184
Assessment, see Evaluation of interventions;
Screening and case identification
Assessment Protocol for Physicians, 365
Assisted-living settings, 4-5, 10-11, 62, 64, 80, 86, 133, 134, 467, 469
Attitudes, 242, 264, 278-279, 284, 296, 297, 299, 503
see also Depression;
Emotional abuse;
Trust relationships
about aging and the elderly, 63, 168, 242, 264-265, 271-272, 276, 296, 299, 400, 406
financial abuse, 391-392, 396, 399-402, 404, 406, 407, 414, 415, 429, 438
long-term care settings, 10, 446-447
screening and case identification, 109, 242, 264-265, 271-272, 276, 278-279, 284, 293, 294, 296, 299, 396
sexual abuse, 264, 278
stigma, 69, 242, 243, 264, 278-279, 332, 415, 429, 503
Attorneys, 304
see also Guardianship and power of attorney
financial abuse, 52, 390, 398, 411-412, 413, 423, 433-434
reporting of abuse, 52, 123, 390, 411-412, 413
B
Banks and banking, 130, 388, 396, 398, 426
incidence and prevalence research, 73, 244
prevention of abuse, 132, 296, 414, 430, 431-433, 435, 437
reporting practices, 411(n.36), 412, 421
Bedsores, see Decubiti
Belmont Report, 303-304, 305, 306, 309, 311, 316-318, 319-320, 321, 327, 334
Benjamin Rose Institute, 239
Biomarkers, 3, 23, 74, 84, 101-102, 340, 360-362
Blacks, see African Americans
Blenkner, Margaret, 239, 243
Block grants, 14
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Board and care homes, see Residential care facilities
Brief Abuse Screen for the Elderly, 100-111, 366
Bruises, 20, 49, 54, 114, 116, 117, 119, 120, 127, 166, 183, 186, 216, 340, 342-343, 345-347, 454
Bureau of Justice Statistics, 268
Burns, 20, 54, 119, 120, 166, 183, 186, 216, 226, 340, 343, 353-354, 371-372
C
California, 127, 184-185
Canada
financial abuse, 390, 394
incidence and prevalence, 74, 390
legislation, 506
Caregiver abuse and neglect, xiii, 7, 11, 15, 17, 26, 30, 33, 42, 44, 122, 240
see also Assisted-living settings;Institutional settings;
Long-term care settings;
Medical interventions;
Nurses and nursing;
Nursing homes;
Restraints;
Trust relationships
Alzheimer’s patients, 10, 92, 93-95
child abuse model, 403
definitional issues, 1, 39, 40-41, 44, 49, 51-53, 61, 181-237 (passim), 342
ethical issues, research, 322, 333-334
informed consent, 143, 147-148, 311, 314-315, 333-334
financial, 40-41, 65, 385, 388, 395, 397-400, 435-436
forensics, 342, 343-381 (passim)
incidence and prevalence, 73, 74, 76, 261, 270-273
respite care, 93, 94-95, 125, 130, 270
risk factors, 93-95, 98-103
screening and case identification, 104-120, 166-167, 242, 270, 271-277, 293-302 (passim), 504-505
institutional staff, 100, 134-135, 490, 504-505
theoretical models, 61, 63, 64-65, 69-70
Caregiver Abuse Screen (CAS), 112-113, 271
Case-control studies, see Controlled studies
Case management, 4-5, 105-106, 116, 277
see also Screening and case identification
Center for Mental Health Services, 152
Centers for Disease Control and Protection (CDC), 80, 306-307
Centers for Medicare and Medicaid Services (CMS), 152, 448, 457-459, 460-462, 479
see also Health Care Financing Administration (HCFA)
Medicaid, 128, 134, 448, 451, 457, 466, 479
Medicare, 294, 448, 451, 456-457
Child abuse and neglect, 126, 277-281, 339-340
cognitive status of children, 116-117, 404-406
community-level factors, 16, 126, 505, 510-516
criminal justice system, 116-117, 280-281, 507
financial abuse models, 402-408
forensics, 339-340, 360-361
historical perspectives, 12-13, 14, 16-17, 18-19, 126, 339, 383, 501, 506
hospitals, 503, 504
incidence and prevalence research, 13, 277-281, 287
informed consent, 143
intergenerational transmission of mistreatment, 99
international perspectives, 13, 506
isolation, 35, 36, 52, 56, 448, 450
legislation, 13, 14, 506, 507-510
LONGSCAN, 329, 330, 331, 333
public education, 267-268, 505, 517-518
reporting practices, 13, 123, 329(n.6), 330
research ethics, 143, 315-316, 329-331, 333
research methodology, general, xiii-xiv, 18-19, 23, 26-27, 245, 262-263, 267, 268
risk factors, 88, 91, 99, 103, 242, 503-504
screening and case identification, 116-117, 119, 267, 273, 403-404, 503-505
sentinel reports, 267, 268
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Child Abuse Prevention and Treatment Act, 13
Children, adult, see Adult children of elderly persons;
Household settings
Civil justice interventions, 28, 32, 130, 131, 134, 145, 221, 251, 255, 324, 341, 342, 343, 362, 374, 421, 423-429
Clinical practices and research, 4, 5, 25, 45, 334-381
see also Ethical issues;
Forensics;
Medical interventions;
Screening and case identification
guidelines for measurement, 45, 144
incidence and prevalence of mistreatment, 71, 76
measures of mistreatment, table, 166-167
Coalition of Advocates for the Rights and Interest of the Elderly (CARIE), 136-137, 489
Cognitive impairments, 6, 14, 76, 125, 169, 262-263, 264, 340
see also Dementia;
Guardianship and power of attorney, 76, 83, 270-272, 273, 284
child abuse, general, 404-406
child abuse witnesses, 116-117
definitional issues, 35, 36, 50, 406
financial abuse, 391-392, 393, 395, 396, 397, 404-406, 407, 413, 421, 422, 433-434, 435, 438
forensics, 343, 354-357, 360, 366-367, 371-372
incidence and prevalence research, 76, 83, 270-272, 273, 284, 286, 287, 451
informed consent, 6, 140, 141-143, 309-311, 312, 314-317
long-term care settings, 446, 451, 452, 465, 466, 467, 482
medications, effects of, 264, 406(n.29)
nursing homes, 451, 452, 482
prospective studies, 90-91
recall problems, 90-91, 264
residential care facilities, 465, 466, 467, 482
screening and case identification, 76, 83, 105, 109, 114, 116-117, 270-272, 273, 284, 314, 366-367, 396, 397
state legislation, 35, 36, 184, 405, 406
theoretical models, 66, 70
Cohort studies, see Longitudinal studies
Colleges and universities, see Academic research
Colorado, 186-187
Common Rule, see Federal Policy for the Protection of Human Subjects
Community Based Education Model for Identification and Prevention of Elder Abuse, 277
Community-level factors, 2, 3, 4, 7, 24, 91, 122, 151, 170, 522
see also Adult protective services;
Assisted-living settings;
Criminal justice system;
Families and households;
Hospitals;
Local government
child protection, 16, 126, 505, 510-516
domestic violence, 505, 510, 510-516
evaluation of interventions, 122, 128
financial abuse, 430-432, 436
incidence and prevalence data, xiii, 71, 80, 86, 87
interdisciplinary approaches, 131-132
professional specialization and collaboration, 130-133
screening and case identification, 104, 106, 107, 109, 114, 115
Competence With Compassion, 136-137
Comprehensive Drug Abuse Prevention and Control Act, 145-146
Comprehensive Geriatric Assessment, 364
Computer applications, 169, 170
financial abuse, 392, 395, 398, 431
forensics, 362
OSCAR database, 457, 471, 476-477, 478
residential care databases, 471, 476-477, 478
screening and case identification, 108-109
telephone interviews, 281, 283, 285-286, 287
Confidentiality, 33, 83, 145-147, 304, 308-309, 312, 323-324, 328, 329-330, 334, 411
Confinement, see Isolation and confinement;
Restraints
Conflicts Tactics Scale (CTS), 20, 26-27, 55, 85, 166-167, 244, 271, 274-275, 300-302
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Connecticut, 187
Connolly, Marie-Therese, 255-256, 339-381
Controlled studies, 2, 25, 72, 90, 91, 168, 174
abuser dependency, 96, 241
adult protective services, 239
alcohol abuse, 95
disabled persons, 98-99
household settings, 137-138
screening and case identification, 110-111
Cost factors, xiii, 286
see also Funding
adult protective services, 126, 239
community-level programs, 510
evaluation of interventions, 121, 126
financial abuse, legal interventions, 422, 429, 434-435
incidence and prevalence data, 80, 265, 282, 286, 287
interventions, general, 18, 282, 286, 287, 510
interviews, 18, 282, 286, 287, 510
research ethics, evaluation, 313, 321, 322
residential care facilities, 467
risk factors and, 89
screening and case identification, 104, 106, 120, 267, 282
sentinel reports, 267
Criminal justice system, 15, 28, 55, 245-246
see also Forensics; Legislation; Police
adult protective services and, 124-125, 126, 127-128, 129
child abuse, 116-117, 280-281, 507
evaluation of, 32, 122, 127-128, 129-130, 131
Federal Bureau of Investigation (FBI), 268, 269, 284, 285-286
financial abuse, 392, 393, 400, 411-412, 420-423
historical perspectives, 15, 240, 506
incidence and prevalence research, 71, 77, 261, 264, 267-269, 280, 284, 287
institutional inspections, 137
police, 16, 21, 60, 73, 81, 93, 104, 122, 123, 125, 127, 129, 131, 138, 269, 282, 341, 422
professional education, 127-131 (passim)
protective orders, 418, 425
reporting practices, 123, 267-269, 279
screening and case identification, 104, 105-106, 115, 116-117, 127-128
theoretical models, 65
witnesses, 116-117, 127-128, 129-130, 421
Cross-sectional studies, 72, 169
Cultural factors, see Sociocultural factors
D
Deaths, see Fatalities
Decubiti, 340, 343, 348, 349-350, 360, 372
Definitional issues, 3, 30, 34-59, 61, 133, 150, 238, 244, 245, 384, 448-450
age factors, 41-42, 43, 90, 115, 124, 181-237 (passim), 246
caregiver abuse and neglect, general, 1, 39, 40-41, 44, 49, 51-53, 61, 181-237 (passim), 342
cognitive impairments, 35, 36, 50, 406
disabled persons, 35, 36, 37, 50, 188
elder mistreatment, general, 1, 2, 4, 19-21, 30, 73, 108, 114-115
emotional abuse, 28, 35, 36, 54-55, 448, 449
epidemiology, 72, 73, 75-77, 85, 87, 266, 278, 280
ethics, research, 306, 307, 308, 310
expert judgment, 45-47
families, 35, 36, 181-237 (passim), 244-246
forensics, 341, 342, 343, 344, 364
harm, general, 1, 3, 28, 34, 39, 40
guidelines for measurement, 48, 53-55, 56-58
institutional settings, general, 35, 36, 37, 187-188, 194, 196, 201, 202, 209, 214, 215, 217, 218, 220, 221, 222, 223, 225-226, 233, 235
isolation and confinement, 35, 36, 181-237 (passim)
medications, 35, 52, 56, 81
mental illness, 50
neglect, 19, 20-21, 34-37 (passim), 39, 41, 44, 181-237 (passim), 342, 449-450
guidelines for measurement, 44, 56
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older person, 47-48, 50, 343
operational, 42-45, 47-59, 75, 108
protective factors, 48, 49, 50, 58
psychological factors, 50, 448
residential care facilities, 4, 465, 475
risk factors, 5, 20-21, 35, 72, 89
guidelines for measurement, 48, 49-50, 58, 81-82, 85
screening and case identification, 108, 114-115, 266, 278
self-abuse and neglect, 35, 36, 40, 41, 81
guidelines for measurement, 44
sexual abuse, 35, 49, 183-237 (passim), 280, 281
state legislation, 13, 28, 34-39, 44, 60, 181-237, 384, 385, 400
strangers, abuse by, 35, 40, 44, 52
trust relationships, 39, 40-41, 43, 44, 61, 238, 384-385
guidelines for measurement, 44, 47-48, 51-53, 57
vulnerability, general, 39, 41-42, 43, 50, 182-237 (passim), 246-247
Dehydration, 119, 166, 183, 186, 272, 340, 351-352, 372, 448, 463
Delaware, 187-188
Dementia, 126, 152, 168, 175, 516-517
see also Guardianship and power of attorney
financial guardianship, 53
forensics, 355, 356-357, 362-363, 366
incidence and prevalence and, 10, 246, 262, 270, 276, 286, 451, 452
nursing homes, 451, 452, 482, 485, 486
research, informed consent, 6, 140, 141-143
residential care facilities, 469, 482
risk factors, 92, 93-94, 451
screening and case identification, 114, 116-117, 270, 276, 277, 366
theoretical models, 66
Demographic factors, 168
see also Geographic factors;
Marriage and marital status;
Race/ethnicity;
Rural areas;
Sociocultural factors;
Socioeconomic status;
Urban areas
adult children, 11
aging of general population, xiii, 9-10, 78, 152
incidence of mistreatment, xiii, 73, 86, 266, 269
nursing homes, 452
residential care facilities, 465
Denmark, 74
Department of Health and Human Services (DHHS), 304
see also Administration on Aging
Agency for Healthcare Research and Quality, 12, 152
Centers for Disease Control and Protection (CDC), 80, 306-307
Centers for Medicare and Medicaid Services (CMS), 152, 448, 457-459, 460-462, 479
ethical issues, research,
confidentiality, 33, 145, 146-147, 323
Federal Policy for the Protection of Human Subjects (Common Rule), 304, 305, 306, 307-309, 312, 314, 319, 323, 325-326, 332, 334
informed consent, 149, 315, 316(n.4)
Food and Drug Administration (FDA), 140, 307-308
forensics, 341, 363
Health Care Financing Administration (HCFA), 152, 448, 457-459
National Institute on Aging (NIA), 2, 6-7, 11, 12, 24-25, 95, 144, 149, 150, 151, 243, 483
National Institutes of Health (NIH), 12
confidentiality, 33, 145, 146-147
informed consent, 149
nursing homes, 457, 479
Office of the Assistant Secretary for Planning and Evaluation, 3, 479-480
Department of Justice, 132, 151
Bureau of Justice Statistics, 268
forensics, 341
National Institute of Justice, 7, 131, 137-138, 150
Department of Veterans’ Affairs, 431
Depression, 54, 64, 66, 69, 94-95, 100, 117, 242, 243, 366
financial abuse, 392
forensics, 355, 357, 362-363, 366
Descriptive studies, 27, 44, 53, 55, 87, 168-177 (passim), 359, 365, 371
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Detection and Treatment of Elderly Abuse and Neglect , 277
Diagnosis, see Forensics; Screening and case identification
Disabled persons, 7, 11, 42, 97-98, 100-101, 150, 171, 241-242
see also Activities of daily living (ADLs);
Cognitive impairments;
Dementia;
Long-term care settings;
Nursing homes
definitional issues, 35, 36, 37, 50, 188
emotional abuse, 28
evaluation of interventions, 124
financial abuse, 391-392, 395, 401, 406, 409, 422, 435
forensics, 343
incidence and prevalence, 10, 11, 264, 265, 270-271, 285
residential care facilities, 465, 466
screening and case identification, 109, 114, 117, 270-271, 294
state law, 35, 36, 37, 124, 181-237
theoretical models, 64, 70
Diagnostic and Treatment Guidelines on Elder Abuse and Neglect (AMA), 104, 109
Diseases and disorders, 11, 97-98
see also Dementia;
Disabled persons;
Fatalities;
Forensics;
Long-term care settings;
Medical interventions;
Mental illness;
Nursing homes
AIDS, 69
financial abuse, 399, 409
geriatric syndrome, 89-90
historical perspectives, 14, 61, 69
incidence and prevalence of mistreatment and, 10, 76, 79, 81
religious/spiritual treatment, state law, 35, 200, 202, 204, 206, 214, 220, 228, 236
residential care facilities, 471
screening and case identification, 105, 108, 109, 117
theoretical models, 61, 66, 68, 69
District of Columbia, 189
Domestic violence, 15, 501-522
see also Child abuse and neglect;
Families and households;
Intimate partner mistreatment;
Marriage and marital status
intergenerational transmission of mistreatment, 99
Dresser, Rebecca, 140, 141, 148, 256, 303-338
Drug abuse, see Substance abuse
Drugs, see Medications
Duress, see Undue influence and duress
Dyer, Carmel Bitondo, 79, 256, 339-381
E
Economic factors, 16
see also Cost factors; Financial abuse; Funding; Socioeconomic status
incidence and prevalence research, 79, 81-82, 87, 270, 280
institutional mistreatment, 66, 67
research ethics, 313, 321, 322
status inequality, theoretical models, 61, 62, 63, 64, 241
theoretical models, other, 66, 67
victim compensation, 130, 419-420
Education and training, see Professional education;
Public education
Elder Abuse Attitudes and Behavior Intention Scale, 276
Elder Abuse Detection Indicators, 277
Elder Abuse Screening Test, see Hwalek-Sengstock Elder Abuse Screening Test (HSEAST)
Elder Assessment Instrument (EAI), 112-113, 166-167, 272, 294-295, 365
Emergency departments/response services, 23-24, 170, 243
committee recommendations, 6, 139
evaluation of effectiveness, 124, 128, 139
financial abuse reporting, 416(n.39)
incidence and prevalence data, 79, 471, 472-473
reporting practices, 472-473
screening and case identification, 107, 109
Emotional abuse, 3
see also Isolation and confinement
definitional issues, 28, 35, 36, 54-55, 448, 449
financial abuse, impacts of, 391, 392, 399, 409
forensics, 340
incidence and prevalence, 74, 275, 284, 451, 454-455
institutional settings, general, 99
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nursing homes, 448, 449, 451, 454-455, 462
research ethics, 322
screening and case identification, 105, 109, 110-111, 117, 166-167, 275, 295, 296
social embarrassment, 57, 339-340
state law, definitional issues, 35, 36, 181-237 (passim)
theoretical models, 63, 64
Epidemiology, 24-25, 71, 75-84, 261-302
see also Demographic factors;
Incidence and prevalence;
Population-based studies;
Reporting practices;
Risk factors
definitional issues, 72, 73, 75-77, 85, 87, 266, 278, 280
forensics and, 371, 373-374
screening and case identification, 107
surveillance, 4, 42, 46, 59, 75, 79, 80, 87
Established Population for Epidemiologic Studies in the Elderly (EPESE), 24-25
Ethical issues
see also Informed consent
caregiver abuse and neglect, 322, 333-334
informed consent, 143, 147-148, 311, 314-315, 333-334
child abuse and neglect, 315-316, 329-331, 333
confidentiality, 33, 83, 145-147, 304, 308-309, 312, 323-324, 328, 329-330, 334, 411
cost factors, 313, 321, 322
definitional issues, 306, 307, 308, 310
Department of Health and Human Services (DHHS),
Federal Policy for the Protection of Human Subjects (Common Rule), 304, 305, 306, 307-309, 312, 314, 319, 323, 325-326, 332, 334
informed consent, 149, 315, 316(n.4)
families, 322, 324
informed consent, 143, 147-148, 311, 314-315
harm, general, 311, 319, 321-322, 324-326, 329
institutional review boards (IRBs), 304, 308-309, 313, 319-321, 323-324, 331
informed consent, 142, 143, 148-149, 304, 316(n.4), 317-319, 323
interviews, 311, 312, 323
National Bioethics Advisory Commission (NBAC), 306, 312, 313, 320-322, 326, 331, 334
private sector, 307, 323-324
research, general, 6, 32-33, 140-149, 303-338, 482-483
funding, 305, 307, 321, 323, 327
sampling, 144
socioeconomic status, 327
Ethnicity, see Race/ethnicity
Evaluation of interventions, xiii, 2, 5, 6, 12, 17-18, 25, 32, 121-139, 285
see also Ethical issues;
Outcome measures;
Reporting practices
adult protective services, 6, 32, 122, 124-127, 139, 506
child and domestic abuse, 501-525
community-level factors, 122, 128
cost factors, 121, 126
criminal justice system, 32, 122, 127-128, 129-130, 131
emergency medical services, 124, 128, 139
ethical issues, 303, 305
informed consent, 6, 140, 141-143
financial abuse, 418-429
funding, 121, 131, 137-138
guidelines for measurement, 46-47
Expertise, 169, 170
see also Interdisciplinary approaches;
Professional education;
specific disciplines and specific expertise
committee biographical sketches, 249-259
definitional issues, 45-47
financial abuse, criminal investigation, 421
forensics, 366, 369-370, 373, 375
guidelines for measurement, 45-47, 57-58
peer review, 18, 74, 152, 321
specialists, 130-131, 132-133, 272;
see also specific experts
Exploitation, 1, 9, 11, 13, 14, 18, 25, 28
see also Financial abuse
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F
Families and households, 18, 24, 133, 137-138, 173, 176, 177, 342, 384-385, 501-522 (passim)
see also Adult children of elderly persons;
Child abuse and neglect;
Intimate partner mistreatment;
Marriage and marital status
committee research recommendations, 4, 7, 70
Conflicts Tactics Scale (CTS), 20, 26-27, 55, 85, 166-167, 244, 271, 274-275, 300-302
ethical issues, research, 322, 324
financial abuse, 40-41, 96, 382, 385, 392, 395, 397, 398, 399, 414, 415, 438
preventive measures, 430-431, 437
historical perspectives, 12, 14, 15, 240, 501, 502
home health workers, 52, 127-128
incidence and prevalence research, 74, 76, 85, 86, 261, 262, 264-267, 268-269, 270-273, 274-275, 284
informed consent, research, 143, 147-148, 311, 314-315
intergenerational transmission of mistreatment, 99
nursing homes, 453-454, 462, 482
reporting practices, 122, 123, 414, 453-454, 462, 473-474
residential care facilities, 467, 473-474, 482
risk factors, 88, 91, 92, 96, 98-99, 100, 242
screening and case identification, 104, 113-114, 270, 271, 273, 293, 294, 295-297
state law, definitional issues, 35, 36, 181-237 (passim), 244-246
theoretical models, 62, 63, 70, 138
Fatalities, 239
see also Forensics
child abuse, 340
financial abuse, 392, 393
incidence and prevalence data, 76, 78, 80, 243
interdisciplinary investigation, 132
long-term care settings, 447
suicide, 78
Federal Bureau of Investigation (FBI), 268, 269, 284, 285-286
Federal government, 6-7, 239-240
see also Funding;
Legislation;
specific agencies and departments
funding
ethical guidelines, 32-33
protective measures, 14, 18
research, 1-2, 6-7, 11-12, 21-22, 24-25, 33
historical perspectives, 12-15
National Bioethics Advisory Commission (NBAC), 306, 312, 313, 320-322, 326, 331, 334
nursing homes, 449-450
reporting requirements, 125
residential care facilities, 464-465
Federal Policy for the Protection of Human Subjects (Common Rule), 304, 305, 306, 307-309, 312, 314, 319, 323, 325-326, 332, 334
Fiduciaries, 28, 41, 132, 385, 389, 390, 403, 419, 426(n.49), 427, 428
preventive measures, 434-435, 436
state legislation, definitions, 190-191, 192, 197, 203, 206, 211, 218, 219
Financial abuse, 167, 359-360, 382-445
see also Banks and banking;
Fiduciaries;
Guardianship and power of attorney
abuser dependency, 96, 241, 242, 270, 293, 296, 300, 387(n.11)
adult protective services, 390, 394, 405(n.25), 417, 436, 437
attitudes and, 391-392, 396, 399-402, 404, 406, 407, 414, 415, 429, 438
attorneys, 52, 390, 398, 411-412, 413, 423, 433-434
caregiver abuse and neglect, 40-41, 65, 385, 388, 395, 397-400, 435-436
child abuse models, 402-408
cognitive impairments, 393, 395, 396, 397, 404-406, 407, 413, 421, 422, 433-434, 435, 438
community-level factors, 430-432, 436
computer technology, 392, 395, 398, 431
cost factors, legal interventions, 422, 429, 434-435
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criminal justice system, 392, 393, 400, 411-412, 420-423
definitional issues, 35, 38, 40-41, 382(n.1), 385-386, 388-389, 409, 415, 420-421
guidelines for measurement, 51-53, 54-55
disabled persons, 391-392, 395, 401, 406, 409, 422, 435
emotional impacts of, 391, 392, 399, 409
families, 40-41, 96, 382, 385, 392, 395, 397, 398, 399, 414, 415, 438
preventive measures, 430-431, 437
forensics, 340
fraud, 131, 132, 134, 185, 207, 210, 211, 213, 216, 221, 227, 231, 236, 340, 359, 360, 372, 385, 387, 400, 404-405
gender factors, 394-395
incidence and prevalence, 1, 9, 11, 74, 243-244, 274, 389-391, 401, 437-438
inheritance, 392, 399, 403(n.22)
international perspectives, 390, 394
intimate partners, 394, 401, 402-403, 408-410
isolation and, 393, 395, 397, 402, 435
marriage and marital status, 394, 401, 402-403, 408-410
medical services, 397, 399, 416, 435-436
mental illness, 397, 399
neglect, 387, 395, 409
professional education, of specialists, 130, 131, 132, 419, 432, 436, 437
protective orders, 418, 425
psychological factors, 391, 392, 399, 401, 409
race/ethnicity factors, 388, 390-391, 394
reporting requirements, 123, 383, 391, 393, 410-418
research recommendations, 3, 7, 436-439
risk factors, 92, 96, 393-402
screening and case identification, 110-113, 166-167, 274, 293, 295, 300, 382, 421, 429-436, 438
self-abuse and neglect, 397, 414
sociocultural factors, 388, 393, 395, 397, 417, 438
preventive measures, 430-431, 435
socioeconomic status, 394
state law, definitional issues, 35, 38, 181-237 (passim), 247
state programs, 14
strangers, 52, 110-113, 261, 384, 400
theoretical models, 65
trust relationships, 382, 385, 387, 392, 393, 395, 401-402, 415
undue influence and duress, 131, 192, 195, 197, 203, 206-207, 210, 211, 212, 219, 222, 226, 231, 233, 237, 304, 309, 312, 386, 387, 389, 400, 404, 405, 407, 425
Finland, 244
Florida, 125, 189-191
Food, see Nutrition
Food and Drug Administration (FDA), 140, 307-308
Foreign countries, see International perspectives;
specific countries
Forensics, 65, 101-102, 119-120, 129, 132, 339-381
abrasions and lacerations, 54, 118, 119, 340, 344-345, 359, 360, 361, 372, 454
age factors, 341, 344-360 (passim)
biomarkers, 3, 23, 74, 84, 101-102, 340, 360-362
bruises, 20, 49, 54, 114, 116, 117, 119, 120, 127, 166, 183, 186, 216, 340, 342-343, 345-347, 454
burns, 119, 120, 340, 343, 353-354
caregiver abuse and neglect, 342, 343-381 (passim)
centers, 368-369, 375
child abuse and neglect, 339-340, 360-361
cognitive impairments, 343, 354-357, 360, 366-367, 371-372
computer applications, 362
decubiti, 340, 343, 348, 349-350, 360, 372
definitional issues, 341, 342, 343, 344, 364
dementia, 355, 356-357, 362-363, 366
depression, 355, 357, 362-363, 366
emotional abuse, , 340
epidemiology, 371, 373-374
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fractures, 20, 79, 114, 118, 119, 120, 127, 166, 183, 255, 340, 342-343, 347-348, 360, 362, 371, 372, 373, 448(n.2), 454, 471, 472
interdisciplinary approaches, 366, 369-370, 375
medications, use of, 340, 343, 352-353
mental illness, 340, 355, 357, 362-363, 366, 371-372
neglect, 342, 343, 372
dehydration, 119, 340, 351-352, 372, 448, 463
hygiene, 340, 350, 357-358, 360, 448, 463
malnutrition, 340, 350-351, 448, 464
restraints, 340, 348-349
self-abuse and neglect, 343
sexual abuse, 340, 358-359, 372
standards, 363-364, 370, 372
violence, physical, 340, 342-343, 360-362
Fractures, 20, 79, 114, 118, 119, 120, 127, 166, 183, 255, 340, 342-343, 347-348, 360, 362, 371, 372, 373, 448(n.2), 454, 471, 472
Fraud, 131, 132, 134, 185, 207, 210, 211, 213, 216, 221, 227, 231, 236, 340, 359, 360, 372, 385, 387, 400, 404-405, 412-413, 422-423, 424, 438
Medicaid, 456
Fulmer Restriction Scale, 167
Funding, 1-2, 11-12, 27, 42, 150
adult protective services, 14, 126, 239, 240, 418-419
block grants, 14
ethical issues, research, 305, 307, 321, 323, 327
evaluation of interventions, 121, 131, 137-138
forensics, 341
incidence and prevalence and, 3-4, 71, 84-86, 244
interdisciplinary approaches, 131
Medicaid, 128
population-based studies, 3, 84-85
prevention, 121, 131, 418-419
professional education, 32, 132, 133, 151
protective care, 14, 126, 239, 240, 418-419
research, general, 1-2, 6-7, 11-12, 21-22, 24-25, 33, 42, 71, 95, 140, 150, 151-152, 521-522
screening and case identification, 105
G
Gender factors, 60, 96, 168, 176, 242-243, 294
see also Intimate partner mistreatment;
Marriage and marital status;
Sexual abuse
financial abuse, 394-395
institutional settings, 100
long-term care settings, 447
violent crime victims, 269
General Accounting Office, 413
Georgia, 191-192
Geographic factors, 4
see also Community-level factors;
Urban areas;
specific states and countries
incidence and prevalence and, 72, 79, 81-82, 86, 283, 284
rural areas, 61, 66, 67
screening and case identification, 104, 106, 107
telephone interviews, 283
theoretical models, 61, 62, 66, 67
Geriatric syndrome, 89-90
Government role, see Federal government;
Local government;
State government
Guardianship and power of attorney, 13, 51, 239
financial abuse, 40-41, 184, 191, 192, 200, 210, 212, 227, 389, 398-399, 413, 418, 426-429, 433
preventive measures, 431
forensics, 341, 344
informed consent for research participation, 314, 315-316, 321, 328
professional education, 130, 131
reporting requirements, 123
state legislation, 137, 182, 184, 191, 192, 200, 210, 211, 212, 213, 217, 222, 227, 234
Guidelines for Defining Public Health Research and Public Health Non-Research, 306-307
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Medical interventions, 79-80, 150-151
see also Clinical practices and research;
Emergency departments/response services;
Forensics;
Nurses and nursing;
Physicians
biomarkers, 3, 23, 74, 84, 101-102, 340, 360-362
community-level programs, 510-512
evaluation of interventions, 122, 127-129
financial abuse, 397, 399, 416, 435-436
Medicaid, 128, 134, 448, 451, 457, 466, 479
Medicare, 294, 448, 451, 456-457
screening during, 75, 104, 108, 127-128
state legislation, 181-237 (passim)
Medicare, 294, 448, 451, 456-457
Medications
cognitive effects, 264, 406(n.29)
definition of maltreatment, 35, 52, 56, 81
financial abuse, 406(n.29)
forensics, 340, 343, 352-353
residential care facilities, 466, 467, 468-469
restraints, 52, 448, 466, 468-469
screening and case identification, 108, 293, 295
Mental illness, 12, 50
see also Cognitive impairments;
Dementia;
Depression
alcohol abuse, 21, 91, 94, 95, 242, 270, 282, 293, 294, 296, 299, 355, 357, 398
financial abuse and, 397, 399
forensics, 340, 355, 357, 362-363, 366, 371-372
incidence and prevalence of mistreatment and, 87, 270, 282
informed consent, 6, 140, 141-143
reporting requirements, 122
residential care facilities, 465, 466, 467
as risk factor, general, 94-95, 242
screening and case identification, 109, 117, 270, 282, 294, 296
substance abuse, 94, 95, 145-146, 242, 366, 398, 399
theoretical models, 63, 64, 240-241
Michigan, 203-204, 473
Minimum Data Set (MDS), 479
Minnesota, 125, 205-207
Minorities, see Race/ethnicity
Mississippi, 207-208
Missouri, 208-210
Mistreatment, see Child abuse and neglect;
Definitional issues;
Domestic violence;
Emotional abuse;
Exploitation;
Financial abuse;
Self-abuse/self-neglect;
Sexual abuse
Models and modeling, see Definitional issues;
Theory and theoretical models
Montana, 210-211
Mortality, see Fatalities
Mount Sinai/Victim Services Agency Elder Abuse Project Questionnaire, 365
Multidisciplinary approaches, see Interdisciplinary approaches
N
National Association of Adult Protective Services Administrators, 126
National Bioethics Advisory Commission (NBAC), 306, 312, 313, 320-322, 326, 331, 334
National Center for Injury Prevention, 80
National Center on Elder Abuse (NCEA), 15, 22-23, 132, 265-266, 385, 389-390
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 315-316, 319-320, 327
National Crime Victimization Survey (NCVS), 268-269
National Elder Abuse Incidence Study (NEAIS), 263, 266-267, 277, 286
financial abuse, 383, 394, 401, 412, 417, 432, 437
National Incident Based Reporting System (NIBRS), 268, 269
National Institute of Justice, 7, 131, 137-138, 150
National Institute on Aging (NIA), 2, 6-7, 11, 12, 24-25, 95, 144, 149, 150, 151, 243, 483
National Institutes of Health (NIH), 12
confidentiality, 33, 145, 146-147
informed consent, 149
National Long Term Care Survey, 11
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National Mortality Followback Survey, 447
National Ombudsman Reporting System (NORS), 457
National Survey of Adolescents, 279, 285
National Violent Death Reporting System, 80
National Women’s Study, 279, 280-281, 285
Nebraska, 211
Neglect, general, xiii, xiv, 5, 11, 12, 13, 14, 17, 22-23, 95, 168
see Child abuse and neglect;
Isolation and confinement;
Nutrition;
Restraints;
Self-abuse/self-neglect
abandonment, 36, 184, 188, 199, 216, 222, 225, 236, 357
community-level programs, 510
decubiti, 340, 343, 348, 349-350, 360, 372
definitional issues, 19, 20-21, 34-37 (passim), 39, 41, 44, 181-237 (passim), 342, 449-450
guidelines for measurement, 44, 56
dehydration, 119, 166, 183, 186, 272, 340, 351-352, 372, 448, 463
financial, 387, 395, 409
forensics, 342, 343, 372
hygiene, 136, 169, 192, 217, 218, 340, 350, 357-358, 360, 448, 463
incidence and prevalence, 74, 81, 173, 274, 462-464
malnutrition, 340, 350-351, 448, 464
nursing homes, 449-450, 462-464, 469
residential care facilities, 467-468
restraints, 340, 348-349
screening and case identification, 110-113, 118, 119, 274, 293-302 (passim)
state law, 124, 387
Nevada, 212-213
New Hampshire, 213
New Jersey, 213-214
New Mexico, 214-215
New York, 216-217, 432
North Carolina, 217-219
North Dakota, 219
Nurse Aid Registry, 471
Nurses and nursing, 21, 22, 41, 52, 60, 61, 73, 169, 272
adult protective services and, 456-460
cognitive impairments, 451, 452, 482
communication deficits of residents, 452, 462
definition of abuse, 448-449
financial abuse, 435
home health workers, 52, 127-128
neglect, 449-450, 462-464, 469
reporting practices, 460-462, 470, 472-473, 474-476
research ethics, 313
residential care facilities, 470, 472-473, 485-487, 490
staff, 134-135, 136-137, 448-449, 455, 456, 459, 460-464, 485-487, 490
registries, 460-462, 483, 484, 485-487, 490-491
Nursing homes, 11, 13-14, 176, 351, 447, 450-464
activities of daily living (ADLs), 452, 479
adult protective services and, 13-14, 239, 243
cognitive impairments, 313, 333, 351
decubiti, 345
definition of mistreatment, 18, 51, 52, 448-450
dementia, 451, 452, 482, 485, 486
demographics, 11, 447
emotional abuse, 448, 449, 451, 454-455, 462
evaluation of interventions, 125, 133-137 (passim)
families and, 453-454, 462, 482
financial abuse, 51, 52, 384, 385, 389, 411, 412, 414
forensics, 347, 350, 351-352, 359, 364, 367, 371, 375
incidence and prevalence of mistreatment, xiii, 77, 79-80, 86, 99, 176, 447, 450-464, 471, 477-483
isolation and confinement, 448, 450, 454
number of elderly in, 10-11, 151, 447
nutrition, 350, 351-352
preventive measures, 7, 151, 152, 455, 489-491
reporting practices, 446-447, 450-464, 471
research ethics, 313, 333, 482-483
risk factors, 64, 66, 99, 100, 102, 451-453, 479, 483-491
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sampling, 478-481
screening and case identification, 104, 109, 113, 117, 119, 357, 488
sexual abuse, 359, 451, 452, 485
state government, general, 200, 208, 448, 457, 460-462
state legislation, definitional issues, 200, 208, 448
theoretical models, 62, 64, 66
violent abuse, 448-450, 451, 452-454, 455
Nutrition
dehydration, 119, 166, 183, 186, 272, 340, 351-352, 372, 448, 463
Elder Assessment Instrument (EAI), 166-167, 272, 294, 365
forensics, 340, 350-351, 360, 448, 464
nursing homes, 350, 351-352
weight loss, 340, 350-351, 448, 464
O
Occurrence of mistreatment, see Incidence and prevalence
Office for Human Research Protections, 6-7, 33, 149, 151
Office of Behavioral and Social Science Research on Women’s Health, 12
Office of the Assistant Secretary for Planning and Evaluation, 3, 479-480
Ohio, 219-221
Oklahoma, 221-222
Older Americans Act, 15, 42, 131, 240
Ombudsmen, 25, 122, 123, 125, 131, 134, 137, 169, 170, 366, 373, 448, 450, 453, 456-460, 463, 467, 468, 470, 471, 473-474, 485, 488-489
Omnibus Budget Reconciliation Act, 450, 451
Online Survey Certification and Reporting System (OSCAR), 471
Oregon, 223
OSCAR database, 457, 471, 476-477, 478
Outcome measures, 3, 4, 5-6, 78-79, 86-87, 243, 284
see also Fatalities
adult protective services, 126
committee recommendations, 4-6 (passim), 45, 137-139
guidelines for measurement, 45, 50
screening and case identification, 108
strangers, abuse by, 261
theoretical models, 62-64
P
Pennsylvania, 21, 223-234
Pepper, Claude, 14-15, 18, 239, 240
Pharmaceuticals, see Medications
Physical abuse, see Restraints;
Sexual abuse;
Violence, physical abuse
Physicians, 13, 21, 41, 60, 109, 123, 127, 170, 175, 199
reporting practices, 472
research ethics, 313
screening and case identification, 278, 293, 365
Police, 16, 21, 60, 73, 81, 93, 104, 122, 123, 125, 127, 129, 130, 132, 137, 138, 269, 282
financial abuse, 422
forensics, 341
Political and policy issues, 1, 7, 14-15, 18, 238-240, 262(n.1), 303-338
see also Ethical issues;
Federal government;
Funding;
Legislation;
Local government;
Standards;
State government
advocacy, 14, 15, 17, 130, 136, 239, 251, 256, 316, 356, 388, 418, 419, 422, 423, 429, 430, 489, 490, 505-506, 516
Population-based studies, xiv, 2, 23-24, 73, 74, 76-77
biomarkers and, 84
committee recommendations, 3, 30-31
funding, 3, 84-85
Power of attorney, see Guardianship and power of attorney
Prevalence, see Incidence and prevalence
Preventive interventions, 2, 12, 285, 517-519
see also Adult protective services;
Professional education;
Public education;
Screening and case identification
child abuse and domestic violence, 501-522 (passim)
committee recommendations, 4, 6, 139, 151
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financial abuse, 418-419, 429-436, 437
banks and banking, 132, 296, 414, 430, 431-433, 435, 437
funding, 121, 131, 418-419
historical perspectives, 12, 15
incidence and prevalence and, 71, 78, 86
institutional settings, 13
nursing homes, 7, 151, 152, 455, 489-491
research, ethical guidelines, 144, 306-307
residential care facilities, 489-491
risk factors and, 88-89
theoretical models, 69-70
Privacy, see Confidentiality
Private sector, 7, 32, 151, 152
see also Attorneys;
Banks and banking
financial abuse, 433
incidence and prevalence and funding, 71
research ethics, 307, 323-324
Professional education, 32
adult protective services, 126
criminal justice system, 127-131 (passim)
financial abuse, 130, 131, 132, 419, 432, 436, 437
funding, 32, 132, 133, 151
guardianship and power of attorney, 130, 131
institutional staff, 115, 127-128, 134, 136-137, 485-487, 488, 517, 518
interdisciplinary approaches, 130-131
reporting requirements, 123, 266-267
screening and case identification, 115, 127-128
sentinels, 22-23, 55, 74, 77, 128, 172, 244, 246, 261, 262, 266-268, 277, 278, 284, 286, 287, 394
specialists, general, 130-131, 132-133
Prospective studies, 2, 24-25, 90-91, 334
see also Ethical issues
Protective factors, 101-103
see also Interventions
definitional issues, 48, 49, 50, 58
disabled persons, 98
incidence and prevalence and, 71, 73, 76, 79-80
Protective orders, 418, 425
Protective services, see Adult protective services
Protocol for Health Care Professionals, 277
Psychological factors, 24, 97
see also Attitudes;
Cognitive impairments;
Emotional abuse;
Isolation and confinement;
Mental illness
community-level programs, 510-512
definitional issues, 50, 448
effects of mistreatment, 3, 4, 35, 58, 64, 78, 79, 87, 279, 284, 391
financial abuse, 391, 392, 399, 401, 409
nursing homes, 448
theoretical models, 63, 64, 66, 68, 69, 240-241
trust relationships, 2, 3
Public education, 267-268, 517-518
child abuse, 267-268, 505, 517-518
mass media, 15, 519
reporting practices, 123, 267-268
screening and case identification, 105, 107
Public Health Service Act, 145, 146, 323
Q
QUALCARE Scale, 166-167, 173, 174
Questionnaires
see also specific instruments and surveys
incidence and prevalence of abuse, 74, 86, 270-277, 280-281, 287
screening and case identification, 110-113, 120, 166-173 (passim), 270-277, 280-281, 293-302, 365, 366, 504
R
Race/ethnicity, 97, 171
African Americans, 97, 269, 390-391, 466
financial abuse, 388, 390-391, 394
incidence and prevalence and risk factors, 82, 269
informed consent, language issues, 312
nursing homes, 451, 452
residential care facilities, 465
screening and case identification, 114
theoretical models, 61, 62, 64
Records and record-keeping, 21, 22, 23, 35, 45, 46, 53, 55, 71, 74, 78
see also Reporting practices
computer applications, 108-109, 120
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ethical issues, 308, 324
financial, 54
incidence and prevalence, 83-84, 261, 262, 265-266, 267, 269, 286, 287
linkages, 3, 5, 25, 75, 83-84, 108-109, 120, 267, 286
screening and case identification, 108-109, 120, 261, 262, 265-266, 267
Registries, 107, 125, 135, 482, 483, 484, 485-487, 490-491
nursing homes, 450, 460-462
residential care facilities, 470, 474-476
Regulatory issues, 133
see also Institutional review boards (IRBs);
Legislation;
Standards
assisted-living settings, 133
hospital accreditation, 128
institutional facilities, 7, 66, 133-134, 490-491
inspection of, 80, 134, 137
licensing, 80, 134, 316(n.4), 411
research ethics, 27, 140, 303-309, 315-319, 328
Belmont Report, 303-304, 305, 306, 309, 311, 316-318, 319-320, 321, 327, 334
Federal Policy for the Protection of Human Subjects (Common Rule), 304, 305, 306, 307-309, 312, 314, 319, 323, 325-326
Religious institutions, 243
screening and case identification, 114
state law, definitional issues, 35, 200, 202, 204, 206, 214, 220, 228, 236
Remedial interventions, 2, 12
see also Adult protective services;
Criminal justice system;
Medical interventions
case management, 4-5, 105-106, 116, 277
civil justice interventions, 28, 32, 130, 131, 134, 145, 221, 251, 255, 324, 341, 342, 343, 362, 374, 421, 423-429
committee recommendations, 4, 6
epidemiology, 78
financial abuse, 418-429
informal, 93, 123
screening and case identification, 105
victim compensation, 130, 419-420
victim services networks, 365, 419-420
victim/witness assistance, 129-130
Reporting practices, 76, 122-124, 126, 175, 177, 264, 265-268, 269, 383
see also Confidentiality;
Records and record-keeping;
Registries
adult protective services, 27, 28, 115, 122, 167, 261, 267, 383-384, 411-412, 417, 456-460
attorneys, 52, 123, 390, 411-412, 413
child abuse, 13, 16, 123, 329(n.6), 330
committee recommendations, 6, 33, 139
emergency medical services, 472-473
ethical issues, 324, 328-333, 334-335
evaluation of, 122-124
families, 122, 123, 414, 453-454, 462, 473-474
financial abuse, 123, 383, 391, 393, 410-418
banks and banking, 411(n.36), 412, 421
forensics, 374-375
guardianship and power of attorney, 123
guidelines for measurement, 55
nurses, 460-462, 470, 472-473, 474-476
nursing homes, 446-447, 450-464, 471
professional accounts, 21-23
professional education, 123, 266-267
public education, 123, 267-268
sentinel reports, 22-23, 55, 74, 77, 128, 172, 244, 246, 261, 262, 266- 268, 277, 278, 284, 286, 287, 394
state government, general, 122-126, 144-148, 286, 328-329, 448, 471-472, 476-477, 482-483
state legislation, 13, 18, 33, 60, 122-124, 267, 410-418
surveillance, 4, 42, 46, 59, 75, 79, 80, 87
Residential care facilities, 4, 464-469
see also Assisted-living settings;
Institutional settings;
Long-term care settings;
Nursing homes;
Respite care
activities of daily living (ADLs), 466, 469, 479
cognitive impairments, 465, 466, 467, 482
databases, 471, 476-477, 478
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definitional issues, 4, 465, 475
state legislation, 198, 210, 237
disabled persons, 465, 466
evaluation of interventions, 122, 126, 133-134, 137
families and, 467, 473-474, 482
financial abuse, 384
forensics, 344, 372, 375
historical perspectives, 468-469
incidence and prevalence of mistreatment, 80, 86, 464-483
isolation, 466-467
medications, 466, 467, 468-469
mental illness, 465, 466, 467
neglect, 467-468
number of elderly in, 10
nurses, 470, 472-473, 485-487, 490
reporting practices, 470-477
research ethics, 303, 313, 482-483
restraints, 466, 468-469
risk factors, 465-468, 479, 483-491
sampling, 478-481
screening and case identification, 114, 488
sociocultural factors, 466-467
socioeconomic status, 466, 467, 480
standards, 464-465
Respite care, 93, 94-95, 125, 130, 270
Restraints, 36, 52, 448, 455
chemical, 52, 448, 466, 468-469
forensics, 340, 348-349
state law, legal definitions, 181-237 (passim), 469
Retrospective studies, see Controlled studies;
Longitudinal studies
Rhode Island, 224-226
Risk factors, 1, 14, 88-103, 124, 170, 241-242, 262-263, 284-285
see also Epidemiology;
Forensics;
Incidence and prevalence;
Screening and case identification;
Vulnerability, general
abuser dependency, 96, 241, 242, 270, 293, 296, 300
adult protective services, 96, 97, 98
caregivers, general, 93-95, 98-103
child abuse and domestic violence, 88, 91, 99, 103, 242, 503-504
definitional issues, 5, 20-21, 35, 72, 89
guidelines for measurement, 48, 49-50, 58, 81-82, 85
dementia, 92, 93-94, 451
families, 88, 91, 92, 96, 98-99, 100, 242
geriatric syndrome, 89-90
incidence and prevalence and, 71, 72, 81-82, 85, 86-87, 261-302
isolation, 91, 93, 241, 270, 293, 294, 300
nursing homes, 64, 66, 99, 100, 102, 451-453, 479, 483-491
race/ethnicity, 82, 269
research ethics, 309-310, 311, 313, 319, 320-326, 329-334
see also Informed consent
research recommendations, 3, 5, 31, 489
residential care facilities, 465-468, 479, 483-491
sociocultural, 88, 91, 241, 270
theoretical models, 60-70, 87
Risk of Future Abuse instrument, 170
Rural areas, theoretical models, 61, 66, 67
S
Sampling, 4-5, 22-23, 24-25, 27, 90, 124, 168-177 (passim)
ethical guidelines, 144
incidence and prevalence of abuse, 74, 86, 87, 282, 283, 284, 286
long-term care facilities, 478-481
Screening and case identification, 23-24, 65, 76-77, 88, 104-120, 166-167, 169, 242, 503-505
see also Forensics;
Professional education;
Reporting practices;
Risk factors
abandonment, 112-113
activities of daily living (ADLs), 105, 270-271
adult protective services, 104, 105-106, 115-116, 124, 167, 261, 267, 277, 365
attitudinal factors, 109, 242, 264-265, 271-272, 276, 278-279, 284, 293, 294, 296, 299, 396
biomarkers, 3, 23, 74, 84, 101-102, 340, 360-362
caregivers, 104-120, 166-167, 242, 270, 271-277, 293-302 (passim), 504-505
child abuse and domestic violence, 116-117, 119, 267, 273, 403-404, 503-505
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cognitive impairments, 76, 83, 105, 109, 114, 116-117, 270-272, 273, 284, 314, 366-367, 396, 397
committee recommendations, 3, 4, 5-6, 31
community-level factors, 104, 106, 107, 109, 114, 115
computer applications, 108-109
cost factors, 104, 106, 120, 267, 282
criminal justice system, 104, 105-106, 115, 116-117, 127-128
dementia, 114, 116-117, 270, 276, 277, 366
disabled persons, 109, 114, 117, 270-271, 294
diseases and disorders, 105, 108, 109, 117
emergency medical services, 107, 109
emotional abuse, 105, 109, 110-111, 117, 166-167, 275, 295, 296
epidemiology, 107
expertise, 45-47, 57-58
families, 104, 113-114, 270, 271, 273, 293, 294, 295-297
financial abuse, 132, 396-399, 419, 403-404, 432, 436-437
forensics, 363-368, 370, 372, 375
funding, 105
geographic factors, 104, 106, 107
historical perspectives, 73
hospitals, 105, 503, 504
incidence and prevalence of abuse, 74-77, 79-80, 270-273
institutional staff, screening of, 100, 134-135, 490, 504-505
interdisciplinary approaches, 131-132
interviews, 110-113, 115, 120, 166-173 (passim), 270-276, 277, 281-283
medical care specialists, 75, 104, 108, 127-128
medications, 108, 293, 295
mental illness, 109, 117, 270, 282, 294, 296
neglect, 110-113, 118, 119, 274, 293-302 (passim)
state law, 124, 387
nursing homes, 104, 109, 113, 117, 119, 357, 488
physicians, 278, 293, 365
prescreening, 5, 107, 120
professional education, 115, 127-128
public education, 105, 107
questionnaires, 110-113, 120, 166-173 (passim), 270-277, 280-281, 293-302, 365, 366, 504
records and record-keeping, 108-109, 120, 261, 262, 265-266, 267
registries, 107
religious institutions, 114
research, informed consent, 6, 141
residential care facilities, 108, 114-115, 266, 278
sociocultural factors, 114, 270, 280, 293-296 (passim)
socioeconomic status, 114
standards, 106-107, 112, 113-114, 115, 116-118, 363-364, 370, 372
state government, 115, 488
statistical analysis 107-108, 110-113, 270-272, 273, 277
time factors, 105, 106, 107, 113, 114, 115, 238, 243, 282, 296, 365, 367
trust relationships, general, 109, 113, 114, 118, 293
violence, physical, 110-113, 114, 117, 118-120, 273-276, 278, 283-284, 293, 294, 297, 403
Screening Protocol for Identification of Abuse and Neglect of the Elderly, 277
Self-abuse/self-neglect, 1, 19
adult protective services, 126-127
definitional issues, 35, 36, 40, 41, 81
guidelines for measurement, 44
state law, 35, 36
financial abuse and, 397, 414
forensics, 343
Sentinel reports, 22-23, 55, 74, 77, 128, 172, 244, 246, 261, 262, 266-268, 277, 278, 284, 286, 287, 394
child abuse and neglect, 267, 268
Sex differences, see Gender factors
Sexual abuse, 16-17, 127, 280, 281
see also Intimate partner mistreatment
definitional issues, 35, 49, 183-237 (passim), 280, 281
forensics, 340, 358-359, 372
incidence and prevalence, 75, 78, 275, 276, 280, 284
nursing homes, 359, 451, 452, 485
state law, definitional issues, 35, 183-237 (passim)
stigma, 264, 278
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Social Security Act, 13, 14, 239
Social Security Administration, 431
Sociocultural factors
see also Demographic factors;
Ethical issues;
Families and households;
Institutional settings;
Isolation and confinement;
Race/ethnicity;
Religious institutions
financial abuse, 388, 393, 395, 397, 417, 438
preventive measures, 430-431, 435
incidence and prevalence and, 79, 81-82, 87, 270, 280
residential care facilities, 466-467
risk factors, 88, 91, 241, 270
screening and case identification, 114, 270, 280, 293-296 (passim)
stigma, 69, 242, 243, 264, 278-279, 332, 415, 429, 503
theoretical models, 60, 61, 62-64, 67, 68, 91, 240
Socioeconomic status, 171
ethical research, 327
financial abuse, 394
incidence and prevalence research, 81-82, 262, 282-283
Medicaid, 128, 134, 448, 451, 457, 466, 479
residential care facilities, 466, 467, 480
screening and case identification, 114
telephone interviews, 282-283
theoretical models, 61, 62, 63, 64, 241
South Carolina, 226-227
South Dakota, 227-228
Spouses, see Intimate partner mistreatment;
Marriage and marital status
Standards, 6, 27, 45, 56, 342
see also Definitional issues;
Ethical issues;
Institutional review boards;
Regulatory issues
financial abuse, proof of, 423-424
forensics, 363-364, 370, 372
guidelines for measurement, 45-47, 56, 58-59
hospital accreditation, 128
informed consent, 6, 140, 141-143, 309-311
LEAD methodology, 45-47, 59, 106-107, 115, 118
residential care facilities, 464-465
screening and case identification, 106-107, 112, 113-114, 115, 116-118, 363-364, 370, 372
Supplemental Security Income (SSI), 466, 467
State government
see also Criminal justice system;
specific states
adult protective services, 14, 18, 124, 167, 239
child abuse legislation, 13, 123, 506, 507-508
confidentiality, 33, 304
disabled persons, definitional issues, 35, 36, 37, 124, 181-237 (passim)
elder abuse legislation, 14, 19, 28, 130, 143, 144, 245
adult protective services, 27, 28, 115, 124, 181-182, 185, 189, 411- 412, 417, 418-419, 505, 506-507
age factors, 27, 28, 115, 124, 181-182, 185
cognitive impairments, 35, 36, 184, 405, 406
definitional issues, 13, 28, 34-39, 44, 60, 181-237, 384, 385, 400
fiduciaries, 190-191, 192, 197, 203, 206, 211, 218, 219
financial abuse, 13, 14, 18, 28, 184-236 (passim), 384, 386-387, 405, 406, 410-418, 422, 423-429, 433, 439
fraud, 185, 207, 210, 211, 213, 216, 221, 227, 231, 236, 387
forensics, 343-344
guardianship and power of attorney, 137, 182, 184, 191, 192, 200, 210, 211, 212, 213, 217, 222, 227, 234
individual statutes, 181-237
informed consent, 142-143, 145-148, 314
institutional settings, general, 35, 36, 37, 187-188, 194, 196, 201, 202, 209, 214, 215, 217, 218, 220, 221, 222, 223, 225-226, 233, 235
medical care, 181-237 (passim)
neglect, 34-37, 44, 124, 181-237 (passim), 387
nursing homes, 200, 208, 448
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religious institutions, 35, 200, 202, 204, 206, 214, 220, 228, 236
reporting requirements, 13, 18, 33, 60, 122-126, 144-148, 267, 286, 328-329, 410-418, 448
residential care, 13, 28, 34-39, 44, 60, 198, 210, 237
screening and case identification, 115-116, 124
sexual abuse, 35, 183-237 (passim)
vulnerability, 39, 41-42, 43, 50, 182-237 (passim), 246-247
financial abuse, 137, 182, 184-236 (passim), 384, 386-387, 390, 405, 406, 410-418, 419, 422-429
funding, 7, 14, 419
historical perspectives, 13, 14
institutional settings, inspections, 80, 84, 134, 137;
see also Institutional review boards (IRBs)
nursing homes, 200, 208, 448, 457, 460-462
reporting practices, 122-126, 144-148, 286, 328-329, 448, 471-472, 476-477, 482-483
residential care facilities, 469, 470, 471, 476-477
screening and case identification, 115, 488
theoretical models, 66
Statistical analyses, 170-174
screening and case identification, 107-108, 110-113, 270-272, 273, 277
Strangers, abuse by, 1
definitional issues, 40
guidelines for measurement, 44, 52
state law, definitional issues, 35
financial, 52, 110-113, 261, 384, 400
incidence and prevalence, 74, 261, 283, 284
Substance abuse, 94, 95, 145-146, 242, 366, 398, 399
Suicide, 78
Sullivan, Louis, 240
Supplemental Security Income (SSI), 466, 467
Surgeon General, 240
Surveillance, 4, 42, 46, 59, 75, 79, 80, 87
Surveys, xiii, 2, 75, 79, 82-83, 84-86, 168-177 (passim), 243-244
see also Interviews, Questionnaires
community, 23, 81
criminal justice, 268-269
harm measurement, 53
mail, 21
Medical Expenditure Panel Survey (MEPS), 479
National Crime Victimization Survey (NCVS), 268-269
National Elder Abuse Incidence Study (NEAIS), 263, 266-267, 277, 286
financial abuse, 383, 394, 401, 412, 417, 432, 437
National Long Term Care Survey, 11
National Mortality Followback Survey, 447
National Survey of Adolescents, 279, 285
National Women’s Study, 279, 280-281, 285
nursing homes, 464
Online Survey Certification and Reporting System (OSCAR), 471
population-based, 3, 4, 11, 24, 45, 30, 82-83
of professionals, 21, 23
screening and case identification, 115
telephone, 73-74, 82, 243, 261, 280, 281-283, 285-286, 287, 481
victims and family members, 26
Sweden, 74
T
Telephone
computer applications, 281, 283, 285-286, 287
hotlines, 75, 124, 167, 168, 270
surveys, 73-74, 82, 243, 261, 280, 281-283, 285-286, 287, 481
telemarketing fraud, 438
Temporal factors, see Time factors
Tennessee, 228
Texas, 228-229
Theory and theoretical models, 60-70, 87, 91, 240-241, 271, 283
see also Definitional issues
adult protective services, 60, 65
caregiver abuse and neglect, general, 61, 63, 64-65, 69-70
cognitive impairments, 66, 70
dementia, 66
disabled persons, 64, 70
diseases and disorders, 61, 66, 68, 69
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emotional abuse, 63, 64
families, 62, 63, 70, 138
geographic factors, 61, 62, 66, 67
historical perspectives, 61, 240-241
individual personal factors, 61, 62, 63, 67, 91
institutional review boards (IRBs), 62, 64, 66-69
isolation, 64, 91
lacking, 2, 27, 521
longitudinal research, 30, 87
mental illness, 63, 64, 240-241
nursing homes, 62, 64, 66
psychological factors, 63, 64, 66, 68, 69, 240-241
race/ethnicity factors, 61, 62, 64
risk factors, 60-70, 87
rural areas, 61, 66, 67
sociocultural factors, 60, 61, 62-64, 67, 68, 91, 240
socioeconomic status, 61, 62, 63, 64, 241
state government, 66
trust relationships, 63, 66, 91
urban areas, 61, 67
Time factors, 3
see also Longitudinal studies
adult protective services, response time, 124, 129-130
agency/researcher cooperation, 26
child abuse, 280, 281, 510
community-level programs, 510
criminal justice system, 129-130
epidemiology, 72, 77, 78, 87, 238, 243, 282
financial abuse investigations, 422
financial abuse reporting, 411
guidelines for measurement, 47, 54-55, 87
household settings, 137-138
intensity of abuse, 5
nursing home use, 447
remission, 5
residential care facilities, family visit intervals, 467
risk factors, 5, 65, 69
screening and case identification, 105, 106, 107, 113, 114, 115, 238, 243, 282, 296, 365, 367
Trust relationships, general, 2, 3, 58
see also Caregiver abuse and neglect;
Guardianship and power of attorney
definitional issues, 39, 40-41, 43, 44, 61, 238, 384-385
guidelines for measurement, 44, 47-48, 51-53, 57
financial abuse, 382, 385, 387, 392, 393, 395, 401-402, 415
incidence and prevalence of abuse, 74, 77
risk factors, 88, 91
screening and case identification, 109, 113, 114, 118, 293
theoretical models, 63, 66, 91
U
Understanding Child Abuse and Neglect, xiii-xiv
Undue influence and duress, 131, 192, 195, 197, 203, 206-207, 210, 211, 212, 219, 222, 226, 231, 233, 237, 304, 309, 312, 386, 387, 389, 400, 404, 405, 407, 425
Uniform Crime Reports (UCR), 268, 269, 284, 285-286
United Kingdom, 244
Universities and colleges, see Academic research
Urban areas, 512
incidence and prevalence, 73, 269, 275
theoretical models, 61, 67
Utah, 229-230
V
Vermont, 230-231
Veteran’s Administration, 431
Victim services networks, 365, 419-420
Victims of Crime Act, 419-420
Violence, physical abuse, 78, 168, 173, 245-246
see also Child abuse and neglect;
Criminal justice system;
Sexual abuse
abrasions and lacerations, 54, 118, 119, 340, 344-345, 359, 360, 361, 372, 449, 454
adult protective services, 125
alcohol abuse, 95
Alzheimer’s patients, 93-94
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bruises, 20, 49, 54, 114, 116, 117, 119, 120, 127, 166, 183, 186, 216, 340, 342-343, 345-347, 454
burns, 20, 54, 119, 120, 166, 183, 186, 216, 226, 340, 343, 353-354, 371-372
Conflicts Tactics Scale (CTS), 20, 26-27, 55, 85, 166-167, 244, 271, 274-275, 300-302
definitional issues, 35, 36, 238, 244, 342, 448-450
guidelines for measurement, 48-49, 54-55, 56, 57
state statutes, 35, 36, 181-237 (passim)
financial abuse and, 403, 404, 409-410, 419
forensics, 340, 342-343, 360-362
fractures, 119, 120, 127, 166, 183, 255, 340, 342-343, 347-348, 360, 362, 371, 372, 373, 448(n.2), 454, 471, 472
gender of violent crime victims, 269
incidence and prevalence, 74, 76, 79, 81, 85, 262, 273-276, 278, 283-285, 287, 451, 452-453, 455
institutional settings, 99-100, 181-237 (passim)
intergenerational transmission of mistreatment, 99
intimate partner violence, 41, 55, 63, 65, 99, 241-242, 261-262(n.1), 271, 274, 300-302, 409-410, 502-503, 504-522 (passim)
measures of mistreatment, table, 20, 26-27, 55, 85, 166-167, 262, 273-276, 278, 283-284, 285
nursing homes, 448-450, 451, 452-454, 455
screening and case identification, 110-113, 114, 117, 118-120, 273-276, 278, 283-284, 293, 294, 297, 403
Virginia, 231-232
Vulnerability, general, 100-101
adult protective services, 124
age factors, 41-42, 43
definitional issues, 39, 41-42, 43, 50, 182-237 (passim), 246-247
financial abuse, 401
theoretical models, 64
W
Washington, D.C., see District of Columbia
Washington, 232-234
Weight loss, 340, 350-351, 448, 464
West Virginia, 234
Wisconsin, 125, 234-236
Witnesses, criminal justice system, 116-117, 127-128, 129-130, 421
Wolf, Rosalie, 238-248, 257
Wolfe, David, 127, 257, 501-525
Wyoming, 236-237
Representative terms from entire chapter:
definitional issues
