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ELDERABUSE

Although elder abuse is a pervasive and growing prob-

lem, much about this topic remains unknown, and

inconsistency in definitions has hampered research and

practice. Both the lack of clarity of definition and the

underreporting of cases have prevented a clear picture

of prevalence. Notwithstanding, it is estimated that

between 1 and 2 million Americans over age 65 have

experienced some type of abuse. Elder abuse occurs in

both institutional and domestic settings. Currently six

types of abuse are generally agreed on. Profiles of vic-

tims have found no gender differences, but likelihood

of abuse is higher in elders with low income and in

those who are depressed or who have experienced ear-

lier domestic abuse. Abusers are most often children

and other family members of victims. Regarding treat-

ment and prevention, collaborative approaches have

been shown to be best suited for elder abuse victims;

psychologists play an important role on these teams.

Finally, additional funding has been noted as critical for

improving prevention and treatment services, but

equally important is the need for additional research.

Definitions and Prevalence

Early attempts to compile statistics on elder abuse suf-

fered from a lack of consistency in definition. While

there is still some disagreement among the various

interested professional groups, a generally accepted

definition of elder abuse now exists. Elder abuseis the

umbrella term used to refer to any act that causes harm

or risk of harm to a vulnerable adult. The acts can

occur to elders living in domestic settings (private

homes, apartments, etc.) and to elders in institutional

or residential facilities. Regardless of site, six differ-

ent types of abuse have been identified. For all types,

acts are considered abuse whether they are intentional

or not and whether they include verbal or nonverbal

behavior. Physical abuseincludes inflicting pain or

injury or depriving a basic need. Sexual abuse

includes nonconsensual sexual contact of any kind.

Emotional or psychological abuseis the infliction of

emotional anguish or distress. Financial or material

exploitation involves funds, property, and assets.

Neglectis the loss of food, shelter, health care, or pro-

tection and is the most common type in domestic set-

tings. Self-neglectis any act by the elder himself or

herself that threatens health or safety. Finally,aban-

donmentis the desertion of an elder by anyone who

has assumed responsibility for care.

An accurate picture of the incidence and prevalence

of elder abuse is elusive for a number of reasons. First,

not all states use the preceding definitions. Second,

there are no uniform reporting standards or systems.

This has prevented the collection of comprehensive

national data. Third, only a portion of elder abuse cases

is ever reported. Vulnerable elders are even less able or

willing, and thus less likely, than are victims of other

domestic abuse to report abuse or neglect. Current esti-

mates suggest that only 1 out of every 5 cases in all

settings is reported and only 1 in every 14 cases in

domestic settings. Consequently, statistics suffer from

underreporting. The National Center on Elder Abuse

estimates that between 1 and 2 million Americans aged

65 and over, a frequency of 2% to 10%, have been

injured, exploited, or otherwise mistreated. Specific

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