An Update on the Nature and Scope of Elder Abuse

Abstract

It may be difficult to refine the definition of elder abuse because of existing prevention and detection programs, but studies are underway that will affect our understanding of this complex problem.Dr. Rosalie S. Wolf served as co-guest editor for the Summer 2000 issue of Generations- the first issue of the journal to focus solely on elder abuse-and wrote the issue's introductory article, Nature and Scope of Elder Abuse: Changes in Perspective and Response over the Past 25 Years (Wolf, 2000). Wolf was wellsuited to assess how far research on this complex and disturbing problem had progressed over twenty-five years: she was a pioneer researcher in the field, with studies extending as far back as the early 1980s. She also helped to mentor many elder abuse investigators, showcasing their work in the peer-reviewed journal she launched, the Journal of Elder Abuse & Neglect, begun in 1989 as the official publication of the National Committee for the Prevention of Elder Abuse.Wolf's Generations article explored the four primary areas of elder abuse inquiry leading up to the millennium: definitions, prevalence and incidence, theoretical explanations, and consequences. Clearly, the field had come a long way since the late 1970s, when the major thrust of investigation was on establishing the existence of elder abuse and delineating its various forms.Today, our understanding of elder abuse is changing because there has been more research, propelled in part by a related National Research Council agenda, increased federal funding for investigations, and a growing number of scholars interested in the problem. This article examines selected important studies since 2000, and suggests how their findings are affecting our understanding of elder abuse.The Search for a Definition of Elder AbuseIn 2000, Wolf presented elder abuse as a fairly straightforward concept. She emphasized that in common usage it is a term with broad meaning, including many forms and examples, but always describing harm or loss to an older victim. Wolf limited the term's complexities to how frequency, severity, and/or cultural context can affect perception and response to the problem. There was no mention of the controversies that have plagued attempts to define elder abuse since the mid-1980s.Concern about the absence of a generally accepted definition of elder abuse was articulated at the first Research Conference on Elder Abuse and Neglect at the University of New Hampshire in 1986, and reinforced at the National Research Council's Panel to Review Risk and Prevalence in 2003. In 2011, defining elder abuse was the lead priority at the Research-to-Practice Consensus Workshop in New York.There are three primary reasons why generally accepted definitions of elder abuse remain elusive. First, in the early years of recognizing elder abuse, there was no federal government or national leadership (ideally coupled with funding or other incentive for compliance) to compel states or researchers to use common definitions. No uniform term was established and one probably cannot be established now-at least not for states and their elder abuse or adult protective services laws; too many years have passed, and systems are in place.Second, there has been a tendency to continually expand the concept of elder abuse. Payne (2005), for example, offers three broad types: collective, institutional, and individual. Each type has several forms and sub-forms. Together, they capture virtually any possible harm inflicted on an older person by society, care setting, or person. The media, members of Congress, and even researchers sometimes label fraud, abuse, and homicide by strangers as elder abuse. Ultimately, elder abuse has become a convenient catch-all term for the various wrongs against older people.Finally, the many controversies that surround defining elder abuse have not been resolved, and currently there exists no national consensus body with authority to accomplish this. …

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