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Summer/Fall 2002 Vol. 2 No. 2

Table of Contents

Elderly woman in wheelchair staring out window ŠJose Luis Pelaez Inc./Corbis
How Many of the Elderly Are Abused or Neglected?

The Answer Requires
an Expanded
Research Effort

Their golden years are hardly peaceful for the estimated 1 million to 2 million elderly people who are victims of abuse and neglect. Even though the problem of "granny battering" hit the news in 1978 as a result of congressional hearings, there is an abysmal absence of research into the neglect and abuse of elderly Americans, says a new report from the National Research Council.

Fewer than 50 peer-reviewed studies of elder mistreatment exist in the scientific literature. Current research is spotty, and most of the reports have methodological weaknesses, said the committee that wrote the report. This mistreatment, as the committee defined it, includes physical and emotional abuse, neglect, and financial abuse of vulnerable elderly people by individuals they trust or rely on for care. Who commits it and why, the circumstances under which it occurs, and what preventive measures are effective -- even what constitutes "elderly" -- are questions still to be answered. "The current knowledge base about even the most elementary facts concerning elder mistreatment is incomplete, contradictory, misleading, and noncumulative," the report says. Meanwhile, between 3 percent and 5 percent of elderly people are thought to be abused. As the nation's over-65 population figures climb in the 21st century, so too will the number of victims.

"I was genuinely surprised at how little we know -- the gaps in our knowledge are enormous," said committee chair Richard J. Bonnie, director of the Institute of Law, Psychiatry, and Public Policy at the University of Virginia, Charlottesville. "In terms of the development of knowledge, the field of elder abuse is about where the child-abuse field was in the early 1970s. We are really at the beginning."

Even good base line data on the magnitude and social costs of the problem are lacking. Current estimates of how many Americans over the age of 65 have suffered some type of mistreatment at the hands of a caretaker are little more than educated guesses. There has never been a national survey to determine the size of the problem. Still more poorly understood are the situations that lead to mistreatment and the underlying causes of the abuse. Designing effective public policies to prevent and counteract elder mistreatment requires this basic information.

But more of the same type of research won't do the trick, the report says. Current reports of research findings lack standardization and control groups and are based on reported cases, rather than studies of a population as a whole; therefore the findings cannot be extrapolated to the larger population. Even before collecting the much-needed data on the extent of the problem, researchers in the field need to develop uniform definitions and modes of measurement. Such systematizing of the field's research methodologies is essential before launching a full-scale national study of the extent and types of elder mistreatment in the United States.

Discovering the scope and significance of elder mistreatment requires attracting a new generation of interdisciplinary scientists to the field. Establishing the necessary infrastructure demands a long-term funding commitment by federal, state, and private agencies.

"As a society, we have a strong moral obligation to protect people who, as they are aging, lose the capacity to protect themselves," Bonnie said. "A meaningful investment in building the foundation for this field is truly needed."    --Mari N. Jensen

Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Panel to Review Risk and Prevalence of Elder Abuse and Neglect, Committee on National Statistics and Committee on Law and Justice, Division of Behavioral and Social Sciences and Education (2002, 568 pp.; ISBN 0-309-08434-2; available from the National Academies Press, tel. 1-800-624-6242; $57.95 plus $4.50 shipping for single copies).

The committee was chaired Richard J. Bonnie, John S. Battle Professor of Law and director, Institute of Law, Psychiatry, and Public Policy, University of Virginia, Charlottesville. The study was funded by the National Institute on Aging.

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Copyright 2002 by the National Academy of Sciences