Elder neglect and abuse: a review of the literature.

The 31 pioneering studies tell us that elder neglect and abuse occur in various forms and are often inflicted on older women by relatives who are in a caregiving role. Yet, the studies' findings are insufficient to document the prevalence or to identify the cause(s) of elder mistreatment. Given our concern about elders and their families, further research is needed, guided by consideration of some priority issues (Callahan, 1982). The first question is what is and is not elder mistreatment and by whose definition. Since one's professional orientation has a major impact on one's perceptions, will we see what we expect or fear we will see when confronted with a possible mistreatment situation? Is elder mistreatment a legal problem, a criminal act, or is it one symptom of our society's lack of preparation for the care of its old-old? Research needs to address ways our society can prepare itself (families and communities) to care for our increasing population of old-old citizens. Second, as researchers, practitioners, and policymakers, we need to be clear about our own motives and incentives for focusing on elder mistreatment. Are our behaviors self-serving or other-serving? How can we each most effectively help our elders and their families and thus prevent the occurrence of elder mistreatment? Third, we need public and professional education that provides accurate information about aging, elder care, community resources, and elder mistreatment-education that can correct or counterbalance the mass media's misleading accounts. A fourth issue is the need to respond to the existence of elder mistreatment in reasonable ways so that social benefits will not exceed social costs. Greater effort and money put into programs that provide alternative forms of elder care and that support and assist families providing elder care will be most cost effective (human and monetary) in the long run than will laws that inappropriately decrease family privacy and control. We need to direct our energies and interventions at the causes, rather than the symptoms, of elder mistreatment. Finally, given the existing data base on elder mistreatment and the access barriers, consideration should be given to determining which research designs would produce the most valid, reliable, and useful findings. Gaining understanding of elder mistreatment-its antecedents, causes, and consequences-is prerequisite to effective and efficient prevention, identification, and treatment.