Developmental Research on Elder Mistreatment

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DESCRIPTION (provided by applicant): The projected rapid increase in numbers of older Americans raises the concern that elder mistreatment will grow as much and as fast as the population of elders. Although it is clear that the problem of elder mistreatment is already large - the best estimate is that one to two million older Americans are victims of mistreatment annually - most events are never reported. The personal costs are profound: not only do victims suffer from their injuries and losses, they are likely to die at an earlier age than elders who are not victims of mistreatment. There is very little understanding of the issues that surround elder mistreatment, for example risk or preventive factors, physical markers, consequences and clinical courses, healthcare and other costs, successful interventions and, methods for studying each of these issues. Current approaches to detecting abuse for research purposes are either invalid and unreliable or cumbersome, and difficult to apply on a broad scale, making population studies infeasible. There is a desperate need for a standardized measurement approach that can be generalized across groups. This application recommends development and testing of a self-report, survey-based measure that can be broadly applied to generate population estimates of abuse and move elder mistreatment research forward. This project must confront a number of methodological issues, including (a) lack of standardized conceptual and operational definitions of the five generally-accepted categories of mistreatment: physical, psychological and sexual abuse, neglect by a trusted other and financial exploitation; (b) cognitively-impaired older adults who are unreliable reporters of their experiences; (c) generalization of the instrument across ethnic groups; and (d) relevance to the community of elder mistreatment professionals. Thus we aim to: Aim 1. Develop conceptual definitions and methods for operationalizing the definitions for all five categories of elder mistreatment. Aim 2. Design a self-reported, survey-based measure for detecting presence and severity of all types of elder mistreatment. Aim 3. Determine whether the survey-based measure validly and reliably predicts elder mistreatment in samples of Mexican American and Non-Hispanic white community-dwelling elders, including the cognitively impaired. With a valid, reliable criterion standard for detecting elder mistreatment, researchers can begin to measure and understand and policy makers can activate the resources needed to adequately address this significant and distressing public health problem.