vulnerable people do not have any contact with people outside their home or institution. The National Center on Elder Abuse has tried to find out how to reach these isolated elders. Currently some demonstration projects are trying to do that.

About 470,790 reports came to adult protective services units in the year 1999, with all states reporting (including Guam and the District of Columbia) except Mississippi. Of that number, 332,000 were investigated. That means the others did not meet minimal criteria for conducting an investigation. It is interesting that some states investigate every report, while some states do so in a triage arrangement. If it doesn’t seem to be abuse, they pass it along or refer that case to whatever agency is appropriate. Of those that were investigated, 45 percent were validated.


Richard Bonnie: In the beginning of your talk, you referred to different images of the problem, as you put it, which appealed to different constituencies. One was the adult in need of protection, then “elder” abuse and neglect and exploitation, which obviously borrowed from the child abuse tradition, and then the family violence orientation. You made the observation that, overall, you thought that this had a positive impact, at least from the standpoint of building constituencies. But I detected some reservations among some people, as to whether this interweaving of strands has been a good thing or not. Could you comment on that?

Rosalie Wolf: I think it comes mostly from the social service field. I’m not sure whether that is true today. It was true a few years ago, I believe.

Bonnie: One thing I am wondering about, in terms of the agenda for this panel, is that elder abuse is a very complicated construct. There are these three different strands that you have mentioned, and each one focuses on a different thing. For example, in the context of adult protective services, the “perpetrator,” the third party, is not the centerpiece. It is the vulnerability of the individual. From the other two perspectives, at least, a third-party focus emerges.

I think this explains at least in part some of the confusion about definitions. For a sound research base to develop, isn’t greater cohesion needed about the concept of elder abuse itself?

Wolf: I think that the whole criminal justice perspective has brought in an emphasis on the perpetrator—you’re right, let me say, that the emphasis previously was totally on the victim. If you look at the laws of the states, I’m not sure the perpetrator is mentioned at all. Yet, as we know, it could be a mutual problem, but the perpetrator certainly bears the guilt in these situations.

I think when you bring in the criminal justice system, this was definitely

The National Academies of Sciences, Engineering, and Medicine
500 Fifth St. N.W. | Washington, D.C. 20001

Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement