Panel to Review Risk and Prevalence of Elder Abuse and Neglect Richard J. Bonnie and Robert B. Wallace, Editors Committee on National Statistics and Committee on Law and Justice Division of Behavioral and Social Sciences and Education THE NATIONAL ACADEMIES PRESS Washington, D.C. www.nap.edu THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, N.W. • Washington, DC 20001 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee respon- sible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract/Grant No. N01-0D-4-2139 between the National Academy of Sciences and DHHS/National Institutes of Health. Any opin- ions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. Library of Congress Cataloging-in-Publication Data Bonnie, Richard J. Elder mistreatment : abuse, neglect, and exploitation in an aging America / Richard J. Bonnie and Robert B. Wallace, Editors. p. cm. Includes bibliographical references and index. ISBN 0-309-08434-2 (hardback) 1. Aged—Abuse of—United States I. Wallace, Robert B. II. Title. HV6626.3+ 362.6—dc21 2002012762 Additional copies of this report are available from The National Academies Press, 500 Fifth Street, N.W., Lockbox 285, Washington, DC 20055; (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area); Internet, http:// www.nap.edu Printed in the United States of America Copyright 2003 by the National Academy of Sciences. All rights reserved. Suggested citation: National Research Council. (2003). Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Panel to Review Risk and Preva- lence of Elder Abuse and Neglect. Richard J. Bonnie and Robert B. Wallace, Editors. Committee on National Statistics and Committee on Law and Justice, Division of Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press. The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Acad- emy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences. 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Wulf are chair and vice chair, respectively, of the National Research Council. www.national-academies.org PANEL TO REVIEW RISK AND PREVALANCE OF ELDER ABUSE AND NEGLECT RICHARD J. BONNIE (Chair), Schools of Law and Medicine, University of Virginia TERRY FULMER, School of Nursing, New York University RICHARD A. KULKA, Research Triangle Institute, Research Triangle Park, NC EVA KUTAS, Mental Health and Development Disabilities Service Division, National Association of Adult Protective Administrators, Salem, OR EDWARD O. LAUMANN, Department of Sociology, University of Chicago CONSTANTINE G. LYKETSOS, Division of Geriatric Psychiatry and Neuropsychiatry, School of Medicine, The Johns Hopkins University, MD GARY B. MELTON, Institute on Family and Neighborhood Life, Clemson University, SC LAURA MOSQUEDA, Department of Family Medicine, University of California, Irvine GREGORY PAVEZA, School of Social Work, University of South Florida KARL PILLEMER, Department of Human Development, Cornell University, NY LORI A. STIEGEL, Commission on Legal Problems of the Elderly, American Bar Association, Washington, DC ROBERT B. WALLACE, Department of Epidemiology and Internal Medicine, University of Iowa Colleges of Public Health and Medicine EARL S. POLLACK, Study Director MARISA GERSTEIN, Research Assistant DANELLE DESSAINT, Senior Project Assistant TANYA M. LEE, Project Assistant LORA FLATTUM HAMP, Consultant v COMMITTEE ON NATIONAL STATISTICS 2001-2002 JOHN E. ROLPH (Chair), Marshall School of Business, University of Southern California JOSEPH G. ALTONJI, Department of Economics, Northwestern University, IL ROBERT BELL, AT&T Research Laboratories, Florham Park, NJ LAWRENCE D. BROWN, Department of Statistics, University of Pennsylvania ROBERT M. GROVES, Survey Research Center, University of Michigan HERMAN HABERMANN, United Nations Statistical Division, New York, NY JOEL L. HOROWITZ, Department of Economics, Northwestern University, IL WILLIAM KALSBEEK, Survey Research Unit, Department of Biostatistics, University of North Carolina ARLEEN LEIBOWITZ, School of Public Policy and Social Research, University of California, Los Angeles RODERICK J.A. LITTLE, School of Public Health, University of Michigan THOMAS A. LOUIS, The RAND Corporation, Arlington, VA DARYL PREGIBON, AT&T Laboratories-Research, Florham, NJ NORA CATE SCHAEFFER, Department of Sociology, University of Wisconsin-Madison MATTHEW D. SHAPIRO, Department of Economics, University of Michigan ANDREW A. WHITE, Director vi COMMITTEE ON LAW AND JUSTICE 2001 CHARLES F. WELLFORD (Chair), Center for Applied Policy Studies and Department of Criminology and Criminal Justice, University of Maryland JOAN PETERSILIA (Vice Chair), School of Social Ecology, University of California, Irvine ALFRED BLUMSTEIN, H. John Heinz III School of Public Policy and Management, Carnegie Mellon University JEANETTE COVINGTON, Department of Sociology, Rutgers University RUTH DAVIS, The Pymatuning Group, Inc., Alexandria, VA JEFFREY FAGAN, Schools of Law and Public Health, Columbia University DARNELL HAWKINS, Department of African American Studies, University of Illinois at Chicago PHILIP HEYMANN, Center for Criminal Justice, Harvard Law School CANDACE KRUTTSCHNITT, Department of Sociology, University of Minnesota MARK LIPSEY, Department of Psychology and Human Development, Vanderbilt University COLIN LOFTIN, School of Criminal Justice, State University of New York at Albany JOHN MONAHAN, School of Law, University of Virginia DANIEL NAGIN, H. John Heinz III School of Public Policy and Management, Carnegie Mellon University PETER REUTER, Department of Criminology and Criminal Justice, University of Maryland WESLEY SKOGAN, Department of Political Science and Institute for Policy Research, Northwestern University KATE STITH, School of Law, Yale University MICHAEL TONRY, Institute of Criminology, Cambridge University CATHY SPATZ WIDOM, Department of Psychiatry, New Jersey Medical School CAROL PETRIE, Director RALPH PATTERSON, Senior Project Assistant vii Acknowledgments T he Panel to Review Risk and Prevalence of Elder Abuse and Neglect wishes to thank the many individuals who contributed to the preparation to this report. The project was sponsored by the Na- tional Institute on Aging, National Institutes of Health, U.S. Department of Health and Human Services, with additional support from the Office of Behavioral and Social Science Research and the Office of Research on Women’s Health of the National Institutes of Health and the Agency for Health Care Research and Quality. Sidney Stahl served as project officer and was very helpful in orienting the panel to the major issues on elder abuse and neglect that needed to be considered. The panel also expresses its appreciation to Laurence Branch, Duke University; Larry Corder, Duke University; and Brian Kemp, University of California, Irvine, who prepared background papers in addition to those included in this volume. Thanks are also due to those who reviewed the papers commissioned by the panel and provided many helpful comments— Barbara Altman, National Center for Health Statistics; Jack Guralnik, Na- tional Institute on Aging; Jane Tilly, Urban Institute; Jordan Kosberg, Uni- versity of Alabama; Kenneth Minaker, Massachusetts General Hospital; Carla VandeWeerd, University of South Florida; Richard Schulz, University of Pittsburgh; and George Annas, Boston University. The panel also wishes to thank Marie-Therese Connolly, U.S. Depart- ment of Justice; Patricia McFeeley, University of New Mexico; Joanne Otto, Colorado Department of Human Services; and Patsy Klaus, U.S. ix