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   Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America.   
      
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   13Financial Abuse of the Elderly in Domestic Setting   
   Thomas L. Hafemeister*.   
      
   In some ways financial abuse is very similar to other forms of elder abuse in   
   that it can be devastating to the victim and is frequently traced to family   
   members, trusted friends, and caregivers. But unlike physical abuse and   
   neglect, financial abuse is    
   more likely to occur with the tacit acknowledgment and consent of the elder   
   person1 and can be more difficult to detect and establish. As a result,   
   financial abuse requires a distinct analytical perspective and response.   
   Unfortunately, these differences    
   are often overlooked.   
      
   Little empirical research has been conducted that directly addresses financial   
   abuse of the elderly, and in general it has received less attention than other   
   forms of elder abuse (Nerenberg, 2000b). Although the amount of attention   
   given to it has    
   increased in recent years, most commentary rests on a relatively thin   
   empirical base and draws heavily on anecdotal observations and relies (perhaps   
   inappropriately) on research and analysis addressing other forms of elder   
   abuse, child abuse, and spouse/   
   partner abuse. Because financial abuse is frequently addressed in conjunction   
   with other forms of elder abuse, a brief overview of elder abuse in general is   
   provided before turning specifically to financial abuse of the elderly.   
      
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   PREVALENCE OF ELDER ABUSE IN GENERAL   
      
   Elder abuse, at least to some degree, has probably always existed. Only in the   
   past few decades, however, has it been recognized as a major societal problem.   
   Attention to elder abuse followed the “discovery” of child abuse in the   
   1960s and spouse    
   abuse in the 1970s. Today, elder abuse is widely characterized as both a   
   pervasive problem and a growing concern (Dessin, 2000; Heisler, 2000;   
   Moskowitz, 1998b).   
      
   The National Elder Abuse Incidence Study (NEAIS), which was described as the   
   first national study of the incidence of elder abuse in the United States,2   
   estimated that nearly a half million persons aged 60 and over in domestic   
   settings were abused or    
   neglected during 1996 (National Center on Elder Abuse, 1998).3 Furthermore,   
   this study determined that for every reported incident of elder abuse or   
   neglect, approximately five incidents were unreported (National Center on   
   Elder Abuse, 1998), supporting    
   a wide consensus that elder abuse is greatly underreported (Choi and Mayer,   
   2000; Dessin, 2000; U.S. General Accounting Office, 1991; Kleinschmidt, 1997;   
   Moskowitz, 1998b; National Center on Elder Abuse, 1996). The NEAIS confirmed a   
   general view that    
   state agencies established to receive such reports, such as Adult Protective   
   Services (APS) agencies, receive reports of the most visible and obvious   
   occurrences of elder abuse, but that there are many other incidents that are   
   not reported. Nevertheless,    
   the number of APS elder abuse reports substantially increased over the past 10   
   years, an increase that exceeded the growth in the elderly population during   
   this period (National Center on Elder Abuse, 1998).   
      
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   FORMS OF ELDER ABUSE   
      
   What constitutes elder abuse is defined by state law, and state definitions   
   vary considerably (U.S. General Accounting Office, 1991; Kapp, 1995; National   
   Center on Elder Abuse, 2001; Moskowitz, 1998b; Roby and Sullivan, 2000).4 Not   
   surprisingly,    
   researchers have also used many different definitions in studying the problem   
   (Choi and Mayer, 2000; Kleinschmidt, 1997; Macolini, 1995; National Center on   
   Elder Abuse, 2001; Pillemer and Finkelhor, 1988).5 The variation in   
   definitions has been cited as    
   a significant impediment to elder abuse recognition, management, research, and   
   analysis (U.S. General Accounting Office, 1991; Kleinschmidt, 1997; Lachs and   
   Pillemer, 1995; Moskowitz, 1998b; Nerenberg, 2000a; Roby and Sullivan, 2000;   
   Rosenblatt et al.,    
   1996).   
      
   Elder abuse in domestic settings (i.e., within the older person's own home or   
   in the home of a caregiver) is often differentiated from elder abuse within   
   institutional settings (i.e., within residential facilities for older persons   
   such as nursing homes)    
   (Brandl and Meuer, 2000; National Center on Elder Abuse, 1996, 2001). Domestic   
   elder abuse has been asserted to be more prevalent than institutional elder   
   abuse (Kosberg and Nahmiash, 1996; Marshall et al., 2000; Moskowitz, 1998b),   
   in part because it has    
   been estimated that 80 percent of the dependent elders in this country are   
   cared for at home (National Center on Elder Abuse, 1996). However, research   
   directly substantiating this assertion is lacking.6 Another dichotomy   
   frequently used distinguishes    
   between elder abuse by individuals who have a special relationship with the   
   elder person (e.g., spouses, children, other relatives, friends, or caregivers   
   providing services within the elder person's home) and individuals with whom   
   such a preexisting    
   special relationship does not exist (Kosberg and Nahmiash, 1996; Marshall et   
   al., 2000; National Center on Elder Abuse, 1996, 2001).7 Within domestic   
   settings, it has been reported that the perpetrators of elder abuse are much   
   more likely to be family    
   members (National Center on Elder Abuse, 1996).   
      
   Although conceptualizations of what elder abuse encompasses vary considerably,   
   the National Center on Elder Abuse (2001) identifies six major categories of   
   elder abuse. They include physical abuse, sexual abuse, emotional or   
   psychological abuse, neglect,    
   abandonment, and financial abuse. Among these categories, financial abuse has   
   received limited attention and is often not assessed in studies of elder abuse   
   (Choi et al., 1999; Kleinschmidt, 1997; Tueth, 2000). Nonetheless, financial   
   abuse is    
   increasingly viewed as both sufficiently important to necessitate its   
   inclusion in studies of elder abuse in general and sufficiently distinct to   
   justify addressing it separately (Choi and Mayer, 2000).   
      
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   PARAMETERS OF FINANCIAL ABUSE OF THE ELDERLY   
      
      
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