The term older/disabled adult is used throughout this text, which refers to adults age 60 years and older and any adult having a physical and/or mental disability. Therefore we have used these terms combined in order to address abuse surrounding both populations. Abuse, neglect and exploitation are widespread problems. The purpose of this manual is to reduce the incidence of elder and/or disabled adult abuse through heightened awareness and education.

America’s fast growing elderly population has affected every segment of the social, economic, and political scene. Public awareness and concern has been elevated regarding the needs of this population. Approximately 44 million persons in the United States are 60 years of age and older. It is estimated that by the year 2050 this population will increase to 75 million adults age sixty and older. As a result, public policies pertinent to issues such as retirement security, affordable long-term care, and older adults’ quality of life are being modified to meet the special needs of the aging population.

There are three categories of elder abuse: domestic, institutional, and self-neglect. Domestic elder abuse refers to the mistreatment of an older person residing in his/her own home or the home of a caregiver. Institutional abuse refers to the mistreatment of an older person living in a residential facility, e.g., nursing homes, or adult care homes. Self-neglect refers to the conduct of an older person living alone, which brings harm to his/her own safety or well being.

The National Elder Abuse Incidence Study (1996) reports that elder abuse is a significant problem. Findings show that approximately 450,000 older adults in domestic settings were abused and/or neglected during 1996. When older adults who experienced self-neglect were factored into the study, the number increased to approximately 551,000 in 1996. This study also pointed out some additional problems. The following are statistics from the National Elder Abuse Incidence Study:

• Female elders are abused at a higher rate than males, after accounting for their larger proportion in the aging population.
  
• Those adults (age 80 and over) are abused and neglected at two to three times the proportion of the 79 and under population.
  
• In almost 90 percent of the elder abuse and neglect incidents with a known perpetrator, the perpetrator is a family member, and two-thirds of the perpetrators are adult children or spouses.
  
• Victims of self-neglect are usually depressed, confused, or extremely frail.
  
• One to 1.5 million cases of elder abuse occurs in the U.S. annually. These cases occur in both home and health care environments regardless of race or social status.
  
• In 1998, North Carolina reported 4,985 cases of elder abuse and neglect, which occurred in the home, and additional 1,246 cases were reported in health care facilities (46% in Nursing Homes, 51% in Adult Care Homes, 3% in Developmentally Disabled Adult Homes).
  

Because abuse, neglect, and exploitation of the elderly are usually hidden, it is difficult for the professional community to address these problems effectively. This manual is designed to help recognize abuse, neglect, and exploitation of the elderly and provide needed information to ensure that victims receive proper assistance. With an enhanced awareness of these issues, we can more effectively ensure the protection of the older adults in our community.

From 1986 to 1996 there was a steady increase in the reporting of domestic elder abuse nationwide, amounting to a 150% rise during the period.

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