Ethnic and generational variation in elder mistreatment has only recently been explored. This research builds upon pioneer work in the field by examining perceptions of elder mistreatment across four ethnic groups (European-American, African-American, Puerto Rican, and Japanese-American) and two generations (elder and 'baby boom' caregiver). Focus group discussions revealed differences in defining elder mistreatment and responding to it. They also suggested that psychological abuse and neglect may be more important mistreatment forms than previously acknowledged. Policy and practice implications of study results are considered. jg]Key words gw]Elder mistreatment gw]Elder abuse gw]Ethnic groups gw]Generations.

This paper describes a protocol for an integrated response by health care professionals to the problem of elder abuse. Standard training, reporting, and response procedures have been emphasized in order to assess and treat elderly abuse/neglect. The protocol consists of guidelines for interviewing the elderly patient and caregiver separately; and suggests interventions which are both direct and indirect, for use in the home, in a hospital emergency room, in an outpatient clinic or on an inpatient floor. Physical and occupational therapists can provide valuable information for detection and can treat the patient and caregiver educationally to reduce incidences of elderly abuselneglect.

Denial is often mentioned as a constraining factor in the assessment and intervention of domestic violence cases. Within the context of elder mistreatment, this paper utilizes neutralization theory to explain how the abuser and the elderly victim justify or rationalize abusive or neglectful behavior. Intervention techniques are provided to counteract different types of denial, and practitioners are cautioned against utilizing neutralization techniques themselves.

Within the context of elder mistreatment, little attention has been paid to ethnicity and cultural factors as independent or causal variables. Focusing on the Japanese as an example, this paper explores cultural factors that may be associated with family conflict and elder mistreatment, including the use of silence as an extreme form of punishment. Also explored are the interrelationships of dependency (amae), holding back (enryo), and being in the way (jama); of social obligation (giri), personal indebtedness (on), and natural feelings or desires (ninjo); and of filial piety and casting away the elder (obasute). Currently-used research and detection protocols will not identify elder mistreatment among the Japanese unless they are modified. This paper provides suggestions for these modifications, as well as suggestions for practitioners who may treat Asian victims of elder mistreatment.