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In the broadest context, elder mistreatment subsumes a variety of activities perpetrated upon an older person by others. Some proposed strategies for defining or classifying elder mistreatment have been based on the type of abuse (e.g., physical vs. verbal abuse), motive (e.g., intentional vs. unintentional neglect), perpetrator relationship (e.g., family vs. paid caregiver), and setting (e.g., community vs. nursing home). There is as yet no universally agreed definition or classification of elder mistreatment. Nonetheless, the clinician attempting to care for a victimized older person or to understand the spectrum of elder mistreatment will encounter several thematically similar definitions. For example, the older Americans Act of 1975 defines elder abuse as “the willful infliction of pain, injury, or mental anguish.” This definition has been adopted, and/or modified, by many state protective service agencies that investigate cases of abuse. A more recent and encompassing definition created by an expert panel convened by the National Academy of Sciences adopted the definition that elder mistreatment in all its forms involves a trusting relationship between an older person and another individual in which that trust is violated in some way. Table 60-1 lists other representative definitions and examples of elder mistreatment. Whatever definition is employed, a consistent and important feature of elder mistreatment, and other forms of family violence, is that multiple types of mistreatment, such as physical and verbal abuse, neglect, and financial exploitation frequently coexist in the same abuser–victim dyad.

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Table 60-1 Representative Definitions of Elder Mistreatment
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Virtually all experts, ...

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