Elder Mistreatment and Abuse

Elder abuse remains an insidious global phenomenon that has historically been underrecognized by healthcare professionals and is likely to have worsened in prevalence and severity during the COVID19 pandemic. It spans physical abuse, psychological and emotional abuse, sexual abuse, financial exploitation, and neglect, with more than one form of mistreatment often occurring simultaneously (polyvictimization). A person-centered perspective integrates several principles beyond simply identifying the older adult victim’s medical and psychological comorbidities. Clinical and ethical controversies and dilemmas include identifying which tools and overarching guidelines to use during evaluation and decision-making, mitigating potential conflicts between respect for the autonomy of victims and reporting and safety requirements, and clarifying what constitutes a “successful” intervention for both victim and perpetrator. Several practical considerations and strategies for individual providers and multidisciplinary teams are reviewed with respect to the evolving body of literature supporting a person-centered approach across care settings.