CLINICAL PRACTICE IN LONG-TERM CARE Elder Mistreatment in the Nursing Home: A Systematic Review

Although estimates of the prevalence and incidence of elder mistreatment vary widely, it is likely that at least 3% to 4% of Americans 65 years or older have suffered some form of mistreatment in their later years. 4 Despite having a prevalence that is likely on par with that of child abuse, standardized definitions of elder mistreatment were not published until the early 1990s (see Table 1). Researchers have established the detrimental health effects of abuse and neglect, such as frequent emergency department visits and a threefold increase in mortality. However, much remains unknown in this area, as outlined in the recent report from the National Research Council, Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Even less is known about elder mistreatment specifically involving nursing home residents. This sizeable population is particularly vulnerable to abuse and neglect because most suffer from cognitive impairment, behavioral abnormalities, or physical limitations that have been reported as risk factors for abuse and neglect. –16 Vulnerability in nursing homes is heightened because many residents are unable