The 1987 amendments to the Older Americans Act define elder abuse, neglect, and exploitation. These definitions set a framework for states to identify elder abuse and to enact their own statutory definitions. Three types of elder abuse exist: 1) self-neglect, also referred to as self-abuse; 2) domestic abuse; and 3) institutional abuse.
Self-neglect occurs when an elderly person threatens or impairs his own health or safety. The second type of abuse, domestic elder abuse, focuses on mistreatment committed by someone who has a special relationship with the elder. The National Elder Abuse Incidence Study of 1998 concluded that at least 500,000 elders were victims of domestic abuse during 1996. The third category, institutional elder abuse, refers to mistreatment committed in residential facilities such as nursing homes. Individuals who commit institutional elder abuse often have a legal or contractual duty to the elder person, such as nursing home staff or professionals. Similar to domestic elder abuse, institutional abuse encompasses several different types of exploitation and mistreatment, including physical and psychological abuse.
Of the three types of abuse (self neglect, domestic abuse, and institutional abuse), this comment primarily focuses on emotional and physical elder abuse sustained in institutions, primarily nursing home facilities.