Consultant Nerenberg addresses the multifaceted issue of elder abuse prevention in a methodical, detailed manner that enhances the reader's knowledge and understanding of this most pressing contemporary issue. She begins with the identification of eight trends that make the study of elder abuse prevention important, and concludes with a discussion of service modalities, research, and evaluation needs among current human service provider systems. Woven into these discussions are references to issues such as multiculturalism, ethical dilemmas, and ambiguous definitions of abuse that pose challenges to the quality and effectiveness of services delivered. This reviewer is pleased with Nerenberg's comprehensive discussion and the detail she provides on this complex issue. However, further research and strategizing is warranted to overcome the formidable challenges identified in reducing the incidence of elder abuse in societies where the number and proportion of older adults at risk is constantly growing. Summing Up: Recommended. Upper-division undergraduates and above. Upper-division Undergraduates; Graduate Students; Researchers/Faculty; Professionals/Practitioners. Reviewed by S.H. Smith. From: Syndetics Solutions, Inc. Distributed by Syndetic Solutions, Inc.

Preface	xv
Acknowledgments	xix
1 Eight Trends Shaping Practice	1
1 Increasingly Frail Elders Living at Home
2 Shifting Paradigms: From Protection to Empowerment
3 Heightened Understanding of Victims
4 The Circle Widens: The Burgeoning Abuse Prevention Network
5 The Changing Role of APS
6 The "Criminalization" of Elder Abuse
7 Focus on Forensics
8 Going Global: International Initiatives to Prevent Elder Abuse
2 Defining Elder Abuse: The Controversies	19
Controversies in Defining Elder Abuse
The Disability Requirement
The "Special Relationship" Requirement
Intentionality
Focusing on Conduct or Its Impact
Frequency and Severity
What the Experts Say
Challenges in Defining Specific Forms of Abuse
Financial Abuse
Physical Abuse
Elder Sexual Abuse
Emotional Abuse
Neglect
Self-Neglect
Abandonment
Other
3 Service Models from Which We Have Drawn	35
Introduction
The Adult Protective Services (APS) Model
The Domestic Violence Prevention Model
The Public Health Model
The Victim Advocacy Model
The Restorative Justice Model
Neutralization Theor
The Family Caregiver Support Model
The Family Preservation Model
4 Factors Influencing Intervention Needs	75
Victim Considerations
Victims' Mental Capacity and Ability to Consent
Victim Risk Factors
Victims' Resources and Support Systems
Perpetrator Considerations
Perpetrator Characteristics that Affect Service Needs
Perpetrators' Reasons or Motives for Abusing
Abusers' Willingness and Ability to Change
Abusers' Access and Level of Threat to Victims and Their Assets
Urgency of the Situation
Ethical Considerations
Autonomy and Self-Determination
Least Restrictive Alternatives
Other Ethical Principles
Competing and Conflicting Principles
Cultural Factors Affecting Service Needs
Cultural Factors Affecting Risk
Attitudes about Abuse
Obstacles to Accessing Services
Cultural Considerations Affecting Practice
5 Preventing and Treating Elder Abuse	101
Assessing Victims' Service Needs
Services and Interventions for Victims
Maximizing Independence
Resolving Crises
Emergency Services
Ensuring Victim Safety
Healing, Empowerment, and Support
Preserving, Protecting, and Recovering Assets
Ensuring Justice
Interventions for Perpetrators and Those at Risk for Abusing
Counseling for Perpetrators
Domestic Violence Treatment
Programs for Caregivers
6 What Agencies, The Justice System, and Communities Can Do	145
What Agencies Can Do
General
Agency-Specific Practices
APS Programs
Domestic Violence Programs
Health Care Facilities
Providers of Home Health Care
Legal Service Providers
Dementia Care Programs
What the Justice System Can Do
Law Enforcement
Prosecutors' Offices
Victim Assistance Programs
Forensics Centers
Elder Justice Centers
Improving Court Access
Elder Courts
Self-Help Clinics
Guardianship Monitoring
What Communities Can Do
Multidisciplinary Teams
Coalitions and Councils
Volunteer Programs
What Community Institutions Can Do
Financial Institutions
Academic Institutions
Churches
7 What States and Tribes Are Doing	173
What States Are Doing
Ensuring that Professionals Report and Respond Appropriately
Ensuring Justice
Ensuring a Comprehensive, Coordinated Service Response
Protecting Elders with Diminished Capacity and Those at Risk for Undue Influence
Special Challenges
What Tribes Are Doing
Improving Coordination
Ensuring Justice
Training Professionals
Meeting the Demand for Services
8 Community Outreach	203
Goals of Outreach
The Impact of Outreach
Local, State, National, Tribal, and International Campaigns
Local Outreach Campaigns
State Outreach Campaigns
National Outreach Campaigns
Tribal Outreach Campaigns
An International Campaign
9 Responding to Challenges	217
Defining Abuse
Responding to a Multicultural Society
Defining Capacity for Specific Tasks
Service Needs
Meeting the Challenge of "Consumer Choice"
Research Challenges and Needs
Evaluating the Impact of Services
Assessing the Impact of Abuse Definitions on Practice
The Economic Costs of Elder Abuse
Shedding Light on "Help-Seeking"
Predicting Helpers' Risk of Abusing
Professional Training Needs
Challenges to Coordination and Collaboration
Ethical Challenges
10 Moving Forward	241
Guiding Principles
A Holistic Response
A Continuum of Service Options
Addressing Cultural Differences
A Public Health Perspective
Long-Term Services
An Approach: Case Management
An Agenda
Promoting Research
Training
Filling Service Gaps
Advocacy
References	263

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