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3 <br />NEED: <br />Elder mistreatment, both abuse and neglect, are typically under-reported. Based <br />on their prevalence study using a random sample of community-dwelling elders, Pillemer <br />and Finkelhor (1988) estimated that yearly in Massachusetts some 3.2% of the elderly <br />are physically or psychologically abused or neglected by their caregivers (financial <br />abuse and self-neglect were not included). Yet, only one in 14 cases came to public <br />attention in spite of that state's mandatory reporting law. In their survey of 577 nurses <br />and nurses' aides working in 31 nursing homes, Pillemer and Moore (1989) found that <br />36% of the staff had seen at least one incident of a resident being physical abused in the <br />previous year, while 81% had seen psychological abuse of residents during that time. <br />Most of this mistreatment in long-term care facilities did not get reported to authorities. <br />Tatara (1993) conducted a national survey of state APS and states' units on aging to <br />estimate the national incidence of domestic elder mistreatment. Based on data from 29 <br />states, he estimated that 735,000 elders were victims of domestic (non-domestic was <br />not included) abuse or neglect during 1991, while another 842,000 were victims of self- <br />neglect in that year. He also found that only some 227,000 of these elders (14.4%) were <br />reported to agencies that could provide protective services. The most recent national <br />study of the incidence of elder abuse and neglect (Takamura & Golden, 1998) estimated <br />that at least one-half million older persons in domestic settings (institutions were not <br />included) were abused and/or neglected, or experienced self-neglect during 1996, and <br />that for every reported incident of elder mistreatment another five went unreported. <br />While the actual incidence and prevalence of elder mistreatment in domestic and <br />institutional settings are unknown, and therefore can only be estimated, all of the studies <br />clearly indicate that most cases are unreported in spite of mandatory reporting laws. <br />Thus, most mistreated elders do not receive the help that is needed. There has been <br />only one study conducted in North Carolina that gives an indication of the prevalence of