title: Framing abuse: explaining the incidence, perpetuation, and intervention in elder abuse.
abstract: BACKGROUND
  The role of individual characteristics in incidences of elder abuse has long been highest on research and policy agendas. Now, it is timely to discuss factors that go beyond victim and perpetrator. Environmental factors also play an important role in elder abuse. In this paper, we address the framing of elder abuse as a social and health problem. Attention is paid to the factors that influence societal context and the healthcare system, its organization, structure, and principles.
  
  
  METHODS
  Focus groups and in-depth semi-structured interviews were held with different professionals and older people themselves. Qualitative analysis of focus groups and interviews transcripts was performed to analyze how different professional groups and older persons themselves view elder abuse, to determine opinions and attitudes toward elder abuse and the necessary actions that should be taken to prevent or intervene in the problem.
  
  
  RESULTS
  Two main explanatory frameworks emerged in the discourse of older persons and care professionals: social arrangements and healthcare system. The themes within the social arrangements included social taboo, social control and responsibility, and institutional cultures. The fragmentation of care and changes in the financing of healthcare were two aspects distinguished within the framework of the healthcare system.
  
  
  CONCLUSIONS
  Two explanatory frameworks showed elder abuse as both a social and health problem. The environmental factors through social arrangements and healthcare system have an influence on framing of abuse. The different ways of framing abuse impact the understanding of abuse, ways of intervention, and prevention measures.
authors.affiliation: Leyden Academy on Vitality and Ageing, Poortgebouw LUMC, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands. mysyuk@leydenacademy.nl
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Mysyuk
authors.forename: Rudi G J
authors.initials: RG
authors.lastname: Westendorp
authors.forename: Jolanda
authors.initials: J
authors.lastname: Lindenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D004552:Elder Abuse / Q000517:prevention & control / Q000706:statistics & numerical data*; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006299:Health Services for the Aged / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D009426:Netherlands / Q000453:epidemiology; D036301:Qualitative Research; D012931:Social Environment