Assistive technology (AT) is defined in this paper as 'any device or system that allows an individual to perform a task that they would otherwise be unable to do, or increases the ease and safety with which the task can be performed ' (Cowan and Turner-Smith 1999). Its importance in contributing to older people's independence and autonomy is increasingly recognised, but there has been little research into the viability of extensive installations of AT. This paper focuses on the acceptability of AT to older people, and reports one component of a multidisciplinary research project that examined the feasibility, acceptability, costs and outcomes of introducing AT into their homes. Sixty-seven people aged 70 or more years were interviewed in-depth during 2001 to find out about their use and experience of a wide range of assistive technologies. The findings suggest a complex model of acceptability, in which a ' felt need ' for assistance combines with ' product quality'. The paper concludes by considering the tensions that may arise in the delivery of acceptable assistive technology.

This paper critically reflects upon policy and research definitions of elder mistreatment in light of the findings of the United Kingdom Study of Abuse and Neglect of Older People that was commissioned by Comic Relief with co-funding from the Department of Health. The study uniquely comprised a national survey and follow-up qualitative research with survey respondents. This paper focuses on the findings of the qualitative component. One focus is the idea of ' expectation of trust ', with an argument being made that the concept needs clarification for different types of relationships. It is particularly important to distinguish between trust in affective relationships and 'positions of trust ' (as of paid carers), and to articulate the concept in terms that engage with older people's experiences and that are meaningful for different relationship categories. The qualitative research also found that ascriptions of neglect and abuse tend to be over-inclusive, in some instances to avoid identifying institutional and service failures. We also question the role and relevance of the use of chronological age in the notion of 'elder abuse '. Given that ' abuse ', ' neglect ' and ' expectation of trust ' are ill-defined and contested concepts, we recommend that although consistent definitions are important, especially for research into the epidemiology and aetiology of the syndrome and for informed policy discussion, they will unavoidably be provisional and pragmatic.

Using a classification of public policy developed by Matland, we examine implementation of policy on adult protection as outlined in 'No Secrets', the government's guidance to local agencies. This policy appears to exemplify a 'high-ambiguity/low-conflict' model. Detailed interviews with staff charged with developing multi-agency procedures, in local authority departments, health authorities, the police and the voluntary sector, confirmed the ambiguity of the policy and the uncertainty experienced by staff as a consequence. However, the interviews also revealed a number of areas of conflict, particularly as people gave precedence to their own professional norms and organizational priorities over partnership working.

Appropriately selected adaptations and AT can make a significant contribution to the provision of living environments which facilitate independence. They can both substitute for traditional formal care services and supplement these services in a cost-effective way.

A pilot survey in Tower Hamlets, London, indicated that many general practitioners (GPs) might not be recognizing abuse of elderly patients through lack of training. The survey was replicated on a large scale in Birmingham, to allow further analysis. 561 Birmingham GPs were mailed questionnaires and responses from 291 were analysed, providing data from 95% of the practices. The findings were similar to those in Tower Hamlets: just under half had diagnosed elder abuse in the previous year. Regression analysis of the combined data-sets (n = 363) indicated that the strongest factor predicting GP diagnosis of abuse was knowledge of 5 or more risk situations (odds ratio 6.77, 95% confidence interval 4.19, 10.93). The findings of these surveys suggest that research-based education and training would help GPs to become better at identifying and managing elder abuse.