How To Recognize and Stop Elder Abuse

The abuse that’s seldom talked about

In less than the time it takes to read this sentence — just five seconds — a senior citizen in this country will be the victim of some sort of physical, sexual, emotional or financial abuse. That’s two dozen elderly abused while you brushed your teeth this the morning. Two hundred forty during your 20-minute commute to work. Or 720 while you watched your favorite hour-long show. And, says Susan Staples, coordinator of the Abuse in Later Life Project for the Attorney General’s office in New Hampshire, those numbers are just the tip of the iceberg. She says there is one national statistic that estimates for every one elder abuse case that is investigated, there are 23 others that never come to light.

Why so many? The answer lies with some obvious facts, like demographics: “Every day millions of us turn 65 and older,” she says. “Just the sheer numbers of older people are growing by leaps and bounds and are expected to continue.” Other reasons for the volume of cases that go unreported have to do with the particulars of being an older person. For starters, Staples says, you might be more physically dependent on someone to help with your daily care. Or you may have cognitive limitations, so you can’t make another plan for yourself or get out of a harmful situation easily. “Particularly for those who have a really diminished capacity physically or mentally, it’s not like you can just pick up and move,” says Staples.

Because they are living on a fixed income and may not have access to funds, says Staples, senior citizens’ ability to find different housing is pretty limited: “It’s a barrier unique to older people.”

The types of maltreatment that occur in people over the age of 60 include not only physical, emotional and sexual abuse, but also neglect, abandonment and financial abuse. Unfortunately the vast majority of cases (about 90 percent) of elder abuse involve family members, most often adult children, spouses or partners, according to the World Health Organization. Staples points out that, with the number of people living longer, to be able to live independently as long as possible means that someone is going to have to take care of us, and that has created a change in our society.

“People who are maybe in their 60s now are care-giving to parents who are still living in their 80s and 90s,” she says. “And we know that care-giving is a really demanding task: it may start off assisting in a few ways but eventually is going to get harder and more involved, taking up more of the caregiver’s energy, time and resources. As more people are doing it, the inevitable number of people who are stressed out and burned out grows.”

She cautions that this alone doesn’t cause abuse, but that stress coexisting with care-giving can exacerbate abusive tendencies. “I don’t like to say caregiver stress causes abuse — there is research showing otherwise — but for those who may have abusive behaviors in their makeup, that stress can trip them.”

For a senior, if it is an adult child committing the abuse, either physically, emotionally or financially, says Staples, the senior citizen probably doesn’t want to tell anybody that. “What we know about people in later life now is that those who are 60, 70, 80 are fiercely independent and loyal to their family. There is a whole element of embarrassment or shame that this is happening.”

The other reason why seniors don’t want people to know they are being abused is fear. “They are scared to death that they will be taken from their homes,” says Staples. “Particularly for those who are dependent, they think that the only option is to be put in nursing home so they’d rather stay in the situation they’re in, just to remain at home. It’s a fear we have to try to combat to let people know there are some alternatives. And sometimes with enough support, a family situation can be turned around and be better and safer.”

Enter the Abuse in Later Life Project, which came about in 2009 when New Hampshire, along with nine other states, received a grant from the Office of Violence Against Women to enhance the training of professionals — law enforcement, elder services agencies, health care workers and adult protective services advocates, among others — and develop new ways of responding to abuse in later life.

“It’s an opportunity for all kinds of different disciplines who share an interest in older people to sit at the same table and respond to issues,” says Staple. “These are complicated issues beyond the ability of one organization to be able to deal with, and having a coordinated response gives us the best chance to succeed.”

Over the past three-plus years, the group has provided a number of trainings to law enforcement officials and more than 150 victim service providers with the goal of increasing professionals’ awareness, including what to look for and how to respond. Those who come into contact with seniors on a daily or regular basis — mail carriers, bank clerks, hairdressers, healthcare workers, those who work in senior centers and others on the “front line” — are key to spotting abuse.

“We’re finally beginning to realize what elder abuse looks like,” says Staples. “It isn’t just hitting or shoving. It’s being emotionally cruel. It can be sexually abusing. It can also be neglect, where a care-giver or loved one either runs out of steam or resources and can’t do it anymore, and rather than seeking help they just withdraw and leave that person without very basic necessities to live: heat, food, human contact. That’s a pretty horrible thing, but it happens.”

Financial exploitation is another form of abuse for seniors — and one of the fastest-growing. And while older adults often are prey to deceitful tactics to get them to part with their money, such as telephone or mail scams, or being taken advantage of by unscrupulous contractors, they can also be cheated by people they know and trust, who think that they are “entitled” to receive their inheritance early or that they deserve it for taking care of the person.

Staples hopes that, through training and more awareness, it might dispel fears for those who might be worried about whether or not what they are seeing is, in fact, elder abuse. “It’s not just friends and neighbors, but also professionals who are afraid that if the senior finds out it was them who called it will jeopardize that important relationship.” She adds that reporting is strictly confidential and anonymous.

The Merrimack County Coordinated Response Team has grown from 10-12 agencies in 2010 to 22 agencies currently. “We built quite a good network of different agencies that they can call and talk to about what they are working on,” says Staples.

With the end of the grant on June 30, she is no longer is formally associated with the project but hopes to see the model live on by finding other pockets of support.  “We’ve accomplished so much so far and what that’s meant to us hopefully means that will keep them meeting in an informal way. What we’ve done is improved our understanding and response, but we’ve only just scratched the surface.”   

Warning Signs of Abuse

• From the NH Dept. of Justice, Office of the Attorney General website
• Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.n
• Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
• Bruises around the breasts or genital area can occur from sexual abuse.
• Sudden changes in financial situations may be the result of exploitation.
• Bedsores, unattended medical needs, poor hygiene and unusual weight loss are indicators of possible neglect.