The media are replete with stories of domestic abuse, child abuse, drug abuse…even animal abuse. But there is another kind of abuse that garners very little attention, abuse that afflicts millions of Americans. It’s elder abuse—a problem that few people want to talk about or even acknowledge.
Sadly, approximately 90 percent of the abusers are family members: children abusing elderly parents, husbands and wives abusing their diminished partners who need assistance and time-consuming attention. Others include attendants or fellow residents in nursing homes and scammers who yearly bilk vulnerable older citizens out of millions of dollars.
The latest survey of Adult Protective Services reports that abuse is on the rise, up by nearly 20 percent from 2000. Most victims are white, 66 percent are women and 43 percent are 80 years old or older. Types of abuse include physical, emotional and sexual abuse. Financial abuse, neglect and abandonment are also growing problems.
Fortunately, there is a growing awareness of this problem and the need to do something about it. Community education programs are sprouting up that focus on educating people to recognize and prevent abuse of the elderly. State adult protective services agencies are also investigating reported incidents of known or suspected abuse. Even Congress is getting involved.
U.S. Senator Herb Kohl, Chairman of the Senate Special Committee on Aging, said, “Our nation has for far too long turned its back on the shame of elder abuse.”
We hope this article series will help you gain awareness of elderly abuse. Public involvement is essential if we are to change this dangerous and humiliating situation.
Opal is 86 years old. Confined to a wheelchair after breaking her hip last year, she recently moved in with daughter Ann. Ann, who is 53, has troubles of her own. Her husband was laid off from his job last month, and her grown kids' personal problems are always on her mind. Opal's need for constant care and attention have stretched Ann's nerves to the breaking point. Today, in a moment of frustration, Ann yelled at her mother and grabbed her wrists so tightly, ugly bruises formed where her fingers gripped the older woman's fragile skin. Cowed by her daughter's rage, Opal retreated to her room where she quietly sits slumped in her wheelchair. As tears roll down her cheeks, she wonders, how did her life come to this?
With old age comes more than the threat posed by household obstacles, slippery bathtubs and space heaters absentmindedly left on "high." A more ominous danger lurks in the hearts and intentions of caregiving spouses, siblings and adult children.
In 1998, a study conducted by the American Public Human Services Association found that approximately half a million people were victims of elder abuse in their homes. But researchers admitted that because so much abuse goes unreported, the number was likely five times that. The Senate Special Committee on Aging estimates as many as five million elderly Americans are abused each year. As the first wave of Baby Boomers crosses the threshold into early old age, these statistics will increase exponentially.
According to the National Center on Elder Abuse, abuse falls into the following categories:
Sadly, the majority of abuse is inflicted by family members – most often, a caregiving spouse. If there is a history of domestic violence, the chances of abuse increase. Strained or tense relationships between elders and adult children can also presage abuse.
Of the many kinds of abuse, neglect is the most common. Not all neglect is intentional. Elderly adults may be geographically cut off from adult children as a result of job moves. The transient nature of American society today makes it problematic for adult children to stay informed about their parents' needs and physical circumstances.
Elderly adults with dementia or Alzheimer's, isolated in their homes, may not remember to take their medications. Lack of access to transportation may prevent them from obtaining needed medical care. Many elderly people on fixed incomes are forced to choose between medications or eating and paying the electric bill.
For those elders fortunate enough to be placed in luxury long-term care facilities with well-trained, well-staffed Alzheimer's units, abuse is rare. But for the elderly warehoused in barebones Medicaid facilities, neglect in particular is pervasive. Neglect comes in the form of residents consigned to tray chairs, where they languish for hours lined up in corridors. Overworked, poorly-paid staff may also manhandle fragile elderly bodies as they're moved from bed to shower to dining hall. Bedridden residents may develop bedsores.
Signs of abuse are not always easy to recognize. For example, emotional and psychological abuse may be subtle. A hostile spouse, sibling or paid caregiver may withhold medication, food or hygiene. They may assault an elderly person's identity by treating them like a child, threatening them or ignoring their requests for help. Signs of abuse include:
Preventing elder abuse begins with education. To be treated with dignity and respect is a basic human right. Families where slapping and hitting are considered acceptable forms of expression must be taught that yelling, pinching, punching and shoving are never acceptable. Neither is the withholding of food or medication. Senility is not a license for caregivers to ignore an elder's innate personhood. Listening when people express their pain, needs and feelings is an act of respect all people are entitled to.
Helping caregivers with the emotional and physical demands of caregiving is one way to reduce instances of abuse. Offering caregivers even a few hours of respite each week can significantly relieve the stress that leads to abuse. Respite care is especially important for those caring for severely disabled elders and those suffering from Alzheimer's and senile dementia. If there is a history of domestic violence in the family of an elderly person, caregivers should seek counseling to deal with underlying emotional issues.
Since abuse happens most often when the elderly are isolated, steps should be taken to increase the social contact for both caregivers and elders. Joining an Alzheimer's support group, for example, allows caregivers to connect and vent with people going through similar experiences. Friends made through these associations can band together to create respite opportunities for each other.
No one person should be left alone to deal with an elder's needs. Families should come together to seek loving, practical solutions for caring for an elderly parent. If the demands of caregiving in a home setting become too demanding emotionally and physically, families should consider moving their elder into a safer setting within a licensed long-term care facility.
Natural catastrophes are bad enough, but we live in an age of chaos and must add another prevalent disaster—financial exploitation, especially of the elderly.
Every year Americans lose billions of dollars to fraudulent scams and investments. The following provides information for avoiding fraudulent schemes, but the list is not exhaustive.
Discuss these matters with your relatives and friends—elderly or not. Let them know that criminals can obtain personal data without ever breaking into our homes. Warn and instruct them about:
Victims of identity fraud often are unaware of what's happening until their credit and reputation are damaged, or assets are stolen.
So check your credit report regularly. You can order your free annual credit report online at http://www.ftc.gov/bcp/edu/microsites/freereports/index.shtml, or call 1-877-322-8228.
If your suspect that you've been an identity theft or fraud victim, report it immediately to your local office of the FBI or the U.S. Secret Service, and online at the Federal Trade Commission's Bureau of Consumer Protection at http://www.ftc.gov*.
The United States Department of Justice also has information to help you identify common scams and avoid becoming a fraud victim at http://www.justice.gov/criminal/fraud/*.
No one could believe it. No one wanted to believe it. Things like this weren't supposed to happen in small towns where tractors and cows were part of the landscape.
But it did.
Bernard Shuman*, 19, broke into his best friend's grandmother's home, beat her unconscious with a baseball bat, wrapped her in toilet paper and set her on fire.
This was a blatant example of disregard for the value of the elderly. However, elder abuse happens regularly through much less violent means. It happens when an adult child neglects her mother by not bathing her often enough, when a nursing home caregiver brushes an 80-year-old man's hair harshly or when an elderly husband verbally abuses his wife.
Not only can elder abuse be subtle, but it also doesn't happen the way we often think it does. Contrary to popular opinion, most elder abuse does not happen in nursing homes. In fact, according to the American Psychological Association, only about 4 percent of the elderly live in nursing homes and most of the residents have their needs met without abuse.
If not in nursing homes, where dies it happen? Surprisingly, behind closed doors within families. In the past, it has been reported that adult children were the most common abusers of their elderly family members. However, according to the National Center for Elder Abuse (NCEA), new information shows that spouses are the top perpetrators. For this reason, elder abuse can be difficult to identify, since dysfunctional ways of relating can become lifelong patterns. Additionally, it's not always easy to distinguish between interpersonal stress and abuse.
Consider Helen. She's 80 and suffers from Alzheimer's disease. When her husband died, her daughter Laura offered to care for her. But the task has been more than she bargained for. Working two jobs, raising three elementary-age children and marital stress has made caring for her mother an extra challenge. Laura finds herself yelling at and belittling her mother on a regular basis.
Is Laura's behavior acceptable? After all, she's under a lot of stress, right? Wrong. No amount of abuse, whether big or small is justifiable under any life stress. So, if it's unjustifiable, how can you identify it?
According to the NCEA, abuse falls into six categories. These will help you identify if it is something that is happening to you or someone you love.
Bernard Shuman's crime received a lot of press but most abusive acts toward the elderly aren't noticed or are ever reported.
According to research by the NCEA, only 16 percent of abuse situations are reported, and a whopping 84 percent remain hidden. The Senate Special Committee on Aging estimates that there "may be as many as 5 million victims each year," with most of the victims being women over 60.
Why are there so many silent cases of abuse? Again, the family factor plays an important role. A woman who is being mistreated by her daughter, husband or grandson may not have the emotional strength or tools needed to report abusive behavior.
When Genevieve became disabled due to a car accident during her 70th year, she became part of the elderly population at greater risk of abuse along with those who are ill, frail, mentally impaired (such as those with Alzheimer's disease or dementia) and the depressed. But just because an elderly person does not suffer from these characteristics does not mean that they are not vulnerable. Abuse can happen to anyone, regardless of sex, ethnic background or social status.
If you are entering your senior years or are already in the midst of them, here are some tips for avoiding and overcoming abuse:
Most importantly, remember that no matter what stage of life you are in, that you deserve to be cared for. Take the necessary steps to protect yourself and your future from abuse.
*Name has been changed.