Focus on the Family

Acknowledging Elderly Abuse

by Bob Kellogg

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.


The Greatest Danger to Many Elders

An ominous danger lurks in the hearts and intentions of many caregiving spouses, siblings and adult children.

by Roberta Rand Caponey

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.

Unintentional Neglect

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.

Dangers Lurking in Long-term Care

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.

Recognizing Signs of Abuse

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 Abuse

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.

Care for Caregivers

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.


Scamming the Elderly and Others

Each year older citizens are bilked out of billions of dollars by scammers on the Internet and on the phone.

by Harvey Nowland

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.

Six Common Ways the Elderly are Bilked

  1. Charity fraud

    Millions of bighearted Americans give to reputable ministries and charities. The devastating hurricane season of 2005 proves that. Unfortunately, it also revealed predators who solicited funds for disreputable or fraudulent charities.

    Most police and fire departments are tax-supported, but it's not uncommon for some to ask for contributions. Yet, just because the words "police" or "firefighter" are used doesn't mean that public servants are involved.

    Call your local police or fire department to verify fundraiser claims. Even with legitimate appeals, often fundraising groups receive a small percentage of what is raised, and the fund raiser pockets most of the money as fees.

    There's no reason to be suspicious of all fund raising. But, before donating, ask how your money will be used and what percentage goes to the local organization. Be sure your money supports activities that are important to you.

  2. "Phishing"

    Phishing—pronounced just like the "fishing" some of us do legitimately—is a common way for con artists to gather your personal information.

    You receive an official looking e-mail. Some criminals cut and paste logos from banks or other financial institutions and create what appears to be a legitimate document from that institution.

    They'll have seemingly legitimate reasons for asking you to update or validate your billing information, including credit card and Social Security numbers You're asked to send the information using a website address that they've inserted in the e-mail.

    Unfortunately, if you send the information and try to contact them later, you'll discover that the site has disappeared. They have "phished" and you took the bait.

  3. Work at home

    A few work-at-home offers might produce minimal income, but don't count on it because you'll be unable to determine which ones are valid. The vast majority fraudulently promise large payouts for little work. "Hurry, thousands of people across America use my system for extra income. Working online in her spare time, Ruth made $470 cash in three days, $2,500 the first month."

    Usually, you're asked to pay for upfront supplies, training, an instructional manual or materials—charges you'll rarely recoup.

  4. Foreign money offers

    Someone supposedly has inherited a large amount of money and contacts you—or a "foreign government official" sends you an e-mail or letter—many from African nations, but could originate anywhere.

    The "inheritance" cannot be taken from the country because the amount is too large. You're asked to help by allowing some of the money to be transferred to your bank account.

    Or, the "foreign official" is out of political favor, or a pressing health issue requires him to get money out of the country himself, so he needs to transfer it to an American bank.

    This will be done at great risk to himself in his country, but he trusts you, you'll be rewarded generously and you're assured that it's a perfectly legitimate for you.

    Naturally, you'll need to send your bank account information in order to make the money transfer—and time is always of the essence. Warning: don't just slow down—stop!

  5. Sweepstakes

    Even though legitimate sweepstakes are conducted by major corporations such as Coca-Cola and Chevrolet, fraudulent sweepstakes scams bilk thousands every year.

    You're informed that you've won something—either by phone or by mail and you'll only need to pay a processing fee, taxes and handling and delivery costs.

    To give the scam an air of legitimacy, you may even receive a portion of your prize as a counterfeit check along with the phony winner notification.

    However, if you cash the fraudulent check, you're committing a crime and you could be liable for fines—not to mention losing any money you send to them.

  6. Internet auctions

    Thousands of legitimate transactions take place daily on popular online auction sties, but sometimes goods purchased from dishonest individuals never arrive or aren't what's been promised.

    And, "phishing" predators send e-mails saying something like: "My payment wasn't accepted by your bank. But, I want to make this transaction right, so please resend your bank's number and your bank account information to me, and I'll resubmit a check to you."

    You're asked to send information to a fake website address. This scam is so prevalent that online auction companies have departments to battle this type of fraud.

How Friends or Relatives Can Help

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.

Cautions to Help Counter the Problem

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/*.


Hidden Abuse

Elder abuse happens regularly. Nursing homes are not the main perpetrators. Family members are too often the culprints.

by Shana Schutte

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?

What is Elder Abuse?

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.

Silent Crimes

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.

Who's Vulnerable?

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.

What to do

If you are entering your senior years or are already in the midst of them, here are some tips for avoiding and overcoming abuse:

  1. Avoid social isolation. In some cases, social isolation cannot be avoided, such as in the case of mental illness. However if this is not part of your story, it's important to stay connected with others in your community to avoid becoming more vulnerable to abuse. Even having one close friend can be your lifeline to emotional and physical safety.
  2. Stay healthy. Of course health issues can become a part of life during your later years. But as long as you are able, take care of your health, which will keep you independent and thriving.
  3. Seek professional help when needed. If you suffer from depression, alcohol or medical problems, get the help you need. If you're unable to solicit help from family members, find a friend who can help.
  4. Find a support group. It's never too late to learn about abuse and overcome it, even though it has been a persistent pattern in your life. Look in your local yellow pages for groups to help those in domestic violence or emotional abuse situations.
  5. Find help ahead of time. Plan ahead before you need help. When Frank thought that he might become disabled at some point due to a poor medical report, he contacted a close friend to handle his personal and financial affairs. Although it was hard, he knew this could save him a lot of future heartache and trouble. His advocate agreed to execute power of attorney and discuss issues with family and/or nursing home staff if needed.
  6. Know your rights. If a family member or paid professional is assisting you with your caregiving needs, you have a legal right to voice your concerns. If you live in a nursing home, the home's ombudsman is your advocate and can intervene in abuse cases. If you are unsure of how to contact your ombudsman, you can contact the Eldercare Locator at the NCEA for referral services at 800-677-1116.

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.


Acknowledging Elderly Abuse

A list of helpful resources, links and organizations related to the topic of elderly abuse.

Popular questions on this topic: