What Everyone Should Know About Elder Abuse
Every year, an estimated 4 million older Americans are victims of physical, psychological or other forms of abuse and neglect. Those statistics may not tell the whole story. For every case of elder abuse and neglect reported to authorities, experts estimate as many as 23 cases go undetected. The quality of life of older individuals who experience abuse is severely jeopardized: worsening functional and financial status, progressive dependency, feelings of helplessness and loneliness and increased psychological distress.
Like other forms of abuse, elder abuse is a complex issue. Defined, “elder abuse is the infliction of physical, emotional/psychological, sexual or financial harm on an older adult. Many believe that such abuse occurs primarily in nursing homes, but in fact most take place at home. About 95 percent of older people live on their own or with their spouses, children, siblings or other relatives, not in institutional settings. When elder abuse happens, family, other household members or paid caregivers are usually the abusers. Often the abuse is subtle, and the distinction between normal interpersonal stress and abuse is not always easy to distinguish. Sometimes, the older adult is unaware of the abuse or is physically incapable of reporting it. Other times, they are reluctant to report abuse because they are embarrassed, or they don’t want to get a family member in trouble. Seniors who rely on caregivers often believe they must put up with the abuse because they have no one else to take care of them.
Factors Contributing to Abuse
There is no single pattern of elder abuse. Sometimes it is a continuation of long-standing patterns of violence within the family. If a woman has been abused during a 50-year marriage, she is not likely to report abuse when she is very old and in poor health. Or, a woman who has been abused for years may turn her rage on her husband when his health fails. An adult child may take the opportunity to “turn the tables” on the abusing parent by withholding nourishment or overmedicating the parent.
More commonly, elder abuse is related to changes in living situations and relationships brought about by the older person’s growing frailty and dependence on others for companionship and for meeting basic needs. When a dependent parent moves into a family member’s home, the lifestyle adjustments can be staggering, and the associated stress can lead to elder abuse. There may be marital stress between an older couple when they must share a home with their adult children. The financial burdens of multigenerational households or living in overcrowded quarters can lead to stress that can trigger elder abuse. Such a situation can be especially difficult when the adult child has no financial resources other than those of the aging parent.
When an older adult’s care needs increase or go beyond the types of help family members typically provide, relatives may find themselves in an unfamiliar situation and not know how to offer proper care and support. Family members may unintentionally fail to ensure that the older adult has adequate and appropriate food, clothing, medical care, supervision or social stimulation.
It isn’t just older adults who have poor physical health or cognitive impairments that are vulnerable to abuse. Older individuals who are frail, alone or depressed, as well as those with a physical disability or mental illness, are vulnerable. It affects older men and women across all socioeconomic groups, cultures, races, and ethnicities.
What You Can Do
Effective interventions can prevent or stop elder abuse. Increasing awareness among physicians, mental health professionals, home health care workers and others who provide services to older adults and family members can help break patterns of abuse or neglect, and both the person experiencing the abuse and the abuser can receive needed help.
If you suspect that an older person is being abused or neglected: First, contact local Law Enforcement. Don’t let your fear of meddling in someone else’s business stop you from reporting your suspicions. You could be saving someone’s life. The reporting agencies in each state are different, but every state has a service designated to receive and investigate allegations of elder abuse and neglect. Do not put the older person in a more vulnerable position by confronting the abuser yourself unless you have the victim’s permission and are in a position to help the victim immediately by moving him or her to a safe place.
Remember that many professionals, including psychologists and other mental health specialists who work closely with older individuals, are “mandatory reporters” according to state statute, which varies from state to state.
Also, you can consider sponsoring an Awareness Information Session for your church, community or civic organization.
Resources: Where to Go for Help
Your personal safety is most important. If you can safely talk to someone about the abuse (such as your doctor or a trusted friend) who can remove you from the situation or find help, do so at once. If your abuser is threatening you with greater abuse if you tell anyone, and if the abuser refuses to leave you alone in a room with others who could help, you are probably afraid to let anyone know what is happening to you. A good strategy is to let your physician know about the abuse. Here are some agencies to contact for help and information:
- National Center on Elder Abuse (NCEA) is a resource for public and private agencies, professionals, service providers, and individuals interested in elder abuse prevention information, training, technical assistance and research. Contact 855-500-3537. Further information and referrals can be found at the Elder Locator at 800-677-1116
- Local Area Agencies on Aging (AAAs) provide support for older adults, their families, and caregivers through advocacy, information and services. Programs and services offered for vulnerable older adults vary by locality but often include a long-term care ombudsman and an elder abuse prevention specialist. Check your local telephone directory.
- Adult Protective Services (APS), present in all 50 states, is designated to receive and investigate allegations of elder abuse and neglect. Each state has a primary agency that houses APS. It may be the Area Agency on Aging, the Division of Aging, the Department of Aging or the Department of Social Services.
- Medicaid Fraud Control Units (MFCU): Each state attorney general’s office is required by federal law to have an MFCU that investigates and prosecutes Medicaid provider fraud and patient abuse and neglect in health care programs and home health services that participate in Medicaid. Contact information for individual state MFCUs is available online.
- Local Department of Social Services and local Legal Aid Society
Elder Abuse is a difficult subject in every way, but as with any other social issues, awareness, compassion and action are key. If you suspect or are experiencing abuse, please reach out for help.
By William Lightfoot
Former Sergeant Bill Lightfoot served with the Richmond Police Department for thirty-six years. He has served as an investigator and supervisor with the Property Crimes Unit, the Robbery & Homicide Unit, The Narcotics Division, the Criminal Intelligence Unit and the Domestic Violence Unit. He is a graduate of the Virginia Criminal Justice Instructors School and the National Intelligence Academy in Ft. Lauderdale, Florida. He holds a B.S. Degree in Criminal Justice. Bill has developed training in Domestic Violence, Stalking Investigations, Elder Abuse Investigations, Financial Exploitation of the Elderly, Forensic Case Studies, Violence Against Women with Disabilities, Domestic Violence in Later Life Violence Against Immigrant Women and Domestic Violence in the Work Place. He provides Policy Development assistance to Government and private agencies as well as financial institutions. Bill also provides legislative and governmental affairs services in the Virginia General Assembly.
Thank you so much Bill for this article. I deal with a lot of seniors and this is very good information to know.
Good article but a true reality of this horror is this list of resources is ONLY helpful if the abuse or neglect, including financial exploitation, is occurring at the hands of a third party and not the spouse. And when the actions are at the hands of a spouse, the abused or neglected must be willing and are forced to advocate for themselves. These mandatory reporters, law enforcement, APS, etc. are amazing but they cannot act if the victim is not willing to move forward. Yet they are victims of abuse – why in the world would we force them into this!!! They are fearful of those necessary steps. So substantiated cases are closed and the cycle of abuse, exploitation, and victimization begins all over again. This writing screams with gender bias. Men are just as vulnerable as women and are just as likely to be the victims…even at the hands of the “cute little Grandma” living next door. Believe me – I am living this nightmare right now and the power of the marriage contract supersedes the decency and the rights of an individual adult who doesn’t have the strength to have a voice. As a society we stand united and up in arms, voicing for children of abuse and neglect, but we are completely silent, and often accusatory, of the adult victims. I respect the views and information shared by Mr. Lightfoot, I can only plead he works more diligently to get this subject to those in the nation and states who have the power to change the climate and culture.
Good afternoon. Thanks so much for your response and I will try and address at least some of your concerns. I agree with the majority of your concerns. This abuse happens for many reasons and each must be understood. Elder abuse is a huge topic to include, physical, sexual, financial, emotional and psychological abuse. Power, financial gain are just a couple of reasons that drive this abuse. We also need to understand that a victim does not need to be physically or mentally incapacitated to become a victim. Fear is an overriding factor in causing the victim to not report. (this needs to change). The fear of losing their freedom, of the loss of a caregiver, unfounded embarrassment all may cause a victim to be silent.
Abuse happens in the home and in care facilities (nursing homes, assisted living facilities etc). Abuse in institutions is another issue we really need to address. Some of the worse incidents I have seen came from care facilities)
It is also true that law enforcement, social services, APS cannot address the issue without the cooperation of the victim. This is the case in many criminal and civil offenses. Our focus must be on awareness and getting the issue out to seniors groups, church groups and community groups. There needs to be an awareness and understanding of the issue.
We also must be sure that we have effective laws to address the problem, which means our legislators need to make this a priority (not just during an election year). Legislators as well as others need to also understand that financial exploitation and Frauds and scams are separate issues with different dynamics. Both are abusive but very different. Financial exploitation is a crime committed by a known person and Frauds and scams are mostly stranger crimes. Legislators and the public need to understand the difference and how to address them both.
I will say that both men and women are victims and as the age goes up you will see less of a gender gap. We do need to understand that both are affected by the violence. It is unfortunate that many states do not address psychological and emotional abuse, this has to change. This type of abuse can and often does cause other physical and psychological problems.
I hope I have touched on some of your concerns and if I can ever be of help, please don’t hesitate to reach out. (Bill Lightfoot, email: [email protected]) Thank you again so very much.
Good afternoon. Thanks so much for your response and I will try and address at least some of your concerns. I agree with the majority of your concerns. This abuse happens for many reasons and each must be understood. Elder abuse is a huge topic to include, physical, sexual, financial, emotional and psychological abuse. Power, financial gain are just a couple of reasons that drive this abuse. We also need to understand that a victim does not need to be physically or mentally incapacitated to become a victim. Fear is an overriding factor in causing the victim to not report. (this needs to change). The fear of losing their freedom, of the loss of a caregiver, unfounded embarrassment all may cause a victim to be silent.
Abuse happens in the home and in care facilities (nursing homes, assisted living facilities etc). Abuse in institutions is another issue we really need to address. Some of the worse incidents I have seen came from care facilities)
It is also true that law enforcement, social services, APS cannot address the issue without the cooperation of the victim. This is the case in many criminal and civil offenses. Our focus must be on awareness and getting the issue out to seniors groups, church groups and community groups. There needs to be an awareness and understanding of the issue.
We also must be sure that we have effective laws to address the problem, which means our legislators need to make this a priority (not just during an election year). Legislators as well as others need to also understand that financial exploitation and Frauds and scams are separate issues with different dynamics. Both are abusive but very different. Financial exploitation is a crime committed by a known person and Frauds and scams are mostly stranger crimes. Legislators and the public need to understand the difference and how to address them both.
I will say that both men and women are victims and as the age goes up you will see less of a gender gap. We do need to understand that both are affected by the violence. It is unfortunate that many states do not address psychological and emotional abuse, this has to change. This type of abuse can and often does cause other physical and psychological problems.
I hope I have touched on some of your concerns and if I can ever be of help, please don’t hesitate to reach out. (Bill Lightfoot, email: [email protected]) Thank you again so very much.