Hidden Abuse

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.

  • Physical: Inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder or depriving them of basic needs.
  • Emotional: Inflicting mental pain, anguish or distress on an elder person through verbal or nonverbal acts.
  • Sexual: Nonconsensual sexual contact of any kind
  • Exploitation: Illegal taking, misuse or concealment of funds, property or assets of a vulnerable elder.
  • Neglect: Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable elder.
  • Abandonment: The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.

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.

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Copyright © July 2007 Shana Schutte. Used with permission. All rights reserved.