While it’s always been around, we have only recognized elder abuse as a social, medical and legal issue since the mid-1970s, says Georgia J. Anetzberger, Ph.D., a nationally recognized expert on elder abuse.

Just because we know it’s there doesn’t mean we can define it, however. When Anetzberger asked a group of nurses, social workers, and other health care professionals attending an elder abuse workshop what it was, their responses were all over the map.

They mentioned situations where seniors:
- were in unsafe surroundings
- had unexplained bruises, abrasions, burns, and broken bones
- had sudden changes in their financial situation
- were being coerced, exploited and humiliated
- had their life structured to fit the needs of their caretaker rather than their own
- had caretakers who were verbally abusive and argumentative
- were denied essentials, such as clothing, medical care, and food
- were subjected to coercion and neglect
- had their privacy and rights ignored or violated

"Obviously," said Anetzberger, "one of the most controversial aspects of elder abuse is how to define it. There is virtually no agreement [on what elder abuse is] and no standard definition."

There is agreement, however, that it is widespread and that women, because they live longer, are more likely to be its victims than men.

In the majority of cases, the abuser is not a monster. He or she is an elderly and/or frail spouse or a sandwich-generation adult child, neither of whom is wealthy enough to hire the help needed to provide adequate care for their loved one or physically and/or emotionally strong enough to handle the caregiving role on their own. Of late, the abuser is a paid family companion or family member.

Due to our large older population, elder abuse is growing in Northeast Ohio, and experts say things are only going to get worse. That’s because most abuse isn’t reported and, even when it is reported, it’s difficult and costly to prove it has taken place.

Types of Abuse

Physical abuse is the easiest form of abuse to spot, said Anetzberger. It shows up as bruises, bed sores, broken bones, burns, or severe dehydration or mal-nourishment. The usual perpetrator of physical abuse is male, economically dependent on the victim, and has emotional or psychological problems, such as mental illness or substance abuse.

In psychological abuse—ignored needs, coercive actions, threats, rage—the perpetrator is much more likely to be a woman.

In neglect—where the person is badly cared for and often living in filth—the perpetrator tends to be stressed out and overwhelmed by the caregiving situation. And the victim tends to be a person who is mentally or physically impaired or functionally incapacitated.

If you think it’s abuse

When abuse is suspected, you should make a referral, call, or report (see below), said Anetzberger.

A call triggers an investigation by a social worker from your county’s department of senior and/or adult services (or a designated social service agency). "Typically, in a visit the older person is interviewed," explained Anetzberger. "Then an assessment is done to substantiate the abuse, determine [the elderly person’s] degree of danger or risk, assess their ability to manage on a daily basis, and, eventually, to determine whether there is need for protective services."

"The whole intent of the investigation is to find appropriate intervention strategies, and to work out a plan that prevents it [abuse] from recurring," she added.

If a plan can’t be worked out, or if the plan that is worked out is not followed, the investigating agency, or its designate, may re-enter the picture. The agency may work to put more services into the home and/or monitor closely what is going on. Or it may begin the paperwork needed to gain the guardianship of the elder person.

Sources and Resources:

Your minister, rabbi, community office on aging, or police department

Cuyahoga County Adult Protective Services (24/7) 216-420-6700 or 216-431-4600

Domestic Violence Hotline 216-391-4357

First Call for Help (24/7) 216-436-2000 (ext. 1)

Western Reserve Area Agency on Aging 216-621-8010

Organizations:

Children of Aging Parents www.CAPS4caregivers.org

Elder Rights Center www.aoa.gov/eldfam/Elder_Rights/Elder_Rights.cfm

Family Caregiver Alliance www.caregiver.org

National Alliance for Caregiving www.caregiving.org

National Council on Aging www.ncoa.org

National Family Caregivers Association www.nfcacares.org

National Center for Elder Abuse www.elderabusecenter.org

Books:

Is Your Parent in Good Hands?: Protecting your aging parent from abuse, financial, emotional, legal and physical, E. J Carnot (2003)

WRAAA Resource Guide for Older Adults and Their Families (free), 216-621-8010