For many older persons, family represents comfort and belonging, and home is typically considered a safe environment. However, 25 years ago this country finally recognized a national hidden problem called “elder abuse and neglect.”
The term elder abuse and neglect, or elder mistreatment, usually implies that a family member is doing something hurtful to an older relative – physically, emotionally, or financially. These hurtful actions might occur only once, periodically, or frequently. They can be done purposefully or accidentally and can result in mild, moderate, or severe pain or suffering. They usually occur in the older person’s own home. If this unacceptable behavior is happening to you, you are not alone– these hurtful things are happening to over 1 million older Americans each year. Help is available.
Who Is Likely To Be Hurt by a Family Member?
Anyone age 60 or older might be a victim of elder abuse. Victims are men and women from all ethnic backgrounds and financial situations (rich, middle class, and poor). They can be healthy or sick, with or without memory problems. The person sitting next to you in the doctor’s office, on the bus, or at a religious service could be an elder abuse victim. This person could be you.
Who Hurts Older Relatives?
Any family member could be abusive or neglectful, but the most likely to act this way are adult children. They are likely to live with the parent they are abusing and to be financially and emotionally dependent on the parent, making for a strained and difficult – and, at times, dangerous – relationship. Other abusive family members may be spouses, adult grandchildren, or other relatives, such as nieces, nephews, cousins, step-children or step-grandchildren, or siblings. It is not unusual to still love the family member who is being hurtful.
Every situation is unique. Examples of types of mistreatment are:
1) Mrs. Rose’s 37-year-old son, Derek, who has a drug problem, pulled a fist full of his mother’s hair out of her head during an argument when she refused to give him money.
- Physical Abuse is any behavior that results (or is likely to result) in injuries to the body, such as bruises, cuts, or broken bones. Examples include hitting, pushing, beating or forcibly restraining. These behaviors also instill great fear in the person being hurt.
2) Mr. Koff’s 44 year-old-mentally ill daughter, Karen, threatened to rip the phone out of the wall and nail his bedroom door shut while he sleeps if her father didn’t let her boyfriend spend the night.
- Psychological/Emotional Abuse is any verbal or non-verbal behavior that causes fear, mental anguish, or emotional pain. Examples include name-calling, “the silent treatment,” insults, threats, isolating the individual or treating him/her like a child, and controlling behavior.
3) Mrs. Goffard’s 21-year-old granddaughter, Ivy, sold her grandmother’s jewelry without permission and used the money to pay back a debt to her friend.
- Financial Abuse/Exploitation is any behavior that causes you harm through the illegal or improper use of your funds, property, or assets. Examples include coercing the change of a will, bank account, or property transfer, using cash or credit cards without permission or knowledge, or forging signatures on checks.
4) Mrs. Noonan’s 32-year-old stepson forced her to watch pornography with him and exposed himself.
- Sexual Abuse is any behavior that hurts you sexually or includes unwanted sexual content without your consent. Examples include inappropriate touching, fondling, or kissing, rape, taking photographs in sexually explicit ways, or exposing you to explicit sexual content without your approval.
5) Mr. Simon is cared for by his overwhelmed 51-year-old daughter,Tasha, who often yells at him. She blames her father for ruining her life and is frequently too busy or “forgets” to give her father dinner.
- Neglect is when a caregiver fails to provide basic care needs, resulting in bedsores, dehydration, poor hygiene, or poor nutritional status. Examples include withholding food, water, clothing, medication, or help with personal hygiene, or abandonment.
How Does an Older Person React When Abuse Happens?
Feeling guilty, anxious, confused, ashamed, or fearful is a very common reaction to abuse or neglect. You may also become depressed because you see yourself and/or your situation as hopeless and you may begin to avoid others. Many older people do not speak up about what is going on in their own home, which can lead to even more abuse. Sometimes they suffer the pain in silence because of such mistaken beliefs as:
- “Family matters are private and should stay that way.” If you believe this, then you are less likely to seek help. But without help, chances are that the abuse and/or neglect will worsen.
- “I have no one to turn to who can help.” It is easy to believe that nobody is available to help, especially since your relative may be isolating you from others. But there are people who will care about you and help you – perhaps a neighbor, friend, doctor, nurse, clergy member – if you can find a way to let them know you are unhappy at home.
- “The abuse is my fault.” The natural inclination is to blame oneself for the abuse or neglect in order to feel more in control of a situation that is out of your control. Also, part of the self-blame may come from feeling guilty, often a common reaction to being mistreated. You may believe that you did something wrong and therefore you somehow caused the abuse. But no matter what happened in the past – even if you made mistakes you deeply regret – it is never okay for someone to hurt you.
- “The consequences of speaking up are worse than keeping quiet.” You may be concerned that if you tell an outsider about your situation, you will have to move from your home or, perhaps, live alone. Or you may become confused about the appropriate action to take because of the impact on your family if you report it to the authorities. Speaking up does not automatically mean strangers will control your life. It does increase the likelihood that you will find someone who can help you problem-solve workable alternatives.
- “I’m so ashamed and embarrassed that my own family member could be behaving in an abusive or neglectful way.” Older people often are ashamed about the mistreatment they are experiencing, so they avoid telling anyone about it. Feeling ashamed usually comes from a fear that others will judge you or your family member harshly if they knew what was happening, and believing their criticism would be too difficult to tolerate. But there are many people who would want to help you and who would not judge you or your relative(s). You just need to ignore those people who do not understand and keep speaking up until you find those who do.
- “I’m afraid if I break the “family secret,” the person hurting me will get back at me in a way worse than what is happening now.” Being afraid that the abuser will retaliate is a real concern. However, doing nothing will rarely end an abusive situation; in fact, it usually gets worse. When seeking help, be sure to discuss your very real safety concerns so that a safety plan can be developed to fit your particular circumstances.
How Do I Tell If I Am Being Abused or Neglected?
When in a difficult family situation, it can be hard to recognize the signs of abuse or neglect. In general, if you’re feeling as if you have a secret “too big” to talk about, feeling guarded or scared when someone asks about your well-being, or feeling like you’re hiding something—you need to ask yourself why you desperately don’t want others to know or see something going on in your life.
Another sign might be your relative becomes angry with you if you talk to others (especially about family problems). Be concerned if your relative does not “allow” you to go out, have people over, talk freely with others in person or on the phone, meet privately with your physician, or read your own mail. Also, if you are doing things like hiding bruises or injuries, doctor hopping or avoiding visits with family or friends, this could signify that something is quite wrong.
If any of these things are going on for you, allow yourself to consider the possibility of abuse or neglect, and seek help.
Many communities have victim assistance programs that offer hotlines,counseling, and support groups. Counselors can provide different kinds of help, depending on what you want and need. They can provide emotional support and practical advice, create a plan for safety, and link you to other resources. Other community programs you might need, depending on your situation, can include legal advice, telephone reassurance calls, safe
housing, court protection, money managers, and/or respite programs. If you are being hurt by a family member:
- Call 911 for help as soon as you feel intimidated and before the situation at home becomes too dangerous or unmanageable. Often people do not think their situation constitutes an emergency until it is too late to get to the phone.
- This may be hard to believe, especially if a loved one has been putting you down. It is important to counteract these messages by telling yourself repeatedly that you have the right to live free from harm.
- Perhaps start by talking with a trusted friend or a family member not hurting you. Remember: If you choose to talk with a professional (like a physician, nurse, social worker, mental health worker, or the police), they may be required by state law to report your situation to Adult Protective Services. (Laws differ from state-to-state.) If you are uncomfortable with this possibility, before you tell a professional anything about your situation, ask, “If an older person wants to tell you something private about a conflict in the family, will you be able to keep the information confidential, or will you have to tell someone else?” If the answer is “I will have to tell someone else,” decide if you want to talk about your situation with that person. Sometimes mistreated older people find the best place to start getting help is with a hotline counselor because of the anonymity you will have.
- It is likely that the abuse will not only continue, but also will get worse over time if you do not involve others to help you. Sometimes the first person you speak to will not know what to do or say. Try someone else, even though this may not be easy to do.
- It may be hard for you to hear a member of your family labeled as an “abuser” or it may be upsetting to hear someone call you a “victim”. This is understandable. The most important thing, however, is to focus on getting help for your situation. Worrying about the label can distract you from this goal.
- Accept this help for yourself. However, you may want to also find help for your family member. You can start to collect names of resources that may be of help to your abusing relative. Seek service information from the people helping you, as well as, advice on how best to get this information to your relative.
WHERE TO GET HELP
As the elderly population increases, elder abuse and other crimes against older persons are also on the rise. 1 in 6 older adults are victims of elder abuse.You do not need to prove that abuse is occurring; it is up to the professionals to investigate the suspicions.
If you or someone you know is in a life-threatening situation or immediate danger contact 911 immediately.
National Domestic Violence Hotline. Provides support counseling for victims of domestic violence and referrals for support services. The anonymous hotline operates 24 hours a day, 365 days a year. Phone: 1−800−799−7233. All calls are confidential. Online chat is also available at www.thehotline.org
The Eldercare Locator.This resource connects older Americans and their caregivers with sources of information on state and local assistance services for older adults, including those concerned about suspected elder abuse. Call 1-800-677-1116 Monday- Friday 9:00am to 8:00pm EST. Website: www.eldercare.gov
National Center on Elder Abuse.This site answers all questions about elder abuse – who to call if abuse is suspected, what to expect when you report abuse, prevention methods, and what can be done to stop elder abuse. Its website includes a state-by-state listing of statewide toll-free telephone numbers to call to report elder abuse.Phone: 855-500-3537. Website: https://ncea.acl.gov/
Long Term Care Ombudsman. To report suspected abuse in a nursing home or long-term care facility contact your state Long Term Care Ombudsman agency. Agency contact information available by state at: http://theconsumervoice.org/get_help
Adult Protective Services (APS). State laws give state and local Adult Protective Service (APS) agencies the responsibility to protect and provide services to “vulnerable, incapacitated, or disabled adults.” You can call APS to report your own situation and ask for help. Most Adult Protective Service agencies are located in the phone book in the state government section or visit the Adult Protective Services website: http://www.napsa-now.org/get-help/help-in-your-area/
This resource provides brief, general information about this topic. It does not take the place of specific instructions you may receive from health care or service providers. The material in this blog has been adapted by the Division of Geriatrics and Palliative Medicine at NewYork-Presbyterian/Weill Cornell Medical Centerwith permission from End Domestic Abuse Wisconsin: The Wisconsin Coalition of Domestic Violence, Madison, WI. All rights reserved ©2019.