The Hidden Epidemic of Elder Abuse at Nursing Facilities and at Home

"If you had told me a couple years ago what my sister was doing to her own mother, I wouldn't have believed you," Richard Hartman, a retired warehouse supervisor states.

At the time, Richard's mother was experiencing diverse forms of elder abuse. Once an unspoken taboo in American culture, the abuse of senior citizens is now a topic that is capturing increased public attention.

The abuse of senior citizens in an institutional or nursing home environment has been reported for a number of years. However, with the increased average age of the population, over 90% of the elderly who need care live in their homes or with a family member.

Abuse is defined as the intentional mistreatment of one person by another. The United States estimates that over 1.5 million senior citizens are abused, mistreated or victimized by family members, friends, caregivers or others they may come in contact with each year. Although those with physical or mental disabilities are more vulnerable, any elderly person is at potential risk.

From physical or emotional abuse to financial mismanagement or neglect, elder abuse comes in many different guises. The common result leaves the victim feeling worthless, alone or guilty.

Physical abuse (i.e., hitting, biting, pushing or other forced contact) can be considered the most extreme form of mistreatment. Elders who are victims of this kind of abusive behavior experience depression or sudden mood swings. Their physical appearance may be an indication of an abusive situation. An abused senior may have unexplained cuts, bruises, fractures or burn marks on his or her body. There are other forms of physical abuse. These are not so easily noticed. A caregiver might be over or under-medicating a senior, for example, or forcibly confining him or her to a single area.

One does not need to have physical contact with a senior in order to abuse them. Emotional, mental or psychological abuse occurs when the senior is ridiculed, threatened, humiliated or treated in a demeaning manner. Even the malicious destruction of an elder's belongings can be considered a form of emotional abuse.

Although not as easily noticeable as physical abuse, emotional mistreatment can still be detected. The senior may appear upset, nervous or agitated. They may be hesitant or afraid to talk to others regarding the abuse they are experiencing.

"We caught her (my sister) on a number of occasions calling my mother names or threatening to put her in a (nursing) home," recalls Richard Hartman. "Although my mother was hearing impaired, I believe she understood how she was being treated."

Financial abuse occurs when a caregiver, guardian or power of attorney steals, mismanages funds or sells personal property of an elder without his or her consent. Lying about the costs of certain needs of the elder is also considered a form of financial abuse.

The abused senior may request large sums of money to be given to the abuser. Other indications that someone is taking financial advantage of an elder may include a significant number of unpaid bills, money or items that are unaccounted for or abrupt changes in the elder's will.

Richard Hartman recalls an incident that occurred with his mother. "She actually caught my sister taking things out of the house. As far as financial aspects go, she did take advantage of my mother. At the time, we didn't know everything that was happening between my sister and my mother. She (my sister) convinced us to give her blank checks to buy groceries for my mother. What really made us suspect something wasn't right was receiving receipts for over $100 every week for groceries. One person doesn't spend that much. We never saw what was being bought with the money."

Neglect can be considered the most common form of abuse. When an abuser withholds food, medical support or any other care which a reasonable person would need, he or she is neglecting the senior.

Untreated bed sores, malnutrition, dehydration and unsanitary living conditions are only a few indications of neglect.

"I believe my sister probably neglected my mother more than anything else," Richard Hartman recollects. "We eventually found out that my sister would leave my mother alone some days. We didn't realize the extent of it until she was admitted to a local hospital with a broken foot. The doctors advised us that my mother was malnourished, dehydrated, had several bed sores and a staph infection. The doctor would only release her to a nursing home for rehabilitation and advised us not to put her back into the same situation after she left that facility. That was my wake-up call."

There are preventive measures that can be taken to avoid a potentially abusive situation. The elder should not be placed in the care of anyone who has a history of abuse. The elder should review his or her will, making sure any changes are truly what they want. Friends, family members and neighbors should visit the senior often to insure that abuse is not occurring. Most importantly, the elder should be reminded not to sign anything until someone else who he or she trusts has seen it.

A person should be educated on signs and symptoms of abuse. If stress is realized early on, a potential abuser can be helped before any adverse effects occur. Talk with friends and family members and offer to help caregivers in order to prevent burnout.

"I wish I would have know about it earlier," Richard Hartman states. "My mother spent the last two years of her life being well cared for, surrounded by people who didn't take advantage of her. She held no ill will toward my sister. My sister, on the other hand, has to live with what she's done. I also feel guilt on my part for not noticing and putting a stop to it sooner."