Of all the possible threats to seniors' physical and financial well-being, you might expect their children to be low on the list. But the fact is, abuse of elders is all too common — annually affecting one in 10 adults over the age of 60, according to a study by the Medical University of South Carolina — and it's often perpetrated by a victim's own offspring.
"People think: 'Who would ever hit their elderly mother? Who would ever push their grandmother down the stairs? Who would ever steal their grandparents' social security checks week after week?'," says Dan Reingold, president and CEO of the Hebrew Home, a long-term care facility in Riverdale, N.Y. "The answer is: about 2 million people."
To combat these crimes, a handful of nursing homes around the country have created shelters within their own walls to provide emergency short-term housing and health care services to victims.
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The Hebrew Home initiated the effort in 2005 with an on-site shelter, the Harry & Jeanette Weinberg Center for Elder Abuse Prevention. At least six other nursing homes have replicated the approach, and officials at the Hebrew Home have been in talks to develop several more.
Elder abuse is similar to child or domestic abuse, though public awareness of it lags decades behind. Abuse or neglect against elders can be physical, emotional, or sexual, but the majority of cases are financial. A common scenario involves adult children cashing their parents' social security checks or stealing money from their bank accounts, according to Reingold. Elder victims of financial abuse lose $2.9 billion a year, according to a 2011 MetLife Mature Market Institute study of elder financial abuse.
Often, victims suffer at the hands of family members or close friends who have a substance abuse problem or an untreated mental illness, according to the National Center on Elder Abuse, a research and resources division of the Department of Health and Human Services' Administration on Aging. Victims usually do not seek help because they might feel guilty or embarrassed, particularly in cases where the abuser is their own child or spouse.
There may be a higher percentage of abuse among older adults who have lower cognitive abilities, says Bonnie Brandl, director of the National Clearinghouse on Abuse in Later Life, an advocacy group based in Madison, Wis. Wrongdoers might think this makes potential victims more vulnerable, she says, or that they wouldn't be believed if they were to report the crime.
At the Weinberg Center, victims are typically referred by hospital emergency room staff, police officers and social service agents. The shelter also offers training to people who are in unique positions to identify elder abuse — doormen, clergy and Meals on Wheels staff. A doorman, for instance, knows who enters and leaves the building, and may notice that a son visits his elderly mother only on the days her social security check arrives, Reingold says. When older adults arrive at the Weinberg Center, they are integrated with the rest of its long-term community, instead of being placed in a separate wing or floor. A victim with dementia will be placed in the memory-support community, for instance, while a victim with a broken leg will be placed into rehabilitation for physical therapy. The Weinberg Center also has attorneys who work on behalf of residents to retrieve money that has been stolen, or to try to evict a harmful person from the home of the victim.
Those close to potential victims can be on the lookout for unexplained withdrawal from regular activities or a sudden change in financial situation. They can look for physical signs of abuse, though these are often difficult to prove. Because the skin of older adults bruises easily, a perpetrator could argue that his mother's injuries are the result of a fall. An elderly person with Alzheimer's or dementia also may not be able to recall how she was injured.
Shirley Barnes, CEO of Crest View Senior Communities in Minnesota, which replicated the Hebrew Home's shelter model, says it's important for neighbors to stay alert to patterns. An elderly man might ask a neighbor to take his wallet for safekeeping, or maybe suddenly starts talking about having trouble affording groceries, she says. Tony Palumbo, county attorney for Anoka County, where Crest View is located, says changes in behavior will be sudden, not gradual. Palumbo, who is the creator of Stop Abuse and Financial Exploitation (SAFE), an initiative to protect seniors from financial abuse, says some scenarios can present an overwhelming temptation for morally compromised individuals. Many family members justify their actions by thinking they are going to inherit money or property eventually, so they might as well get it now, he says.