ELDER ABUSE: WHEN A FAMILY MEMBER CAUSES HARM

“Every person, no matter how young or how old, deserves to be safe from
harm by those who live with them, care for them, or come in day-to-day
contact with them.” — American Psychological Association
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, stepchildren or stepgrandchildren, or siblings. It is not unusual to still love the family member
who is being hurtful. This person could be you.
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What Are Some Examples of Elder Abuse and Neglect?
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.
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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
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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.
What Should I Do If A Family Member is Hurting Me?
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:
• Remember that safety is a priority. Call 911 for help as soon as
you feel intimidated and before the situation at home becomes too
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dangerous or unmanageable. Often people do not think their situation
constitutes an emergency until it is too late to get to the phone.
• Remind yourself over and over that you deserve to live in an
environment free of fear and pain. 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.
• Talk to someone. 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-tostate.) 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.
• Keep talking to people until you get the help you need. 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.
• Do not focus on labels. 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 help. 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.
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Where to Get Help
National Resources
National Committee for the Prevention of Elder Abuse. A
comprehensive Web site for information about elder abuse, including how
to report abuse, what services are available to stop abuse, and how to find
those services in your community. Phone: 1-202-682-4140.
Web site: www.preventelderabuse.org
National Domestic Violence Hotline. Provides support counseling for
victims of domestic violence and referrals for support services. The hotline
operates 24 hours a day, 365 days a year. All calls are confidential.
Callers can also talk anonymously. Phone: 1-800-799-7233.
United States Administration on Aging (AOA). This Health & Human
Services Department supports a range of activities to raise awareness
about elder abuse. Phone: 1-202-619-0724. Web site: www.aoa.gov
The following programs are funded by the Administration on Aging:
• 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. Phone: 1-800-677-1116.
Web site: 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: 1-202-898-2586. Web site: www.elderabusecenter.org
New York State Resources
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. In New York State, call 1-800-342-3009 to find the Adult Protective
Service office in your area.
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New York City Resources
New York City Department for the Aging, Elderly Crime Victims
Resource Center. The Center’s primarily bilingual caseworkers provide
counseling services to abuse and neglect victims, as well as any other
needed help or information to victims. Calls are confidential. Callers can
also talk anonymously. Phone: 1-212-442-3103 or 1-212-442-1000.
Web site: www.nycagainstrape.org/resource_26.html
Safe Horizon’s Domestic Violence Support and Hotline. This non-profit
program provides a range of assistance to victims, such as: counseling,
support groups, information about legal rights, advocacy with the police and
the courts, assistance with emergency housing applications, transportation,
emergency cash, food, and referrals. The 24 hour, toll-free, all-language
Domestic Violence Hotline can help victims of domestic violence find
appropriate support and shelter services. All calls are confidential, and
callers can also talk anonymously.
Domestic Violence Hotline: 1-800-621-4673.
Web site: www.safehorizon.org
Weinberg Center at the Hebrew Home for the Aged at Riverdale.
Provides shelter and support to persons over the age of 65 experiencing
any type of abuse or neglect by a family member, friend, or caregiver
including self-neglect.
Phone: 1-800-567-3646. Web site: www.hebrewhome.org
Online Resources
Stop Abuse For Everyone (SAFE). This site suggests ways for abused
persons, including elder abuse victims, to find help, such as joining an
online support group. It also maintains a domestic violence resource list
that is user built and consumer rated. Web site: www.safe4all.org/help
CornellCARES. Weill Medical College of Cornell University, Division of
Geriatrics and Gerontology provides an easily accessible Web-based
directory of NYC mental health providers. Some specialize in elder abuse.
Web site: www.CornellCARES.com
This resource provides brief, general information about this health care topic. It does not
take the place of specific instructions you receive from your health care providers. For
answers to other questions consult your physician or other health care provider.
Copyright NewYork-Presbyterian Hospital 2006. All rights reserved.