It was a crime scene like no other when law enforcement officials arrived at the home of an 84-year-old woman who had been remanded to intensive care because her core body temperature was below normal, she was dehydrated and had low blood pressure. Her clothes had to be peeled off her body in places and an infected injury about the size of a baseball was oozing on her leg.
Doctors did not like what they saw. Law enforcement officials deemed it cruelty to the elderly. Despite more than 40 trash bags filled with items linked to the home, the four-bedroom trailer still had pots, pans and dishes piled up in the sink with roaches everywhere. Clothes were strewn throughout the hallways and bedrooms -- as high as 3 feet in some places. The bathroom had pots and pans in the tub, again littered with roaches and clothes.
The 84 year old elderly woman was living with her daughter, son-in-law and grandchildren at the time. Warrants have been issued for their arrests.
While instances like this are few and far between in California, it sheds light on one of the most underreported social problems in the country -- the elderly in the country being taken advantage of, abused or neglected.
"Parents raise kids and eventually the kids end up taking care of their parents in some way," says California Elder Law Attorney Steven C. Peck of Van Nuys, California who may be contacted toll free at 1.866.999.9085, "Obviously, cases of child abuse are reported more often because they can't take care of themselves. As people get older, it is taken for granted they can take care of themselves and that isn't always the case."
What are the major problems?
California law basically defines elderly abuse as codified in the Welfare and Institutions Code section 15610.07 which provides:
"Abuse of an elder or a dependent adult" means either of the following:
(a) Physical abuse, neglect, financial abuse, abandonment,
isolation, abduction, or other treatment with resulting physical
harm or pain or mental suffering.
(b) The deprivation by a care custodian of goods or services
that are necessary to avoid physical harm or mental suffering.
• Welfare and Institutions Code section 15610.23 provides:
(a) "Dependent adult" means any person residing in this state
between the ages of 18 and 64 years who has physical or
mental limitations that restrict his or her ability to carry out
normal activities or to protect his or her rights, including, but
not limited to, persons who have physical or developmental
disabilities, or whose physical or mental abilities have
diminished because of age.
(b) "Dependent adult" includes any person between the ages
of 18 and 64 years who is admitted as an inpatient to a 24-
hour health facility, as defined in Sections 1250, 1250.2, and
1250.3 of the Health and Safety Code.
• Welfare and Institutions Code section 15610.27 provides: " 'Elder' means
any person residing in this state, 65 years of age or older."
• Welfare and Institutions Code section 15610.57 provides:
(a) "Neglect" means either of the following:
(1) The negligent failure of any person having the care
or custody of an elder or a dependent adult to exercise
that degree of care that a reasonable person in a like
position would exercise.
(2) The negligent failure of an elder or dependent adult
to exercise that degree of self care that a reasonable
person in a like position would exercise.
(b) Neglect includes, but is not limited to, all of the
following:
(1) Failure to assist in personal hygiene, or in the
provision of food, clothing, or shelter.
(2) Failure to provide medical care for physical and
mental health needs. No person shall be deemed
neglected or abused for the sole reason that he or she
voluntarily relies on treatment by spiritual means
through prayer alone in lieu of medical treatment.
(3) Failure to protect from health and safety hazards.
(4) Failure to prevent malnutrition or dehydration.
(5) Failure of an elder or dependent adult to satisfy the
needs specified in paragraphs (1) to (4), inclusive, for
himself or herself as a result of poor cognitive functioning, mental limitation, substance abuse, or
Changes in an elderly person's behavior or emotions may suggest a problem. The potential problems may in fact be crimes, which often fall into one of four categories: physical abuse, emotional abuse, neglect and financial exploitation.
Physical abuse: In addition to common instances of physical force, examples like inappropriate use of drugs and physical restraints, force-feeding and physical punishment. Sexual abuse is also included in this. Common indications include physical signs like bruises or welts -- especially in unusual places -- open wounds left untreated, lab reports indicating overdoses or underuse of prescribed medication or a sudden change in behavior.
Emotional abuse: Often includes the infliction of anguish, pain or distress through words or actions, including humiliation, intimidation, harassment or verbal assaults. California Elder Abuse Attorney Steven C. Peck also points out instances like treating an elder like an infant, isolating them from family or friends or regular activities and giving an elder the silent treatment as common examples. Symptoms often include emotional distress or agitation, being withdrawn or non-responsive, depression, change in appetite or lack of interest in daily activities.
Neglect: This is a failure to fulfill any part of the care for an elder and is the most common form of elder abuse in the country. While not providing food, water, clothing or assistance in personal hygiene are common examples, it can also include failure to manage the financial aspects of the life of the elderly as well. Symptoms include loss of weight, extreme thirds, untreated bedsores, hazardous or unsafe living conditions, unsanitary living conditions or bills unpaid despite the ability to be paid. There are also instances of self-neglect.
Financial exploitation: Simply put it includes the illegal or improper use of an elder's funds, property or assets. But it is also coercing or deceiving an elder into signing documents related to finances. Both Walton County Sheriff's Office officials and Mark Franklin, attorney at the law offices of Sherry L. Jackson who works with the Northeast Georgia Elderly Legal Assistance Program and Elder Abuser Prevention Program, cite this as being the most common form of abuse in the area.
Who is perpetrating the crimes?
As the elderly continue to age and become more fragile, the likelihood they are able to stand up to bullying or fight back if attacked diminishes. It is believed that, while there are hundreds of thousands of cases of elder abuse and neglect nationwide each year, best estimates are only one out of every five instances end up being reported. Some experts estimate only one in 14.
While elder abuse crosses gender and racial lines, according to the National Center on Elder Abuse, women and older elders are more likely to be victimized. Dementia is a significant risk factor and mental health and substance abuse are risk factors, as is isolation.
Elder abuse usually takes place where the senior lives -- be it in a home or in a care facility -- and is usually intentional. Adult children are most often the person responsible for the abuse. According to the Department of Human Resources Division of Aging Services, two-thirds of the abusers are family members serving in a caregiver role. This is usually the case because a nonprofessional caregiver may find the benefits in caring for an elder family member early on but as the responsibilities and demands increase, the job becomes more stressful.
Because most abusers are family members, this lends itself to cases of elder abuse being underreported.
"This is certainly the fear and probably the reality," Peck says when asked if he believed cases are underreported. "A senior may not self report because of embarrassment or because the abuser is a family member. In cases of identity theft, we sometimes have a difficult time assisting a victim on the civil side (defending a credit card suit for example), because the ID thief is a family member of the senior and the senior will not report them to law enforcement or assist the district attorney in investigating the criminal matter."
What is being done?
No one really knows how big of a problem elderly abuse is in the U.S. Most cases go undetected, so it is important if anyone suspects abuse to report it -- even if they think someone else could have or should have done so.
The first line of defense is law enforcement.
"The key is information being brought to our attention," Peck indicates. "Not all care facilities and operations are what they are cracked up to be. We don't always know if there is an issue. The key for dealing with the situation is the knowledge.
"Once we get involved, it's not unlike any other criminal situation. We contact the Adult Protective Services, which is like the Department of Family and Children Services but for the elderly population. They look after the welfare of the person and help to provide direction and aid."
To help prevent elderly abuse, those close to a victim are encouraged to report suspected mistreatment. Education is a key component in prevention; friends and family should watch for signs of abuse. Suffering by the elderly is often in silence and not taken seriously at first, easily blamed on growing older or dementia. It will be important to listen to seniors and their caregivers and become involved when abuse is suspected.
There are a host of other avenues for information and aid. The Elder Abuse Prevention program promotes awareness of the problem of elder abuse, provide education session in the community about how to avoid becoming a victim and refer to appropriate agencies when people report elder abuse. Victims are usually referred to local law enforcement, adult protective services or the Elderly Legal Assistance Program.
"The Senior Adult Victims' Advocate provides services for those 60 and older who are victims of abuse, neglect or exploitation by linking victims with social service agencies and the court system, assisting with court appearances and access to support groups. The Governor's Office of Elder Abuse primarily works to prosecute crimes related to telemarketing, home construction and home repair fraud, identity theft and Internet fraud. There is also various the Senior Legal Hotline, which provides free legal assistance over the phone.
There are also those throughout the community which are responsible for reporting suspected elder abuse, including physicians, employees of care facilities, employees of financial institutions, social workers and others.
As the population grows older as a result of the Baby Boomers retiring, the likelihood instances of elderly abuse and neglect is a reality. Diversity in the types of care facilities and even those providing the care add potential complications to the mix. While it is believed elderly abuse is underreported, an estimated half-million instances are reported to law enforcement while millions go unreported.
It is a social problem.
It is a public health threat.
It is a human rights issue.
