Elaine had never married and lived alone in her home for most of her adult life. She was very active and friendly with neighbors. Elaine would visit with her nieces and nephews a couple times a year, but they lived several hours away and as they grew older and started families of their own, she saw them less and less. She worked hard most of her life and had retired with a large estate. At the age of 81, she hired Charles, a middle-aged man, to help her with home repairs and yard work when it became difficult for her to do it herself. At about the age of 84, Elaine began exhibiting signs of dementia and needed assistance with more than just odd jobs around the house. She told Charles that she was planning to hire an aide since she had no family near enough to assist her with her daily needs. Charles told Elaine that she did not need to spend any money in hiring a caregiver, as he would gladly do it.
Charles, seizing the opportunity to upgrade his lifestyle, moved into Elaine’s home as her caregiver. He first convinced Elaine to give him power of attorney for her health care under the pretense of providing assistance with her medications and doctor’s appointments. He then stopped mailing in the checks Elaine wrote for payment of the home’s utility bills. When the past due notices arrived, he began to berate Elaine for being forgetful and insisted that she did not have the capacity to handle her finances. At first Elaine refused to allow Charles access to her finances, but eventually he convinced her to make him her agent under a durable power of attorney. Charles then took control of her pension checks. He used some of the money to pay for Elaine’s food, doctor bills, and medications, but deposited the rest of the money in his own checking account. He also added his name as joint owner on all of her bank accounts to gain access to the rest of her funds.
Over the next several months, Charles stopped taking care of the yard and making repairs to the home. The neighbors began to suspect something was amiss. They also began to worry when they did not see or hear from Elaine for weeks. They stopped by the home several times to check up on Elaine, but Charles would tell them that she was either asleep or did not want to speak with them. In order to keep prying eyes and ears out, Charles changed the locks on the doors and made sure that the relatives who called to ask about Elaine did not speak with her and that she didn’t get their phone messages. The only “outside” person Elaine ever talked to was her physician during occasional medical checkups. Elaine did not complain to her doctor about the abuse because Charles had convinced her that he was the only person willing to care for her since she had not heard from her family in months.
Elaine’s mental and physical state began to worsen. She began to lose control of her bladder and bowels. Her eyesight, which had been failing for years, became so degenerated that she could not read the numbers on the telephone to dial out. Charles found it difficult to care for her and would scream expletives at her whenever she fell or could not make it to the bathroom. He began to give Elaine sleeping pills to quiet her when she started to complain. Charles would no longer allow her to leave her bedroom, would not help her to bathe or use the bathroom. Elaine’s health declined rapidly and eventually Charles felt he had no choice but to take her to the hospital. Elaine died within days of being hospitalized.
During Elaine’s life, she had always told her nieces and nephews that she would leave each of them an equal part of her estate since she had no children of her own. She had even shown them a copy of her will. However, after Elaine died, the family discovered that a new will had been executed, which named Charles as executor and left Elaine’s entire estate to Charles outright. The family filed a will contest and the majority of Elaine’s estate was subsequently depleted in the years of litigation that ensued between the family and Charles.
The Scope of Elder Abuse
Although the names in the above account are fictional, the story is true. It is just one of many examples of elder abuse, neglect and financial exploitation that occur in the United States. Like many crimes that can involve isolation, embarrassment and protection of a family member, elder abuse is typically not reported to authorities, even in states like Ohio with mandatory elder abuse reporting laws or when elder abuse can be classified as a crime. Unlike the story above, most elder abusers are not strangers. The National Center for Victims of Crime has reported that of alleged perpetrators of elder abuse, 33% were adult children, 22% were other family members, 16% were strangers, and 11% were spouses/intimate partners. As a result, elder abuse is largely hidden.
According to the 2004 National Center on Elder Abuse Study, the best estimates show that between 1 and 2 million Americans age 65 or older have been injured, exploited, or otherwise mistreated by someone on whom they depended for care or protection. Research indicates that at best one in five elder abuse situations are reported to authorities; for certain forms of abuse, reporting is much lower: as low as one in 14 or one in 25 for physical abuse and financial abuse, respectively. Older women (67%) are far more likely than men (32%) to suffer from abuse and slightly more than half of the alleged perpetrators of elder abuse were female (53%). According to the 2005 Ohio Elder Abuse Task Force Report, in Ohio during fiscal year 2003, with just 60 percent of the 88 counties submitting incident data, there were 10,346 elder abuse reports to Adult Protective Services.
Recognizing and Reporting Elder Abuse
The baby boom and increased life expectancy have resulted in a current and projected increase in the number of elderly Americans. Advances in medicine and laws protecting the needy populations have greatly increased American life spans. In previous generations extended family members could share the responsibility of caring for the aging. Unfortunately, changes in our society, such as increased mobility, strained economic times and smaller nuclear families have placed the strain and responsibility of caring for the elderly on a select few. This may be one of several contributing factors as to why some individuals become abusive towards the elderly.
Recognizing Elder Abuse:
Most states have enacted legislation that defines elder abuse. Under Ohio law, Elder Abuse includes neglect and exploitation as well.
- “Abuse” is defined as infliction upon an adult by self or others of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm, pain, or mental anguish.
- “Neglect” is the failure of an adult to provide for self the goods or services necessary to avoid physical harm, mental anguish, or mental illness or the failure of a caretaker to provide such goods or services.
- “Exploitation” means the unlawful or improper act of a caretaker using an adult or an adult’s resources for their monetary or personal benefit, profit, or gain.
Elder abuse is not always easy to spot, but the key to identifying it is to look for a pattern of behavior, physical symptoms, or other events and telltale signs that, in combination, provide evidence of the abuse, neglect or exploitation of an elder. The following are some risk factors to watch for:
- Elders with memory problems (such as dementia) or who are physically dependent on others.
- Elders with depression, loneliness, or lack of social support.
- Caregiver stress when the caregiver feels overwhelmed with the care of the elder.
- Caregiver has history of substance abuse or history of abusing others.
- Caregiver has high emotional or financial dependence on the elder.
Reporting Elder Abuse in Ohio:
In Ohio, county Departments of Job and Family Services are required to investigate reports of suspected abuse, neglect, and exploitation of adults age 60 and older. Consult the Ohio County Job and Family Services Agencies Directory for county contact information.
If you suspect abuse in a nursing home or assisted living setting or by a home care provider, Ohio’s Office of the State Long-term Care Ombudsman advocates for people receiving those services. Twelve Regional Long-term Care Ombudsmen safeguard consumers of care services in their areas, advocating for quality care, investigating complaints and giving the consumers a voice. The following resources may also provide additional information on elder abuse, how to recognize it and how to avoid it: