Elder abuse: a national tragedy.

Several year ago, officers of the Austin, Texas, Police Department discovered the partially clothed body of a 68-year-old woman in an apartment she shared with her son. The women wore a diaper fashioned from a vacuum cleaner bag and was found on the kitchen floor in the fetal position. Police later discovered that the victim did not die of any aggressive action--she died of starvation.

Law enforcements officers across the Nation often face similar scenes during their careers. They may even ask themselves whether a crime has been committed. Unfortunately, many officers may not know the answer to that question. They may not recognize the warning signs of elder abuse until it is too late.

Increase in Abuse

Elder abuse is increasingly being recognized as a national tragedy. In 1989, hearings before the Subcommittee on Human Services of the House Select Committee on Aging indicated that 1 out of every 25 Americans over the age of 65 suffers from some form of abuse, neglect, or exploitation.(1)

Furthermore, the elder population is increasing. In 1989, persons 65 years of age and older numbered 31 million, representing 12.5 percent of the total population. Since 1980, the number of older Americans has increased by 5.3 million, or 21 percent.(2) By the year 2030, an estimated 66 million persons will be over age 65, representing 21.8 percent of the total population.(3) As our elder population increases, we can logically expect that incidents of eider abuse will also increase, if all other variables remain constant.

Failure to Report

While incidents of elder abuse in domestic settings are estimated at 1.5 million cases per year, only one out of eight cases comes to the attention of State elder abuse reporting systems.(4) Because many older persons wish to maintain their privacy, they either do not report the abuse and neglect, or they tell practitioners that they do not wish to take any action against the abuser. Such was the case of an 81-year-old woman who received treatment in a hospital emergency room twice in one month for serious wounds and abrasions. The woman admitted that her two sisters beat her. Although hospital officials counseled her on filing criminal charges, she refused. The woman died a month later. The coroner's inquest found that the victim had died from "unnatural causes due to the intentional and unlawful conduct of...her sisters."(5)

This incident illustrates the dilemma elderly victims face when they consider reporting abuse to the authorities. They must choose between not reporting incidents and receiving no help, or reporting the abuse by their children or caregivers and risking retaliation or at least jeopardizing their levels of care and their relationships with caregivers.

Indeed, the thought of public exposure and the embarrassment at having a family member--especially a child hurt them this way is a tremendous blow to older persons' self-esteem. As a result, they prefer to suffer in silence rather than share their plight with others outside the family circle. Elder abuse victims often fear rejection, which may be even more intolerable than the abusive relationship itself. Older female victims with a history of unassertive behavior find it especially difficult to report abuse.(6)

Law Enforcement's Role

Law enforcement officers are often the first line of defense for victims of neglect and abuse. They must recognize the signs of mistreatment in households of elderly residents. Officers who are unfamiliar with at-risk settings may overlook the life-threatening signs of abuse. To avoid this, agencies must educate their officers so that they recognize the warning signs of eider abuse. Training must first improve at the academy level. While most police academies address victimization in their programs, these courses emphasize battered women, abused children, and sexual assault victims. They often neglect issues that are unique to the elderly.

Veteran officers also need more complete training. Most inservice training deals with first-aid, firearms, defensive tactics, weapon retention, and physical skills and abilities. Very few, if any, police inservice programs deal with crimes involving elders, including abuse, neglect, theft, and con games.(7) Training should also include the aging process and sensory loss characteristics, communication with the elderly, and characteristics of the potential perpetrator.

Providing training on the issues of aging would increase awareness and sensitivity of law enforcement officers and service providers. This increased awareness would lead to increased reporting of crimes, better investigative techniques, and consequently, higher arrest and conviction rates for the perpetrators of such acts. Furthermore, older citizens would feel less emotionally isolated and more secure within their homes, knowing that others within the community have an understanding of the aging issues and that society will not tolerate their further mistreatment.

Learning from the Past

For many years, young victims of sexual abuse believed that no one understood their dilemma or felt concern for their well-being. However, attitudes toward child abuse have changed. We convinced our children that we care about their health and well-being and encouraged them to talk about their victimization. Law enforcement officials learned to recognize the characteristics of pedophiles and child molesters.

In addition, major campaigns educated the public regarding the safety and welfare of children. As a result, the reporting, investigation, arrest, and conviction of individuals who victimized children rose. Increased public awareness also allowed law enforcement to create additional prevention programs and to establish the National Center for Missing and Exploited Children. Law enforcement then employed the same techniques to increase public awareness concerning rape and spousal abuse which, in turn, led to national centers to deal with advocacy, education and prevention programs, counseling, referrals, and hotlines.

But where are the advocates for the abused and neglected elderly? Where is the first line of defense for this forgotten segment of society? As we did for our youth and other abuse victims, we should follow the same path and bring additional awareness to the law enforcement community for our elders.

Some cities have begun to attack this pressing problem. In 1980, the Milwaukee, Wisconsin, Police Department created the Senior Citizen Assault Prevention Unit, commonly referred to as the "Gray Squad."(8) The unit works closely with the senior population to improve police-community relations, increase crime prevention awareness, and instruct elders on how to better identify and/or deter would-be assailants. Although the squad does not specialize in domestic abuse cases, it is working toward preventing such cases. Moreover, it produces positive effects for a nominal amount of agency resources. As the Gray Squad demonstrates, the most successful prevention efforts eliminate the probability of mistreatment. This level of protection, referred to as primary prevention, is possible only when the causes of a specific type of mistreatment are clearly understood and predictable. Prevention programs can educate and sensitize the public, help potential victims establish methods of self-protection, reduce the opportunities for abuse, and intervene when mistreatment does occur.

Conclusion

In short, proper training regarding basic gerontology and the problems that face our elders on a daily basis is greatly needed. If it is not provided, we are failing to address the issues that concern a large segment of our "at risk" population. According to a leading gerontologist, "Our older population's greatest fear is not death, but is the fear of the quality of life in their later years."(9) Through education of law enforcement personnel, we have the potential to eliminate this fear and guarantee that the elder population does more than just survive.

Endnotes

1 U.S. Congress, House Subcommittee on Human Services, Select Committee on Aging, Elder Abuse: An Assessment of the Federal Response, 101st Cong., 1st Sess., June 7, 1989.

2 American Association of Retired Persons. A Profile of Older Americans, Program Resource Department, Washington, DC, 1990).

3 Ibid.

4 D.Quirk, "An Agenda for the Nineties and Beyond," Generations, 15, no. 3, 1991, 25.

5 Douglas A. Campbell, "Elder Abuse: The Needless Death of Cassandra Life," 50 Plus, 1988, 18-19.

6 Robert Hawkins and Anthony Trazler, "Elder Abuse and Communication," in Human Communication and the Aging Process, ed. C.W. Carmichael, C.H. Botan, and R. Hawkins (Prospect Heights, IL: Waveland Press, 1988), 221-34.

7 Jewett W. Bennett, Southwestern Illinois Law Enforcement Commission Annual Report, SILEC, Belleville, IL, 1991.

8 Richard Q. Zevitz and Dennis M. Marlock, "Senior Citizen Assault Prevention Unit," FBI Law Enforcement Bulletin, March 1989, 10-13.

9 David Paulsmeyer, gerontology interview/lecture at Southern Illinois University, Edwardsville, IL, 1991.