Elder abuse can go unnoticed

DAVENPORT, Iowa -- John Nelsen was a prisoner in his home, his wardens a young couple who lived with him.

They told the 71-year-old man that if he left the house, alarms would sound. When Neslen became more suspicious of them and wanted to call his bank to check on his money, they threatened to send him to a nursing home.

The couple, who were never charged, lived off Nelsen's money for more than six months, he said, using it to pay for everything from rent to the phone bill.

"I just had to get out of there," said Nelsen, who now lives in a boarding house. "I just couldn't take it anymore."

A U.S. Administration on Aging study estimates that up to 1 million elderly are physically abused, neglected, or financially exploited each year. But officials acknowledge that is only a guess.

"We don't have a true grasp of it because it's such a big social problem -- it's underreported, unrecognized -- it's hard to get a good idea of how much of it is out there," said Linda Hildreth, state elder abuse coordinator at the Iowa Department of Elder Affairs.

Even worse than thought

The study looked at reports of elder abuse in 20 counties nationwide. Some say that doesn't represent the problem's true magnitude.

"Unfortunately, it also showed that only one in five comes to the attention of people who can do something to help," said Sara Aravanis, director of the National Center on Elder Abuse in Washington, D.C. "It's only the tiny tip of the iceberg that we know about. The rest remain hidden below the surface."

Kathleen Quinn of the Illinois Department on Aging, believes the detection rate could be as low as 1 in 14.

"There's never been a national random population survey on elder abuse," she said, noting that it's difficult to gauge its scope because victims often are housebound or isolated by those who prey on them.

The federal Caregivers Support Program, implemented last year, provides money to states to open centers to teach caregivers about services such as home meal delivery, home health care and counseling.

"It helps guide them to practical solutions to the issues they are facing," Quinn said.

The aging administration study, completed in 1997, showed that 84 percent of elder abuse comes at the hands of a relative, most often the older person's grown child.

Pretended to be friends

The boyfriend and girlfriend who were Nelsen's roommates pretended to be his friends in order to get at his money, said Scott Schluter, a coordinator for the Generations Area Agency on Aging in Davenport, Iowa.

Nelsen gave the woman power of attorney over his finances, but began to worry about how his money was being spent.

He left the house last spring after a state social worker visited, responding to a concerned call from someone worried about Nelsen.

Because he left voluntarily, the state worker classified the case as unfounded. No criminal charges were filed against Nelsen's roommates, Schluter said.

A Des Moines woman died in January 2000 of septic shock after she was found mired in human waste in her home. She had been left there by her housemate. Blossom Deering, 68, died days later.

Richard Smith Jr., 51, pleaded guilty to neglect and dependent adult abuse. He was sentenced to 10 years in prison.

In New Mexico, a 75-year-old nursing home resident died in January of an infection caused by 22 bed sores, including "one so large you could put your fist into it and bone was visible," said Katrina Hotrum of the state's long-term care ombudsman's program.

"She was unable to scream or ask for help and was left rotting to death," Hotrum said.

State agencies are investigating her death.

Michelle Grisham, the director of the New Mexico Agency on Aging, said her group receives about 8,000 abuse complaints each year concerning state-licensed nursing centers.

"Reporting is low because you have residents who aren't competent and can't communicate and they are afraid of retaliation by staff," Grisham said.

No Missouri law

Only eight states have laws specifically addressing abuse of the elderly: Connecticut, Illinois, Massachusettes, Montana, Nevada, Pennsylvania, Rhode Island and Wisconsin, according to the National Center on Elder Abuse.

Iowa uses a dependent abuse law to protect adults who rely on the help of others, Hildreth said.

Uniform reporting methods are needed nationwide before the extent of elder abuse can be realized, said Chris Shoemaker of the Florida Department of Child and Family Adult Protective Services.

And the way society views its elderly members can make it difficult to recognize abuse, Hildreth said.

"We tend to think they are adults, so they can take care of themselves and they can choose to live how they want," she said.

Sandi Koll of the Iowa Department of Human Services, said elderly people are sometimes vulnerable because of sheer stubbornness.

"I've actually had people tell me, 'I have the right to be abused,'" Koll said.

ON THE NET

Iowa Department of Elder Affairs: www.state.ia.us/elderaffairs/

Illinois Department on Aging: www.state.il.us/aging/

New Mexico State Agency on Aging: www.nmaging.state. nm.us/default.asp

Florida Dept. of Health and Human Services: www.state.fl.us/cf--web/