Reports of elder abuse on the rise in Missouri

The Missouri Department of Health and Senior Services received 12,177 reports of abuse and neglect of the elderly in 2006. The number of reports is on the rise, according to the department, though the crime is widely underreported due to many factors, the most frequent being the emotional and close bond between perpetrator and victim.

A little over 10 percent of the reports were financial exploitation, which is the third most frequent type of abuse of seniors.

"Elder abuse and neglect is a threat, and it's a problem," says Charisse Pappas, public information coordinator for the Missouri Department of Health and Senior Services. "It can occur in a nursing home setting or in a person's own home."

Based on completed investigations into the reports by the DHSS, the biggest problem, 50.1 percent, was physical neglect, with emotional neglect following at 13.1 percent. Emotional and physical abuse as well as financial exploitation closely followed.

Physical neglect can be shown in a number of ways, Pappas says. It can be an elderly person dressed inappropriately for the season, such as wearing lightweight clothing in the winter, making them susceptible to getting sick or freezing. Bed sores or dehydration are other examples. Swollen ankles can be a sign of an elder not being properly medicated or being overmedicated.

"A urine-soaked bed or a very limited variety of food in the house ... if the home is too hot or cold or not ventilated, no screens or windows are all signs of neglect," says Pappas.

Signs of physical abuse surface in the form of bilateral bruises to the arms indicating a person has been shaken, grabbed or restrained. Broken bones, cigarette or appliance burns in unusual places, even patches of hair missing from where it was pulled out are signs that denote abuse.

"Changes in appearance might indicate abuse or neglect," Pappas says. "For instance, if a person has always been interested in keeping up their appearance and all of the sudden they look unkempt, they might be too depressed or afraid to say anything."

Other signs of abuse could be a talkative, engaging senior who abruptly becomes quiet or reserved. Or a seemingly coherent elder suddenly becoming confused and disoriented, sometimes even wandering off, not paying their bills or just giving away money.

According to the DHSS Web site, about 71 percent of the time the abuser is a family member, which includes the spouse. Specifically, the perpetrator is most often — 36.4 percent of the time — the victim's son or daughter, which contributes to the suspected large number of unreported cases. Pappas estimates as few as 1 in 14 cases are reported nationwide.

The abuse and neglect "often occurs by an adult child," she says. "Typically the victim is an elderly female living alone who is too confused or too ashamed to report the crime." They're afraid if they don't do what an adult child wants, they will lose their caregiver and become institutionalized.

The DHSS Web site reports the cases of elder abuse and neglect are most frequently found in white females living alone (42.5 percent) or with a relative (27.7 percent). That relative is most often the abuser.

"It's very hard to verify how many cases there are," she says. "It goes back to this type of crime and the relationship between the senior and caregiver. It's a very emotional relationship. They're very fearful, and some don't want to get their children in trouble."

For older people the consequence of abuse can be especially serious because their bones are more brittle and recuperation takes longer. Even a relatively minor injury can cause serious and permanent damage, Pappas says.

According to the National Center for Victims of Crime Web site, because older victims usually have fewer "support systems and reserves," the impression of abuse and neglect is magnified and a single incident is more likely to trigger depression, illness, and even death.

Financial exploitation usually occurs to an elderly person by their adult child. It's when "someone illegally uses another person's money or property for profit or gain," Pappas says.

Anyone who feels their loved one might be in danger of elder abuse or neglect shouldn't hesitate to call the statewide hot line at 1-800-392-0210. The DHSS is mandated as the adult protective services agency in Missouri and investigates all reports of abuse and exploitation.

Elder abuse is largely treated as an unspoken problem and no community or country in the world is immune from the mistreatment of older adults, Pappas says.

This story was printed in the June edition of TBY, The Best Years, a special publication of the Southeast Missourian.