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The Second Level of Elder Abuse

abused older adult
The Boomers are aging, and that means the percentage of adults 65 years of age an older has now surpassed 13% of the population and growing. It also means that the number of older adults who suffer from physical, financial or mental abuse along with neglect is rising with this tide. But there is a second level of elder abuse that will also be rising, and it provides the added insult to the injury of abuse of those older adults less able to care for themselves. The second level is comprised of those who see abuse and don’t report it as well as those who receive the reports of abuse but fail to act.
In research conducted by the National Center on Elder Abuse, 45% of patients in nursing homes report being abused in some fashion and 95% report being neglected or seeing another resident suffer from neglect. Yet, we do not see this prevalence in any of the other “official” statistics, because it is either not reported or not acted upon. If you are a caregiver to an older loved one, you can do something about it.
1. If you see something, say something. I am borrowing this one from the TSA, but it works here also. Regardless of the age of the older adult whom you know, if you suspect active abuse or passive neglect, report it to a health care provider, social worker or law enforcement professional. These are what are termed “mandatory reporters” who must file, but sometimes they do not. Medical providers may not wish to be seen as violating the confidence of a patient, but that is patently wrong. Keeping silent only allows the perpetuation of this predatory behavior.
2. You do not have to see it to ask about it. Especially neglect may be incredibly subtle, and the abused victim may be hesitant to report a caregiver or even a spouse who is abusive for fear of reprisals. But inquiries have become part of the standard procedure for a lot of health care providers these days. I recall being a bit taken aback when on a doctor’s office visit my older parent was taken out of my earshot by the provider and queried about whether she felt safe at home. That provider was doing her job.
3. Make sure there is action. Reporting abuse or neglect is the first step, but the professional to whom the report is made needs to act on the information. This is where it can get a bit murky, especially if this report is about a nursing home facility or chain that carries weight in political circles. The state of California has passed what has come to be known as the Elder Abuse Act which is intended to counter the potential obstacles to protection that political clout can create. Closer to home, the state of Illinois last year passed a law prohibiting anyone with a history of violence against older adults from holding a job in a position of care for an elder.
Legislative changes are certainly important steps, but it also comes back to my rule about the village. It takes a village to support a senior just as it takes a village to raise a child. It is part of everyone’s job description.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Care Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago. Please email your questions to


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