Life saver: How to spot the roots of elder abuse

Who loves Jane Fonda? Who hates Jane Fonda? Regardless of her politics, she did win an Oscar for Klute, married Ted Turner, and starred with her father (who won an Oscar for On Golden Pond just a few weeks before he died).

Katherine Hepburn won her fourth Oscar in that movie as well, probably for shaking out the words, "You are my kniiiiiight in shining armor." Jane and Henry Fonda supposedly didn't get along well, but you didn't see Jane beating up Henry with a loon on the pond. Do you know any elderly people who are being abused?

According to the National Center of Elder Abuse, about 500,000 cases are reported each year. The statistics are probably underestimated because neglect is pretty hard to catch, and many elderly people who are abused financially, physically, emotionally– and sometimes even sexually– never report it.

Most abuse occurs after age 60 and rises rapidly after 80. Back in Romeo & Juliet times, kids got married as young teenagers and started life soon, because living to the age of 50 was practically like being Methuselah. It wasn't until after WWII that Americans started to live a loooooong time.

In most cultures, the parents lived with the oldest child. Problems that come with advanced age– like Alzheimer's dementia and "failure to thrive"– didn't occur as often in history. However, with modern medicine and nutrition, octogenarians are more common than vegetarians.

So taking care of one's elderly relatives is becoming increasingly more common and– sometimes– more difficult. That's why it's not surprising that the #1 type of elder abuse is neglect. Thirty-nine percent of the cases are self-neglect, and 19 percent are caregiver neglect. In fact, 90 percent of elder abuse is by family members. Egad! It is like The Sopranos.

I have often counseled my patients' families to get help if their loved one is ill. Most people are not professional caregivers, and watching an elderly person 24-7 can be extremely exhausting for a family member: cleaning up after incontinence, preventing skin breakdown, feeding and bathing, dealing with changed personality and mental abilities, giving medicines and wondering if something is going wrong, making sure the elder doesn't fall or get hurt.

In contrast, Survivor is a walk in the park.

Possible signs of self neglect are malnutrition, dehydration, or poor hygiene. Once when I was a medical student, my professor asked us what we thought about an elderly woman's appearance. I was the only one to dare to say, "Her roots are really showing. Does anyone have a box of L'Oreal?" My professor told me it could be a sign that she hadn't been taking care of herself for at least a month.

Financial exploitation occurs, too– even when the caregiver is not the CEO of Enron, Worldcom, or Tyco! An abrupt change in the will is usually a bad sign. "I'm now going to give all my money to my 18th cousin 7 times removed..."

Physical and emotional/verbal abuse occurs in 18 percent of cases. Usually people from violent homes or with alcohol/drug abuse are the perpetrators. We all need to be aware of elders who have broken glasses, bruises, or fractures. Also one needs to be very aware of a caregiver who won't let you see the elder alone.

There aren't many studies about the effects of elder abuse, but one study suggests mistreated elders are three times more like to die, and self-neglected elders are 1.7 times more likely to die than others their age. I know we all have to go some time, but at least we should hope to go with love and dignity.

For more information on elderly abuse and what you can do, look for "Elderly Abuse" at

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