According to Bonnie and Wallce (2002), "between 1 and 2 million Americans 65 or older have been injured, exploited or otherwise mistreated by someone on whom they depended for care or protection" (p. 9). This abuse ranges from physical abuse and sexual abuse to financial exploitation. If the range of victims seems overly broad — there is a 100% variance between the low and high estimates — it is worth noting that some forms of elder abuse are not reported as elder abuse. This is especially true of sexual abuse of elders (Muehlbauer, 2006, p. 46). Furthermore, according to Cohen, et al (2007),
signs of abuse are often difficult to distinguish from symptoms of illness. Especially problematic is the identification of psychological abuse, which usually shows in psychological outcomes such as apathy, depression, and fearfulness, congruent with the reactions of older people to loss, illness, or cognitive deterioration in old age (p. 1225).
Indeed, it can be said that the very obscurity of elder abuse allows its perpetuation. One study found that "95% of respondents [of a sample of healthcare professionals in Maryland] believe that abuse, neglect and domestic violence among the elderly was not a rare event. However, 49.75% of the providers have not come into contact with a victim of abuse, neglect or domestic violence in the past 12 months" (Rinker 2007, pp. 5-6). There is a fundamental disconnect between our understanding of elder abuse and our ability, as a society and as professionals, to detect elder abuse and put a stop to it when detected. Elder abuse takes many forms. As Muehlbauer (2006) lists several forms that may elide into the spectrum of "normal" care-giving to such an extent as to be invisible to the layperson or casual observer (which may, unfortunately, include family members visiting an elderly client): "Abuse may include failure to implement a plan of care or provide treatment,
Cited: Bonnie, R., & Wallace, R. (2002). Elder mistreatment: Abuse, neglect and exploitation in an aging America Washington DC: National Research Council. Cohen M., Levin, S. H., Gagin, R., Friedman, J. (2007). Elder Abuse: Disparities between older people’s disclosure of abuse, evident signs of abuse, and high risk of abuse. Journal of the American Geriatric Society 55: 1224-1230. Lachs, M. S., Pillemer, K. (2004). Elder abuse. The Lancet. 364:1263-1272. Muehlbauer, M. (2006). Elder abuse and neglect. Journal of Psychosocial Nursing 44: 43–48. Rinker, A. G. (2007). Recognition and perception of elder abuse by prehospital and hospital-based care providers. Archives of Gerontology and Geriatrics 1807: 1-10.