June 15 is World Elder Abuse Awareness Day. The day is observed at the United Nations Headquarters and this year’s theme – “Understand and End Financial Abuse of Older People: A Human Rights Issue” – is an important reminder that every human being has the right to live free of abuse by others, without regard to that person’s physical or mental status.

Recent data reported by the National Center on Elder Abuse suggest that as many as 10 percent of older people have experienced some form of abuse, though we know that abuse is significantly underreported. A 2011 New York study found that for every one case of abuse, as many as 24 are unknown. As our population ages and increasing numbers of older adults live to be over the age of 80, many of whom will be aging in place alone at home, the incidence of abuse will surely rise.

It is distressing, but perhaps not surprising, that the majority of abuse is committed by adult children who are more likely to be male, have a history of physical or mental health issues, experiencing financial or other stress, or using substances.

There are several circumstances that increase an older person’s risk factors for being a victim of elder abuse. Those at highest risk are seniors with few social connections and those with dementia. Studies indicate that nearly 50 percent of older adults with dementia experience some form of elder abuse. A history of traumatic events, including domestic violence also increases one’s risk of victimization, as does poor health and limited functional abilities such as reduced ability to walk or perform self-care.

Maine’s Department of Health and Human Services website includes the following definition of abuse: “The infliction of injury, unreasonable confinement, intimidation or cruel punishment that causes or is likely to cause physical harm or pain or mental anguish; sexual abuse or sexual exploitation; or the intentional, knowing or reckless ‘phase’ includes acts of omission deprivation of essential needs. (22 MRSA §3472).

Each state has its own definition of elder abuse and sets the parameters for when state agencies get involved in investigating or prosecuting elder abuse. While there is much overlap among state laws and regulations, the lack of uniformity makes it difficult to analyze and compare data across the country.

The Center for Disease Control and Prevention has recently issued a proposed uniform definition of elder abuse and made recommendations for specific measures so data can be collected and compared across settings and over periods of time. The CDC report compiles and compares several of the most prominent definitions of elder abuse and provides details on the strengths and weaknesses of each, settling on the following definition: “An intentional act or failure to act by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult.”

The CDC report also provides an exhaustive list of abuse-related definitions that help define the contours of unacceptable behavior. For example, in its explanation of the term “harm” the report addresses preventable illnesses and when failure to assist seniors in receiving certain vaccinations (e.g. pneumococcal diseases or influenza) might be considered abuse or neglect. The CDC expects that use of uniform definitions and data collection across communities will further public awareness and support research into abuse prevention practices.

The personal impact of elder abuse is devastating. Victims of abuse endure physical and psychological suffering, feel isolated, trapped, fearful, and ashamed and their perpetrators often deprive them of effective ways of speaking up and asking for help. If victims are able to speak up, they are often reluctant to do so as a result of the shame of being a victim.

Maine’s DHHS Adult Protective Services website and other elder abuse prevention websites offer detailed information about how to recognize the signs of physical, mental, or financial abuse or exploitation and how and where to file a report.

Many Maine professionals are mandated to file a report of abuse when, in their professional capacity, they suspect an older adult has been the victim of abuse, neglect, or exploitation. This list includes, for instance, all types of health care professionals, pharmacists, social workers, clergy, and “any other individual who has assumed full, intermittent or occasional
responsibility for the care or custody of the adult, whether or not the individual receives compensation.” Reports of abuse, neglect, or exploitation can be made 24 hours a day, toll-free at 800-624-8404.

Mary Lou Ciolfi, JD, MS, is a senior policy associate at the University of Southern Maine, Muskie School of Public Service in the Disability and Aging Program. She is an attorney and the former administrator of HillHouse Assisted Living in Bath.