Why would a problem so pervasive, and so potentially deadly, be so easily hidden? Part of the answer lies in the victims themselves.

Many elderly people are both physically and emotionally healthy. They enjoy rewarding lives and remain independent. Others are not so fortunate. They may be mentally alert but physically frail. Or they may be suffering from Alzheimer’s disease or the effects of circulatory problems, both of which reduce mental awareness. Some elderly people who might otherwise be mentally alert suffer from depression, which makes them appear listless and apathetic. These individuals may be victims of abuse and neither fully comprehend nor care. Thus, they make no effort to protect themselves.

Other elderly victims of abuse are no doubt quite aware of what is happening to them. There are a number of reasons why these people might fail to speak out. Often they are embarrassed to admit that they are being abused; they feel that it makes them appear helpless. Some may be protective of those who are abusing them. Being abused may be the preferable option when the only other choice is turning one’s own child in to the local police. Finally, a number of elderly victims are afraid of their abusers. Fear of bodily harm or of abandonment keeps them from taking action.

As with any type of abuse (such as child abuse or domestic violence), the issue is often more complex than simply identifying behavior and taking action. A family that is locked in a cycle of violent behavior may see elder abuse as acceptable despite the obvious reasons why it is not. Substance abusers create a special problem because they may be violent only when they are under the influence of alcohol or other drugs. The elderly parent, like the spouse or the child, may keep quiet as a means of denying that an addiction exists. Sometimes, family members who are put in the role be serving as caregivers react violently out of total frustration with a situation they are totally unprepared to handle. The elderly victim may feel guilty for putting the caregiver in such a stressful position and consequently say nothing. It is also likely, in some cases, that since abuse can take its toll quickly, an elderly person in otherwise reasonable health may go downhill quickly once abuse starts and thus be unwilling or unable to speak out forcefully.