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Is Your Mom or Dad Being Abused?

The shocking reality of adult abuse, what it means, and how to deal with it.

Photo of C.W. Smith by Joseph Brunjes Photograph, used with permission
Photo of C.W.
Source: Photo of C.W. Smith by Joseph Brunjes Photograph, used with permission

According to the National Institute on Aging, at least 1 in 10 adults over the age of 60 has been emotionally, physically, or financially abused — by people they’ve trusted to take care of them (NIH, 2020).

Author Charles W. Smith’s book, Uncle Jimmy (2020), describes a shocking case of adult abuse in his family. The sad story began in 2000 in Wilmington, North Carolina when retired dentist James A. Smith, age 93, known as “Uncle Jimmy” to his family, hired caregivers for his wife, who was in declining health. She died in December 2001, and their only son died of a heart attack four months later. Their funerals were held at the local First Baptist Church where Dr. Smith had long been a member.

Following his son’s death, Dr. Smith made his nephew Billy Smith his power of attorney. Billy lived a mile away and saw his uncle often. Along with his brothers and cousins, he was Uncle Jimmy’s closest living relative. The family continued to visit their uncle, who developed debilitating arthritis, early dementia, and other ailments so the caregivers remained at his house to take care of him.

But then the caregivers and church leaders began edging the family out. A lawyer and church member revoked Billy’s power of attorney, becoming power of attorney in his place, and when family members came to visit Uncle Jimmy, the caregivers made them feel unwelcome.

Confused and concerned, Billy and other family members considered contacting Adult Protective Services but decided not to. Although they felt excluded, they thought the caregivers were taking care of their uncle and hadn’t realized how bad things were. The caregivers had been driving Uncle Jimmy to the bank each day to withdraw thousands of dollars in cash for them, and the lawyer was preparing a new will for their uncle to sign.

Uncle Jimmy’s health continued to deteriorate until he died in February 2005. The family held his funeral at the First Baptist Church, then learned that the new will had left all their uncle’s real estate to the church, dividing the major portion of his financial assets among the church, his power of attorney lawyer, and the caregivers. For over a year, the family contested the will, discovering further evidence of emotional, financial, and physical abuse. After an unsuccessful trial in April 2006, the family finally gave up.

Book by C.W. Smith, used with permission of the author
Source: Book by C.W. Smith, used with permission of the author

Author Charles Smith concludes this sad story: "To families facing similar tragedies: The best advice I can offer to you is this: Tell them you love them, every chance you get, in every way you can ... Know who is caring for them when you are away and try to ensure proper oversight. If you suspect abuse, seek counsel from true experts in the field” and “if you hear about abuse in your community, take it seriously” (2020, p. 299)

How to Recognize Abuse of Older Adults

Like Uncle Jimmy’s family, many people don’t recognize the abuse of their older relatives because they don’t know what to look for. The National Institute on Aging (2020) lists a wide range of abusive behavior, including:

  • Physical abuse: Inflicting bodily harm on the older person, causing bruises, and other injuries.
  • Emotional abuse: Threatening and calling the person names as well as keeping them from seeing close friends and relatives.
  • Neglect: Ignoring the older person’s basic needs, including food, cleanliness, and medical care.
  • Abandonment: Leaving an older person alone, depriving them of basic care.
  • Sexual abuse: Involving the older person in unwanted sexual acts.
  • Financial abuse: Stealing from the older person’s bank account, retirement benefits, or Social Security checks, often involving fraud and forgery.

As Charles Smith recommends, if you suspect elder abuse, take it seriously and get help. Visit the National Adult Protective Services Association website for the phone number of Adult Protective Services in your area. In an emergency, call 911.

Set Up a Plan to Care for Your Loved One

If you are responsible for the care of an older family member, there are steps you can take to ensure reliable care. California geriatric care manager Jane Mahakian recommends working with a bonded caregiver agency licensed by the state. She emphasizes that “the caregiver should be an employee of the agency, not an independent contractor.” She says to ask the agency for proof of liability insurance and whether they do background checks on caregivers. She recommends interviewing prospective caregivers and, if possible, getting references from families they’ve worked with. Now, with the current COVID-19 pandemic, she urges us to find out how often the caregivers are tested and whether they’ve been vaccinated.

To make sure your loved one’s care is reliable, Mahakian says to have a discussion with caregivers about their work schedule, to post a schedule with care tasks at the older relative’s home, and to find out about the agency’s policy to ensure continuity of care when a caregiver calls in sick.

Many problems with caregiving arise from a breakdown in communication. “Communicating your expectations with the caregiver is very important,” Mahakian says. “The more you are aware of what the person needs and the more specific you can be for the caregiver, the better the outcome you can achieve. Put your expectations and specific tasks in writing and review them with the caregiver in person or via Zoom, to make sure the caregiver is clear about them.” And she emphasizes, stay in touch with the needs of your older relative. Their needs will change, she says, especially if they’re developing cognitive decline or dementia. “Remember,” she says, “the person may be doing very well on Wednesday, but on Friday may be experiencing more confusion.” Mahakian’s new book, I Hear You (2021) offers advice on communicating with relatives who have Alzheimer’s and other dementias.

These days, many family members are trying to manage care for older relatives who live many miles away. Some families Mahakian knows have set up video cameras in their loved ones’ homes to monitor their care. A geriatric care manager is a licensed nurse, social worker, or psychologist specializing in senior care, unaffiliated with the caregiver agency to ensure objectivity (Moroch, 2020). One woman I know who lived 400 miles away from her parents hired a geriatric care manager to manage their care, oversee the caregivers, and ensure that her parents’ needs were met.

Caring for older relatives is challenging. At worst, there are cases like Uncle Jimmy’s. And even at best, there will be health emergencies, urgent phone calls, and difficult decisions. Mahakian says “not to feel guilty that you cannot anticipate and control your loved one’s every move.” She advises us all to set up a care plan—“you need a plan in place before the care needs increase.” And when you find yourself in this situation, reach out to your local Council on Aging, Senior Center, or other resources to get the help you need.

This post is for informational purposes and should not substitute for psychotherapy with a qualified professional.

References

Mahakian, J. (2021). Personal communication. For more information, contact Dr. Mahakian at Aging Matters, www.agingmattersinc.com. If you’re dealing with a family member with dementia, check out her new book with Alyson Kuhn (2021). I hear you: Talking and listening to people with Alzheimer's (and other dementias). Aging Matters Press: https://www.amazon.com/hear-you-listening-Alzheimersdementias/dp/0578779609/ref=sr_1_2?crid=22P2WQMG19TPA&dchild=1&keywords=i+hear+you+book&qid=1614218923&s=books&sprefix=I+hear+you%2Caps%2C432&sr=1-2

Moroch, B. (2020, May 15). Geriatric care managers advocate for seniors—and their caregivers

AARP https://www.aarp.org/caregiving/basics/info-2020/geriatric-care-manager.html

National Adult Protective Services Association. (2021) Get Help. https://www.nia.nih.gov/health/elder-abuse

National Institutes of Health. National Institute on Aging. (2020, July 29). Elder Abuse. https://www.nia.nih.gov/health/elder-abuse

Smith, C. W. (2020). Uncle Jimmy: Elder care or elder abuse? 48 Hour Books. https://www.amazon.com/Uncle-Jimmy-Elder-Care-Abuse/dp/1735655805/ref=sr_1_1?crid=2SJIN61N5SFI7&dchild=1&keywords=uncle+jimmy&qid=1614803552&s=books&sprefix=Uncle+Jimmy%2Caps%2C214&sr=1-1https://www.amazon.com/Uncle-Jimmy-Elder-Care-Abuse/dp/1735655805/ref=sr_1_1?crid=2SJIN61N5SFI7&dchild=1&keywords=uncle+jimmy&qid=1614803552&s=books&sprefix=Uncle+Jimmy%2Caps%2C214&sr=1-1

For more information, visit his website, https://www.cwsmith.org/index.htm https://www.cwsmith.org/index.htm

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