THE nightmare of abuse ended for a 70-year-old woman when the police in a Midwestern city found her bruised and hungry at home. Unable to withstand the fists of her alcoholic husband anymore after 40 years, she had finally asked a neighbor to call for help on an elderly abuse hotline.
While statistics are incomplete, physical abuse of the elderly appears to be growing in the United States. The National Center on Elder Abuse in Washington estimates that more than in 1993 700,000 women aged 45 to 65 were physically abused by their spouses, and nearly 400,000 older women in institutions were victims of physical or sexual abuse.
Experts say that, without good data, attention to the problem is unfocused - and offstage for policymakers. ``It's a bit overwhelming now,'' says Dianna Porter, public policy director of the Older Women's League (OWL) in Washington, ``because elderly abuse is more widely known than ever. We usually draw upon data by federal sources, but there is insufficient data collected nationally to indicate the level of violence.''
``We know that awareness of the abuse problem is increasing,'' says Rosalie Wolf, president of the National Committee for the Prevention of Elder Abuse in Worcester, Mass., ``but we don't know how prevalent the problem is nationally, even though reporting of these problems is increasing.''
OWL's annual Mother's Day report last May noted that the National Crime Victimization Survey by the US Bureau of Justice Statistics needs to be ``disaggregated'' to indicate the age, gender, and race of victims. Doing this would provide a more detailed picture than is provided by general reports and scattered state reports.
But some states indicate that the level of violence is on the rise. In Missouri, the number of calls to a state hotline to report elderly abuse rose from 8,359 in 1990 to 9,877 in 1993. ``The problem of abuse is growing in Missouri,'' says Randy Rodgers, a specialist with the Missouri Division of Aging. ``There is more awareness, and the state has tightened laws regarding mandated reporting by health officials and others dealing with the elderly.''
According to a survey of 21 states by the National Aging Resource Center on Elder Abuse, the most common abusers, at 32.5 percent, are adult children at home; next are spouses. In addition, many abuse cases are the result of self-neglect or the inability of an elderly person to care for herself or himself.
Elderly abuse cases are far less likely to be reported than child abuse cases. ``A lot of older people are isolated [from the family],'' Ms. Wolf says, ``and sometimes isolated from the community. No one is checking on them like children in a school setting, and they feel terrible shame when their own children are abusing them.''
The elderly often remain silent because they blame themselves, fear they will be put in a nursing home, fear retaliation, or don't want to be left alone no matter how distressing their home has become. Ms. Porter says, ``Some studies have shown that abusers of older persons were abused themselves at an early age. And older women who are abused by their spouses have probably been abused for a long period of time. But what underlies all abuse is the need for control over another person.''
Alcohol and drug abuse are evident in many cases. ``Alcoholism is a correlational factor, but not a cause,'' Wolf says. ``But it's there in a high proportion of cases. We have to do more about alcoholism treatment and prevention with stronger mental- health service systems that work closely with adult protective services.''
The White House, under the Older Americans Act, is planning a Conference on Aging in 1995 to arrive at recommendations in setting future aging policy. Delaware, in the forefront of prosecuting elderly abusers, has a statue on the books that prosecutes individuals for emotional and psychological abuse of the elderly, regarded by some experts as the most common form of abuse.
Of the 80 cases of emotional, physical, and financial abuse the state has prosecuted, 18 have been for emotional abuse. In 1986, the state had only four referrals for elderly abuse, but now it has more than 200 a year.
``The Violence Against Women Act is in the crime bill being considered by Congress,'' Porter says, ``and we want it passed even though there isn't much age-specific language in it. States receiving grants could then focus on midlife and older women in their programs.'' What experts want, too, is more training for health-care providers and social workers to recognize elderly abuse. ``Some abused elderly are showing up at senior centers,'' Porter says, ``and if the counselors know what is behind the depression or bruises, they can offer help and referral.''