The Abuse She Won't Talk About

Ten days before Christmas last year, 70-year-old Bruce McMillan III picked up a claw hammer and beat his wife to death. When one of the couple's six children happened by the couple's home less than an hour later, the elderly man came outside with the bloody hammer in hand. He calmly informed his son, "I just killed your mom." He then told his son he might want to call the police.The bloody murder ended 27 years of a stormy, violent marriage. Gladys McMillan briefly escaped when she left the abusive Mr. McMillan a few years ago, but when her estranged husband's poor health worsened, she returned home to care for him. McMillan, who suffers from a heart condition and high blood pressure, now is awaiting trial on murder charges.Though the McMillan case may be shocking in nature, it is not uncommon. "If you look at the percentages, they find more abuse cases [reported to] Adult Protective Services that are true than they do for child abuse," says Steve Storie, a family violence investigator. "Unlike child abuse, older people aren't going to school or out in public every day, so it's a lot easier for it to stay hidden. Usually it's after they've been hospitalized, or maybe when the mailman shows up and notices that they've been beat up."Just two months ago, a 70-year-old man in Dallas, Texas strangled his 69-year-old wife while she stood at the sink. He then killed himself with a shotgun blast to the head. Although family members had noted that the man showed some signs of depression, none suspected such a fatal eruption was in store. And, in the end, no one could say whether this was an isolated incident or the tragic end to a violent pattern.Storie, who is helping write research on elder abuse, sees domestic violence among the aging as the next logical step in social awareness. He said that because only an estimated one in 14 cases is ever reported, many people aren't aware of the amount of late-life domestic violence plaguing the country."In the '70s, we became aware of, and started doing something about, child abuse," he says. "In the '80s and into the '90s, it was spousal abuse. The next frontier is the abuse of our older adults. There's a world of research that hasn't been done on this, and it needs to be, because it's happening all the time."With some 10,000 baby boomers turning 50 every day, the so-called graying of America is well under way. By 2010, the population of Americans over the age of 50 is expected to grow to about 96 million -- more than 40 percent of the adult population.As the aging population swells, the country faces a number of concerns and issues, not the least of which are overhauling Medicare and Social Security. Providing for the needs of an aging society that is intent on living longer than previous generations places new demands on government and industry alike. As the country publicly grapples with such issues, though, it privately struggles with far more serious concerns.Incidents of physical and sexual abuse, financial abuse and neglect of the elderly are on the rise nationally, both in institutions and in the home. While the government cracks down on nursing home abuse, many elderly face similar issues in their own homes. As difficult as institutional abuse is to uncover, however, discovering it within the home seems nearly impossible."One thing we do know is that it has increased about 150 percent in the last 10 years," says Nancy Gresham, a specialist in elder law and public health. "We went from around 117,000 cases in 1986 to more than 293,000 cases in 1996, and that's just what was actually reported. The statistics we're looking at now tell us that by 2030, the number of people over the age of 65 on will about double. So we're looking at a huge problem."With such startling numbers before them, it seems logical that social agencies would be looking at ways of quashing this growing problem. Think again. "It seems like nobody has done anything," Gresham complains. "Most people aren't even keeping numbers on this stuff anymore. I keep asking them why they don't record it, why we aren't keeping stats on it, but they just don't. It's just a case where nobody is doing anything about it."Abuse of the elderly bears many similarities to child abuse. It most often is committed by someone the victim knows, usually a family member or caretaker. Gresham identifies three forms: domestic, institutional, and neglect or self-abuse. According to the National Center on Elder Abuse in Washington, neglect is the most common form of elder maltreatment, but unlike domestic abuse, it has declined during the past decade. The center estimates that only about one in 14 cases of elder domestic abuse is ever reported.According to Cami Shankar, an elder abuse counselor, only 1 percent of all cases of elder abuse are committed by someone the victim doesn't know; 90 percent is at the hands of a family member. The family dynamics playing into the situation adds dramatically to the victim's hesitation to report the incident."It's hard for someone to have a family member arrested. It's hard for them to sit down and say that someone in their family did this to them," Shankar says. "What makes it [seem] so rare is that they don't report it. In a lot of cases, these are issues that they have carried through their entire life cycle. They've functioned this way for 30 or 40 years. They aren't going to reach out for help from the outside."In those rare instances when they do reach out for help, Shankar says, "it has to be pretty severe. Usually by that time, they're close to death. It's sad, but that's usually the way it plays out."For example, in the McMillan case, Bruce McMillan's history is rife with assault charges, including a 1992 conviction for aggravated assault -- stemming from an incident in which he tried choking, and then shooting, his wife. He still was on probation for that assault when he killed his wife.Their children told police he was an abusive man with a bad temper, and neighbors relayed numerous incidents in which his violent outbursts spilled out into the street. It wasn't until he tried shooting her that she left, however.Greshem says that in addition to being conditioned to live with abuse, fear plays a major role in not reporting the abuse. "A lot of it is fear of biting the hand that feeds them, so to speak," she says. "Many times, they are dependent upon the person who's abusing them to take care of them. A lot of times it takes someone outside the family to report it." All too often, those cases are stumbled upon accidentally, either when the victim seeks medical attention for an unrelated problem, or when the violence merely has gone too far.Domestic violence among the elderly has two usual perpetrators: either the spouse, or the children/caretakers. By the twilight years, most victims of spousal abuse have become so familiar with the pattern that they give very little thought to it."What concerns me so much is how many women put up with it just because they've gotten used to it," offers Janet Pacatte, a social worker who focuses on aging women. "If it's a case where they're being abused by their husband, they'll stay quiet because they think, what would the children say? So everyone stays quiet about it."As the victim grows older, her options dwindle. Many of today's aged women come from an era that saw them marrying early -- and for life. The idea of leaving a marriage is unthinkable, regardless of how unpleasant, or even dangerous, the situation may become."You are looking at women who haven't ever worked outside the home, who have no idea of what their financial situation is, who don't even know how to balance a checkbook. They are completely dependent upon their husband for those things," Pacatte says. "For them, it's a much harder transition than, say, a woman in her 30s or 40s. Even when you give them alternatives, they may choose to do nothing about it."Unfortunately, Pacatte points out, many battered women stay in an abusive situation hoping it will get better. Typically, it only gets worse. "If men are batterers when they're 40, they're going to be batterers when they're old," she says. "They don't cross into this Never-Never Land at some point and just straighten out. What happens, in actuality, is that our personality traits get worse as we age. That's where you see the real tragedy. Now you have a woman who's in her 70s or 80s. She can't go out and get a job; she has no other means of financial support; she probably has even less interaction with other people. Now she's really stuck.""A woman in her 70s is not even considering leaving," says Sonyia Hartwell, client services director for a women's shelter. "That's just too scary. The fear of the unknown is the greatest fear there is, and at least with him, they know what to expect. At this point in their life, they know what the pattern is. It's a lot easier to go along with that that try starting over."Although Hartwell acknowledges that there are many women in such a situation, she said the shelter rarely sees them. Last year, only one woman who visited the shelter was over the age of 68, and only 61 were over the age of 40. "We know it's the case, but they just don't seek shelter," she says. "A lot of times, they're just so worn out that they just take it. They're tired of fighting it."While episodes may become more frequent as couples grow older and become isolated, they don't necessarily become more violent. By then, the emotional abuse already has taken its toll on the victim, who may be intimidated just by a certain look -- and the implications it once held."A batterer, as he grows older, is going to lose some of his skills," she says, "but unlike other criminals, he isn't going to grow out of it. You don't see a 65-year-old man going out and robbing a liquor store, but you do see a 65-year-old man going home and beating his wife."When children become the abusers, it usually is even more difficult to detect. In most cases, the children step in when their parents become too frail or mentally confused to care for themselves. Studies indicate that those abusing the elderly tend to have more personal problems than those who don't; problems such as mental disorders, alcoholism, drug addiction and financial problems. In many instances, a child may carry on the violence that he or she saw acted out between the parents throughout childhood. People who are physically and/or mentally impaired are more likely to be abused, but less likely to be discovered. In those situations, even if they found the courage to report the incidence, their competency would be called into question."When you start getting into those situations, then you have a real dilemma," says Pacatte. "Say you have a woman who has Alzheimer's or suffers from some other kind of dementia. Anything she says is going to be in question. It's easy for the spouse or child, whoever is caring for them -- and abusing them -- to discount it. They can pass it off as dementia. Unless someone witnesses it, there's really no way for that woman to get any help."Storie agrees, saying, "The problem is, you've got people who start losing competency, and maybe they have trouble remembering exactly what happened. It's difficult from the police end to know exactly what is going on in that situation. It becomes real complicated, and that's one reason we all need to start becoming more aware of what is going on with our older adults."When the system fails, the results can be deadly. In one sensational case, a young adult male shot his grandmother in the head with a .38-caliber pistol when she refused to give him money from her Social Security checks, and told him instead to get a job. "You get people abusing their parents and their grandparents, beating them up for money and neglecting them. This is the thing this country needs to address," Storie says. "It's unbelievable. No other country treats their elderly like we do."

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