Each year, more than two million older Americans are victims of abuse, according to the American Psychological Association. But research suggests elder abuse is significantly under-reported and under-identified.
As few as 1 in 6 cases of elder abuse come to the attention of authorities, according to the National Center on Elder Abuse.
How can you tell if you or your loved one is being abused? What can you do to help? What resources are out there?
The National Center on Elder Abuse defines elder abuse as intentional or negligent acts by a caregiver or "trusted" individual that causes, or can cause, harm to a vulnerable elder.
"Unfortunately from what statistical information we do have, most victimized people are abused by people they know and trust," said Sharon Merriman-Nai, the co-manager of the National Center on Elder Abuse.
Elder abuse can come in many forms: physical abuse, emotional or psychological abuse, financial abuse and exploitation, sexual abuse, neglect, abandonment and self-neglect. A change in general behavior is a universal warning sign, she said. If you notice your loved one is withdrawn or gets upset or agitated easily, it "might mean it's time to ask questions."
An important thing to remember: If your loved one says something happened, take them seriously.
"Sometimes, when older people suffer from dementia or some sort of cognitive problem, they may not be believed," Merriman-Nai said.
Signs of Elder Abuse
Dr. Susan Ginsberg, who publishes a monthly newsletter called "Work & Family Life: Balancing Job and Personal Responsibilities," outlined the warning signs of different forms of elder abuse.
If you notice an untreated injury, or an injury that seems inconsistent with the explanation of its cause, it may be a sign of physical abuse, she said.
"Try to determine if the older person is afraid of anyone -- either at home or in a facility, or whether they have been hit or slapped," she added.
Cues That May Signal Elder Abuse
Emotional abuse can range from name-calling to intimidation and threats.
"Ask the older person what happens when he or she and the caregiver have a disagreement," Ginsberg said. "Are they being treated like a child, humiliated or threatened with punishment?"
Hesitating to talk openly about their relationships, or demonstrating fear, anxiety or withdrawal, may be signs of emotional abuse.
Greed is a contributing factor in many cases of financial abuse, Merriman-Nai said, but the elderly may be susceptible to exploitation.
Be observant. Look for signs of missing personal belongings or credit cards, unusual bank account activity or checks made out to "cash," Ginsberg said. Has your loved one redrawn their will at a time when they seemed unable to write one?
"It's not easy to differentiate between financial abuse and the desire to give money," Ginsberg said.
Many victims are reluctant to report abuse, Merriman-Nai said, adding that the hurdles are overcoming their resistances and identifying the problem.
"They may not come forward because this is somebody they love, maybe they're minimizing or denying the abuse. They may be minimizing it, or taking it with a grain of salt," she said.
Sometimes, the victims may think the alternative may be worse.
"They may have to go to a nursing home or lose their independence," she said.
Be in touch with your loved one and keep lines of communication open, Ginsberg said.
Even if you live several states away, "stay in touch with the people who are there on site. Find a trustworthy neighbor to check in once a week," she said.
If you have any reason to believe you or a loved one is being abused or neglected, there are resources to help. If you believe that an elder is in a life-threatening situation, contact 911 or your local police department.
Visit the National Center on Elder Abuse website for more ways to help your loved ones.