Jane M. never for a moment suspected that her elderly mother, Nora, could become a victim of abuse. Nora lived in a very safe retirement village in a Southern state where her friends and neighbors routinely checked in on one another. If anything went wrong, she could push a panic button in her apartment and, within minutes, medical workers would arrive at her door. Nora suffered from a heart condition, several small strokes, osteoporosis and Parkinson's disease, but the 77-year-old widow was mentally sharp until the day she died.
Nora's children also couldn't have been more loving or supportive. Her daughter Jane is an artist in northern Vermont. Although she lived hundreds of miles away, Jane called her mother several times a week, as did Jane's three siblings, who are scattered around the world.
Nora's abuse was all the more shocking to her family because of how she had lived her life. Nora was an intelligent, strong-willed and well-respected professional with graduate degrees from several prestigious universities. She had worked for years as the executive director of a mental-health agency in New England, helping families, children with special needs and abuse victims.
"She was highly educated, financially secure, very aware of what went on behind closed doors and how people react to abuse. So this wasn't foreign to her," Jane explains. "But when it became her own issue, she was responding exactly the way any victim would. So there is no predicting where abuse is going to occur."
In fact, it took Jane and her siblings two and a half years to discover that their mother was the victim of repeated physical and sexual violence of the most horrific sort, perpetrated by a second husband she had married late in life. Jane, who asked that she not be identified to protect her privacy, agreed to tell her story to Seven Days in the hope that it will prevent other seniors from a similar fate. "It's a way to pay tribute to my mother," she says simply. "She would have done that herself."
Elder abuse is believed to be one of the nation's most underreported crimes, according to local crime-victim advocates. Though its prevalence is difficult to measure, the National Center for Elder Abuse estimates that at least one in 20 senior citizens nationwide suffers from some form of abuse, neglect, abandonment or exploitation. In Vermont, which has a senior-citizen population of about 75,000, that amounts to 3750 new cases each year.
If the response to a recent public-education campaign is any indication, Vermont's rate of elder abuse is consistent with the national average. In the three months after the Vermont Center for Crime Victim Services (CCVS) began airing public-service announcements about elder abuse last November, the state saw a 25 percent increase in the number of abuse cases reported to Adult Protective Services (APS). Sadly, victims' advocates say, those numbers probably represent fewer than one in seven of the cases that actually occur.
Karen Vastine, a training specialist with CCVS, is working to educate prosecutors, police officers, health-care professionals and others who deal with this silent epidemic. "This is a really new topic [in Vermont]," admits Vastine, who adds that the full extent of the problem is only beginning to come to light. In the last three years alone, there's been a nearly 60 percent increase in the number of abuse complaints reported to APS.
Nora's story is particularly telling, Vastine explains, because it typifies the many types of abuse elderly victims can face: physical and sexual violence, psychological threats and coercion, isolation from friends and family members, drug manipulation, theft and financial exploitation. Like most of the abuse cases that occur later in life, Nora's happened at the hands of a family member. And like most domestic-abuse cases, its victim was a woman who became a prisoner in her own home.
Seated in the living room of her 18th-century home along the Lamoille River, Jane recounts her mother's final three years with the deftness of a storyteller. In hindsight, the warning signs seem obvious, she admits. But at the time, Nora's friends and family members never suspected the pain and terror she was enduring.
Nora was widowed at the age of 77. By 82, her health was in decline. With her family living far away, Nora felt isolated, lonely and depressed. Then at 85, she met a man named Ray, who was married to a woman living across the street. As Jane recalls, Nora initially found Ray to be "obnoxious, overbearing and constantly needing to be the center of attention."
Then Ray's wife died in early June 1997, and within a month he began courting Nora heavily, taking her to church, dinner, movies and concerts. By the end of July, the two were together constantly; by September, Jane recalls her mother was giddily in love. A month later, Nora announced that she and Ray were to be married in November.
"My mother was not impulsive. This was out of character," Jane explains. But at her advanced age, Nora had found a renewed zest for life and her children didn't object. And Ray seemed to treat their mother like a queen, doting on her constantly and showering her with new clothes and expensive jewelry.
The first warning sign, Jane says, came at the wedding. Ray, then 82, didn't stop talking about his sexual prowess. Nora's family was initially amused, but his incessant boasting soon became offensive. The family didn't want to spoil their mother's joyous weekend, however, so they made the best of the situation.
After the wedding, things seemed to go well for the newlyweds. The family learned to tolerate Ray's eccentricities, though Jane soon noticed that her mother often seemed irritated with him. Soon, Nora stopped talking altogether whenever Ray was in the room. Eventually, Nora and her family began catching Ray in little lies.
It wasn't long before Ray began to isolate Nora from her friends and family. As soon as he moved into Nora's duplex, he forbade her children and grandchildren from staying in the house when they visited. Nora was also not allowed to eat lunch with her friends at the village clubhouse, as she had done for the previous 12 years. Within months, Nora was virtually cut off from her entire support network.
Ray had a bad temper, Jane remembers, and would often fly into an inexplicable rage. His behavior grew even more erratic at about the same time that Nora's health deteriorated in ways her doctors couldn't explain. Her Parkinson's worsened, but the symptoms didn't seem to fit the disease's normal profile. Then Nora started having panic attacks at night, sleeping all day and pacing the floor at night. "This was a woman who could barely walk 20 or 30 feet without having to sit down," Jane notes.
In March 2002, Nora suffered another stroke and seemed to give up on life. Although she later recovered, Nora said she wouldn't need her family furniture anymore, and asked her children to take it all away -- a request her children found strange. A few months later, Jane's sister flew down to see their mother and pick up the family heirlooms. It was during this visit, Jane says, that Nora finally disclosed her horrifying secret.
"What Ray was doing was, he was terrorizing her. He was raping her and sodomizing her daily," Jane says. "He would start at about two or three o'clock in the afternoon, telling her -- and this a quote from her -- 'I'm going to get you tonight. You don't know when or how, but I'm going to get you.'
"We had no idea how to process this. We'd never been through this before," Jane adds. "Thank God I live in Vermont. Living in a small state has its advantages." Jane immediately sought help from Women Helping Battered Women in Burlington and Vermont Legal Aid. Both agencies put her in touch with similar advocacy groups in her mother's state.
Within days, the family had removed Nora from her home and hired a lawyer experienced with elder abuse. Within a week, Nora had filed for a legal separation and given her children power of attorney over her financial affairs. Then, to the surprise of her children, she asked to move back to Vermont and told Ray she never wanted to see him again.
"As soon as we came on the scene and said, 'Mom, we're going to protect you. Nothing's going to happen to you,' that's when she began talking about the abuse," Jane says. Lest there be any doubt about Nora's mental competency or the veracity of her allegations, the nurses who examined her documented that she was indeed the victim of repeated sexual assaults.
Only after Nora was safely out of the abusive setting was her family able to piece together the various tactics Ray had used to manipulate and control her. Jane discovered, for example, that Ray had been tampering with her hearing aids so that she couldn't talk on the phone with her children or grandchildren. More seriously, he had increased the dosage of her Parkinson's medication in order to pacify her at night so that he could more easily have his way with her. "It's a wonder she didn't die," Jane notes.
Ray also depleted Nora's bank account, cleaned out her safe-deposit box and sold off her engagement ring and family jewelry. Nora's friends later told the family that while she was still in the hospital, Ray was already making overtures towards other single women in their retirement complex, apparently setting his sights on his next victim. A search of their apartment uncovered drawers full of sexual-enhancement drugs, books, videos and, as Jane puts it, "other pornographic material of the grossest sort."
Ray was eventually evicted from the senior-housing complex, but at Nora's request, no further legal action was taken against him. "If he weren't so old, I would have done it in a minute," Jane says. To quell her ethical concern that Ray might try to victimize another woman, however, Jane wrote a letter to his family outlining his aberrant behavior and criminal tendencies.
It's a popular misconceptionthat most abuse against elderly and disabled people is perpetrated by strangers in institutions such as hospitals or nursing homes. Statistically, the crime is just as likely to occur in the home and to be committed by family members or in-home caregivers.
"More and more of the elderly want to stay in their homes, and more and more often, Medicaid pays for the assistance to stay in their homes," says Linda Purdy, director of the Medicaid Fraud and Residential Abuse Unit in the Vermont Attorney General's Office. "Unfortunately, with that goal in mind, we're seeing more crimes being committed in the privacy of their own homes, where caregivers come in and have little, if any, supervision and can easily commit these crimes." That abuse can range from physical or sexual violence to theft and financial exploitation. One of the fastest-growing crimes against the elderly is drug diversion, in which a family member or a caregiver steals or replaces narcotics intended for the patient, then uses or sells them.
Also now coming to light is the extent of financial exploitation perpetrated against the elderly, says Purdy. This can mean anything from a home-health aide swiping a $20 bill from a patient's wallet to more organized rip-offs, including mortgage scams, get-rich-quick schemes and credit-card fraud. Unlike younger victims, who may recoup their losses over time, seniors often suffer catastrophic consequences from the emotional stress of losing a pension or retirement savings.
Statistically, elderly victims of a financial crime are far more likely to be prematurely institutionalized. According to one study in California, seniors in nursing homes who were victims of financial abuse had a mortality rate three times higher than those who were never victimized.
Part of the difficulty of fighting elder abuse, victims' advocates say, is victims' reluctance to report these offenses. Aside from the obvious complication that much of the abuse takes place in very private settings, there are many reasons why most of these crimes are unreported. Many seniors have lost their support networks over the years as friends and family members have died or moved away.
In addition, many elders suffer from physical or mental impairments -- loss of hearing, vision, memory, speech or mobility -- which make them particularly dependent upon others, and thus easy prey. Elderly and disabled victims are often afraid to report these offenses, fearing that they will be targeted for retribution or further victimization, and that they'll lose what little independence they have left, or end up in a hospital or nursing home for the remainder of their lives.
And since most abusers of the elderly are family members -- about 40 percent are their adult children and 15 percent are spouses -- victims often experience the same psychological patterns that plague other domestic-violence victims: shame, fear, guilt, denial, depression, suicidal tendencies and so forth.
Prosecuting abusers of the elderly can pose other challenges, Purdy notes, since victims' physical or mental impairments often make them unable to withstand the rigors of a criminal prosecution. "Oftentimes, one of the biggest criticisms of the criminal-justice system is that it takes so long, that justice delayed is justice denied," Purdy says. "And in these cases, we really have to push to get them prosecuted in the quickest way possible." In Vermont, the rules of evidence now allow prosecutors to videotape a victim's testimony, in the event that he or she becomes too sick or dies before the case goes to trial.
Investigating these crimes poses similar challenges, suggests Tom Raskin, an investigative social worker who looks into elder-abuse allegations for APS. Unlike child-abuse cases, in which the state has considerable authority to remove a victim from an abusive household, APS has virtually no authority to do the same with an adult victim, since most are still their own legal guardians. In cases where a crime has been committed, Raskin can help victims connect with police, prosecutors and victims' advocates. But more often the problem is addressed through mediation, persuasion or, occasionally, a Relief From Abuse order.
It's worth pointing out that APS is an understaffed agency. Raskin estimates that each year Vermont receives about 2000 complaints of elder abuse, about half of which require further investigation. But only five investigative social workers statewide are assigned to look into these reports.
Despite this disheartening picture, there is some cause for optimism. As the Attorney General's Purdy explains, senior citizens and disabled victims often are not frail and submissive; they can prove very effective and competent witnesses against their abusers.
"While there are many challenges to prosecuting these cases, I am continually amazed at the courage, stamina and strength of the victims I have worked with who are older," Purdy says. "They are wise, they have been in this world a long time, they're reasonable and they're really courageous, because it's not easy to go through this process."
One such victim was Martha "Marty" Crilly of Rutland. About 10 years ago, Crilly was working as a cashier in a convenience store when she injured her back while lifting a case of soda over her head. Her condition was compounded by arthritis and fibromyalgia. Within a short time, Crilly was using a walker. Later, she was confined to a wheelchair.
Crilly's injury was so debilitating that in May 1991, her doctor recommended that she move into a residential-care home. Crilly, who is now 53, was much younger than the other residents, who were mostly in their seventies or older. And unlike other residents, many of whom suffered from Alzheimer's or dementia, Crilly had all her mental faculties. So on Sunday mornings after breakfast, she took some of her elderly friends to the chapel to pray and sing hymns together. "These folks were so happy to have an hour of my time," Crilly says. "They looked forward to it every week."
Shortly after she moved in, a pattern of abuse began. It started when one of the aides became verbally abusive and ridiculed their Sunday morning prayer meetings. Crilly, who cannot lift her arms over her head, needs help bathing and dressing. She recalls one weekend when she was left virtually unattended the whole day. "It was a hot, humid weekend," she says. "I had no water, no food, no one emptied my commode, and no one would help me dress." Throughout the weekend, Crilly recalls, other residents were subjected to similar neglect and verbal abuse, and in some instances were reduced to tears. (Due to pending litigation, Crilly asked that Seven Days not identify the name of the facility.)
"I would tell the supervisor, but she wouldn't believe a word I said," Crilly says. Instead, the supervisor called in a psychiatrist, who suggested that Crilly had fabricated the story. They discussed increasing her medication and even hospitalizing her, something she adamantly opposed. "It was beginning to take its toll on me because I knew what I was doing and I knew what I was seeing," she says. "What they did was shoot me down so low that I never thought I was going to make it."
Soon, Crilly was known among the aides as "a troublemaker." From then on, she says, "It was eight months of pure hell." Crilly was subjected to ongoing verbal attacks and even had glass cleaner sprayed in her face. Finally, after her repeated complaints, the facility director reprimanded the abusive aide. Immediately thereafter, Crilly recalls, the aide stormed out of the director's office, spun her around in her wheelchair, cursed at her, spit in her face and punched her in the shoulder. When Crilly reported the attack to a supervisor, she was sent to her room and told to take a painkiller.
Later that night, another aide noticed the severity of her injury and called an ambulance. Crilly was taken to the hospital, where she was met by state police officers who took her complaint. Later, APS intervened and helped Crilly move out of the facility and into an apartment in Rutland. Thanks to her testimony, Crilly's attacker was prosecuted for her crime and no longer works with the elderly.
Today, Crilly feels much better about her living situation and is deeply appreciative of the state workers who rescued her. Though she's still confined to a wheelchair, she can do much more for herself. She looks forward to the day when she can become a senior advocate who checks on the well-being of people at nursing homes and other residential-care facilities. "I miss the friends I had there," Crilly admits. "I forgot my own troubles by putting a smile on their faces and drying their tears."
It's a sad commentary on modern society that citizens in their twilight years should become easy prey. The elderly, the disabled and other vulnerable adults are often victimized simply because they remain largely hidden from view. Roughly half of all abuse cases are turned in by "mandatory reporters" -- doctors, nurses, home-health aides, etc. The rest come from friends, neighbors and volunteers who spend enough time with an elderly or disabled person to recognize changes in their mental or physical state.
And therein lies one small but effective solution: increasing communication and contact with others. As Jane M. discovered, even when her family seemed to be doing everything right, sometimes even that is not enough. Fortunately, Nora's family rescued her before it was too late. After she was removed from the abusive household, Nora only lived another six months before she died on March 26, 2003. But Jane takes comfort in knowing that in her mother's final days, her quality of life dramatically improved and she finally regained some peace.
"Communication is the key, even if it's uncomfortable," Jane says. "We learned so much from this process, even though it was a horrendous thing to go through... We were all educated people. We were aware that abuse occurs in the 'unlikely places' and with people who surprise you. And yet it happened to our most protected member of the family. It walked right in the door."
If you know someone who is being neglected, exploited or abused, report it to Adult Protective Services at 1-800-564-1612. For information about services, call Senior HelpLine at 1-800-642-5119.