Early on in the pandemic’s sweep over the U.S., a nursing home resident in Minnesota left her home for a weekend visit elsewhere. When she returned, the facility wouldn’t allow her back inside, for fears surrounding the coronavirus. The nursing home demanded a COVID-19 test. But at that point in the outbreak, tests weren’t available.
“She was on the verge of being homeless,” says Amanda Vickstrom, executive director of the Minnesota Elder Justice Center in St. Paul, Minn., adding that the woman had immediate medical needs that were previously met in the nursing home and were now being neglected.
Vickstrom’s nonprofit worked with the woman for nearly two weeks while she was couch hopping, using legal services to intervene.
“It took court action,” Vickstrom says. “That’s her home. By law, that’s her home. By law, she has access to it.”
This woman’s story is just one case of the strong correlation between the COVID-19 pandemic and cases of elder abuse and mistreatment.
Among others, the Minnesota Elder Justice Center has seen clients dying in long-term care facilities who are denied visits from family members, despite the Centers for Medicare & Medicaid Services’ (CMS) guidelines saying family is allowed in end-of-life scenarios. It has also received calls from victims being abused by family members or others they are sheltering in place under stay-at-home orders.
“Abusers are using the threat of the virus and the isolation to provide misinformation to people,” says Bonnie Brandl, founder and director of the National Clearinghouse on Abuse in Later Life (NCALL), an organization that assists communities around the country in developing programs that address elder abuse.
“One of the threats that abusers are using is… ‘If you don’t hand over your check, I can get you put into a nursing home, and you will die there’ or ‘If you don’t hand over your check, I’ll come visit you, and I’ve been out and exposed,’” Brandl says. “Being locked in the house with the person they might be most afraid of — who might be threatening, hurting or manipulating them — it takes a situation that was rocky beforehand and makes it worse in this environment.”
The pandemic, which fundamentally already disproportionately impacts older people, has an added layer of making older populations extra vulnerable to neglect, abandonment and abuse financially, emotionally, sexually and physically.
“We expect that it’s getting worse,” says Brandl.
A global trend
Duke Han, who researches elder abuse at the University of Southern California, noted a “massive increase in reports of elder abuse during the pandemic,” in a paper released in April — based on anecdotal reports of surges. He describes this uptick as unsurprising.
The National Center on Elder Abuse says social isolation is one of the greatest risk factors for elder abuse and since it is reported far and wide, the coronavirus pandemic is a breeding ground for social isolation.
“We also know that the pandemic has created greater dependency of older adults on others, which might be exploited by abusers,” Han says.
The nationwide economic downturn, too, can incentivize abusers to target older people who, in many families, have resources saved or receive Social Security income.
Though hard statistics don’t yet exist in the United States, Canada has reported a tenfold increase in elder abuse, and the international advocacy nonprofit HelpAge cited a rise worldwide in places like Nepal, the Democratic Republic of Congo, Jordan and Kyrgystan.
“We are hearing it within the U.S. as well, just informally,” say Han, who is working to solidify data on the impact of the pandemic on elder abuse. He says nearly everyone he knows in the elder abuse research sphere is doing the same.
When elder abuse calls are down
Not every elder abuse organization is seeing high volumes of calls, but that’s not perceived as a positive sign.
Paul Caccamise, the vice president for program at Lifespan in Rochester, N.Y., says Lifespan’s stream of calls is lower than usual. This concerns him because he knows elder abuse has certainly not gone away during the pandemic.
Lifespan normally receives many of its referrals from the health care system. Physicians, hospitals or home care agencies will call to report suspected signs of abuse they’re seeing. But with people avoiding doctors and hospitals or unable to go at all, “that monitoring function isn’t there,” Caccamise says.
The same goes for cases in long-term care facilities where, in many states, ombudsmen who typically investigate institutions like these are not currently allowed inside.
“The pandemic has taken away those eyes and ears on people who were already physically or socially isolated,” says Vickstrom.
The Minnesota Elder Justice Center is experiencing about a 25% reduction in calls over the past three months, which Vickstrom describes as an anomaly when looking at the Center’s call volume historically.
“It doesn’t tell me that suddenly we’ve reduced elder abuse. It tells me that people are unable to reach out for help,” she says.
An added impact of being socially isolated is just this: many victims are alone at home or in facilities, with large barriers to support and very limited access to outside contact.
“Many older adults will feel like they’re the only ones this is happening to, and it becomes difficult for them to reach out for services,” says Brandl. “They might be too afraid with the abuser in the house to make contact with anyone.”
And though the Minnesota Elder Justice Center’s quantity of cases is down, the amount of help needed is up, Vickstrom says. Victims are needing stronger advocacy, oftentimes legal representation, and are assistance for longer stretches of time.
What elder abuse advocacy groups are hearing from colleagues at domestic violence organizations — who’ve far and wide reported rises in pandemic violence — is to expect any dips in calls not to last.
As states open up and older adults emerge from isolation, victims might feel safer to seek help or interact with members of the public who could report signs of abuse.
How elder abuse advocates are adjusting
To rise to the current caseload and brace for what’s to come, groups like NCALL, Lifespan and the Minnesota Elder Justice Center are ramping up vigilance in a number of ways.
Lifespan has contacted every client it’s been in contact with over the past six months to check in.
The Minnesota Elder Justice Center is working to provide all services including legal representation remotely and virtually, while assuring victims’ voices are heard and prioritized. The Center is also tapping into services like Meals on Wheels and other programs still going to homes to observe clients and their home lives.
NCALL put together a letter for faith leaders calling on them to recognize that many older adults are attending virtual services and to bring awareness to abuse in prayers, newsletters and other communications; point congregations to resources and stay alert to red flags of abuse.
“I think people think everything is shut down,” says Brandl. “I want people to know that help is available, whether that’s a care provider or a hotline. Getting connected to services can be lifechanging and lifesaving.”
(If you or someone you know has been the victim of abuse, call Adult Protective Services in your state, a long-term care ombudsman program in your state or reach the Eldercare Locator by phone at 800-677-1116).