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From left, Maryland Secretary of Aging Rona Kramer, Carroll County Commissioner Stephen Wantz and Carroll County States Attorney Brian DeLeonardo prepare to address a group assembled at TownMall of Westminster for a presentation highlighting World Elder Abuse Awareness Day Wednesday, June 15, 2016.
From left, Maryland Secretary of Aging Rona Kramer, Carroll County Commissioner Stephen Wantz and Carroll County States Attorney Brian DeLeonardo prepare to address a group assembled at TownMall of Westminster for a presentation highlighting World Elder Abuse Awareness Day Wednesday, June 15, 2016. (DYLAN SLAGLE/STAFF PHOTO / Carroll County Times)

There has been a great deal of progress over the past few decades in terms of responding to and mitigating domestic and child abuse, but there is one vulnerable demographic still frequently in silence: the elderly.

"We find that with elder abuse, it's about 30 years behind where we are with child abuse and domestic violence," said Katie Cashman, director of elder services with Family and Children's Services in Carroll County.

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As a nonprofit agency with a history of providing services to low-income and medically frail clients — including medical adult day care, senior employment and senior housing programs in Carroll — Family and Children's Services is looking to expand those services over the next year or two to "include some kinds of elder abuse case management and a sheltering component," Cashman said.

But even as those efforts progress, Cashman said, the most important thing is simply to raise awareness of the fact of elder abuse — both physical and, often, financial — and not just among seniors themselves.

"We really wanted to go beyond seniors and target the people who may be doing the abuse. So it may be caregivers, family members or neighbors, or people that may see something and know that something is not quite right," she said. "We know those that are victimized are the ones that are most vulnerable, that are isolated, so they may not be getting our message, so we want to make sure it hits everybody that could be impacted by it."

This messaging fits well with that of other local and state agencies, such as the Carroll County State's Attorney's Office and the Maryland Department of Aging, and on Wednesday — World Elder Abuse Awareness Day — Family and Children's Services brought them all to TownMall of Westminster to help spread the word.

"We have a very large senior population, and fraud and abuse of our senior population is a major, major issue," said Rona Kramer, secretary of the Maryland Department of Aging, who spoke at Wednesday's event. "The public needs to know that it's happening and shockingly, the public really doesn't."

Physical abuse can occur and go unreported because seniors might be socially isolated or cognitively impaired, while financial abuse is common, Kramer said, simply because seniors are where the money is.

"They are one of the wealthiest groups of our population, and, again, they don't want to report abuse because it may have been committed by a family member," she said. "They may feel that if they report it, that their independence will be taken away from them. They feel foolish and humiliated and so don't want to say or do anything about it."

That underreporting makes it difficult to uncover and prosecute abusers, according to Carroll County State's Attorney Brian DeLeonardo, who said that only about one in 14 cases gets reported. His office has learned that addressing elder abuse requires special outreach.

"We have created a special victims unit that focuses on cases of elder abuse and physical abuse, so that we have … not only prosecutors and investigators, but also victims advocates that are trained to work with our elder population and can address the specific needs they have," he said. "We also have a real focus in our economic crimes unit on senior financial exploitation. … We work very hard with the seniors when we find out about that to not only stop it from happening, but also to recover the money to the best extend we can."

Awareness being key, DeLeonardo said his office is also distributing information to senior centers to educate people on the red flags of abuse — things such as unexplained, untreated injuries or lack of hygiene in terms of physical abuse or neglect, or the conspicuous absence of basic amenities a person should be able to afford in the case of financial abuse.

Although there are sometimes malicious individuals behind cases of elder abuse, Cashman said that one thing that distinguishes it from, say, domestic violence, is that elder abuse is not always intentional.

"We have worked with caregivers that are clearly committing abuse and they don't necessarily recognize that what they are doing is considered abuse," she said.

As an example, Cashman described a couple, married for 60 years, whom Family and Children's Services had worked with; the wife was now suffering from dementia. Worried that his wife might get up in the middle of the night, wander off and get hurt, the husband began handcuffing her to him while they slept.

"After a few weeks of doing this we noticed that she had deep bruising on her wrist, and when we inquired about it he very innocently said, 'Oh, I was keeping myself attached to her so that if she got up in the middle of the night I would know.' It never even occurred to him that that would be considered physical abuse or restraint," Cashman said. "We were able to figure out a different solution for him."

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In some cases, caregivers simply burn out, Cashman said, and some cases of neglect develop not from an intent to harm, but an inability to cope, and that's where awareness of services such as those provided by Family and Children's Services can make a difference.

"It really is just about support. For so many of our caregivers that's what they need — just somebody to vent to and that's where adult day care really comes into play," she said. "We offer this service that provides a respite during the day and gives the client a break, and sometimes that's all they need. They just need a few hours away from each other to regroup."

Awareness being the watch word, Kramer said that if everyone in the community is more aware of the possibility of the financial abuse of seniors, it might be possible to prevent many of the most egregious cases from happening. She recounted a case in which an older woman came into a grocery store and asked to make a wire transfer for $10,000.

"The clerk, to her credit, asked the customer if she could ask her a few questions about the transaction and the customer got very angry, and said, 'I know what I am doing,'" Kramer said. "But the clerk was persistent and said, 'Would you be good enough to talk to my manager?'"

The customer finally revealed that she had received a call saying that her grandson was in trouble and needed $10,000 right away and that she was not to tell anyone about it, Kramer said, and the manager persuaded the customer to call her daughter about it. The daughter assured the customer that her grandson was fine and that it was a scam.

That clerk saved the customer $10,000 of assets she had worked hard for and that she truly needed in her retirement, Kramer said.

"If we can get the entire community to be watching out for it and assisting us, then we have a really good chance of tamping this down," she said. "We'd like everyone to participate with us and recognize we have a tremendously burgeoning population of senior citizens and it's a wonderful thing for society, but it also brings additional responsibilities."

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More information

For more information on Family and Children's Services adult and senior programs, call 410-848-2433, send an email to seniors@fcsmd.org, or go to www.fcsmd.org.

If you suspect an instance of elder abuse or neglect is taking place, contact:

•Adult Protective Services at 410-386-3434

•The Carroll County Ombudsman — for cases in assisted living or nursing homes — at 410-386-3800

•The Maryland Attorney General's Office Medicaid Fraud Control Unit at 410-576-6521 or MedicaidFraud@oag.state.md.us

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