Hidden violence: Elder abuse was already hard to track – then a pandemic made it more difficult
Amy Thomas wasn’t new to social work. She had been helping vulnerable children and adults for more than 20 years when she started working at Elder Options, a Gainesville-based nonprofit designated by the government to serve elders in 16 north-central Florida counties.
What was new to Thomas was the COVID-19 pandemic, which began right as she took her position as the organization’s director of community care coordination in early 2020.
The organization realized how important its services would become, she said. Elderly residents in Florida who contracted COVID-19 fared much worse than their younger counterparts. As of April 13, 2023, 77% of Floridians who died from COVID-19 were aged 65 or older, according to the Florida Department of Health.
By mid-March 2020, states began to mandate shutdowns. For elders, quarantine behind closed doors – often out of sight – came with its own dangers, especially abuse.
Thomas said calls to Elder Options reporting elder abuse dropped by one-fifth in 2020 versus 2019. The decrease brought no relief. Elder abuse is already underreported, with only about 1 in 24 cases brought to authorities, according to the National Center on Elder Abuse. Thomas knew that seclusion meant no outside observers to notice an elder’s bruises or emotional distress.
“It's an unfortunate and tragic side effect of being isolated, becoming more vulnerable,” Thomas said.
Florida’s senior population, or people over 65, is greater than 4.5 million. Even as specialists and advocates warned that elder abuse rates would increase during the pandemic, the number of cases reported to help lines and law enforcement remained steady or declined – sometimes hitting zero in some counties.
But experts worry that these numbers may not reflect reality.
When the pandemic began, the shutdown didn’t just affect schools and offices. Courts closed their doors, too. From Miami to Jacksonville, courthouses emptied their halls and halted cases for months. In Leon County, home to Tallahassee, jury trials were largely delayed for nearly a year.
Some cases of physical elder abuse made it through the hurdles of initial reporting and adjudication – but not many, in some counties. In Florida, it’s a specific crime to abuse or neglect an elderly person or disabled adult.
A survey of defendants accused under Florida’s elder abuse law included cases in five of the state’s most populous counties and five counties with the highest proportion of seniors. Some circuit clerks failed to respond to requests for records under the state’s public records law; others demanded hundreds of dollars to turn over records or produced files that were so heavily censored they weren’t useful.
Sumter County in central Florida is home to The Villages, the world’s largest retirement community. The county’s population is 58% seniors, one of the highest concentrations in any American county. But of the county’s 79,000 elderly residents, only two elder abuse cases were brought forward in 2020 – and none in 2021. In 2018 and 2019, three such cases were brought forward.
In Center Hill, a 70-year-old woman told police that her grandson, Gavan Cade Pike, then 26, who had been living with her for two years, used drugs and had become increasingly violent. Officials found holes in the walls, broken windows and dents in the refrigerator, according to court records.
In May 2020 – months into the pandemic – the woman said he held a kitchen knife to her face when she refused to give him money. “Do you want to die now or later?” he asked, according to police records.
The woman said she wanted to evict him, but COVID-19 slowed the process. Her grandson was convicted in May 2021 on charges of simple assault of someone 65 or older and petit theft. He was sentenced to time already served in jail and fined $1,548. Prosecutors dropped the felony charge of elder abuse, saying they had insufficient evidence to convict Pike. He and the woman both declined to discuss the incident.
In the other case in Sumter County, a nursing home employee pleaded guilty to elder neglect, a related crime, and was sentenced to three years of probation after an 87-year-old resident with dementia at the home fell and died. Investigators said the employee failed to adequately check the woman’s condition or notify a doctor or her family immediately after the fall. A judge subsequently released the employee from her probation after only 19 months.
About 100 miles to the southwest, 70-year-old Patrick Mahaffey of Sarasota was accused in January 2021 of keeping an elderly woman secluded for months during quarantine, according to court records.
Police said Mahaffey denied her medical care, which resulted in two hospital visits for blood clots. He also withdrew $20,000 from her bank account, police said. In October 2020, a person whose name was censored in court records visited the woman and found her sitting in her own urine and feces with bed sores. He removed her from the house, the report said.
Police arrested Mahaffey in January 2021. But the woman died later that year and he died in early 2022, closing the case before it was adjudicated. Family members did not respond to phone calls. Sarasota Police Department Det. Maria Llovio, who wrote the police report, declined to discuss the case.
Cases like this represent just the tip of the iceberg, said Karen Murillo, AARP Florida’s associate state director of advocacy.
Florida’s physical elder abuse statute is narrow and can overlap with other criminal charges, including domestic or aggravated battery, she said. This makes cases already difficult to track. Reports flagged as elder abuse often fall victim to a lack of communication between Florida’s many senior service providers, according to Murillo.
“There's a lot of different agencies and organizations that play a role in investigating and enforcing and regulating [elder abuse cases] … but the information is kept siloed in with those different agencies,” she said. “It makes it difficult for us to really analyze what the scope of the problem is across the state.”
'It’s as people choose to report': Fewer cases, but higher severity
Along the Gulf of Mexico north of Fort Myers, Charlotte County is a haven of beaches and docks. Its warmth and atmosphere attracts retirees, with seniors making up more than 40% of its population.
But during the pandemic, the county made no arrests at all under Florida’s physical elder abuse statute, according to the county’s clerk of court. It didn’t make any arrests during 2018 or 2019, either.
That isn’t uncommon. None of Highlands County’s 36,000 seniors in central Florida were reported physically abused in 2020, and only one was in 2021, according to that county’s clerk of court. The charges in the 2021 case were dropped by the prosecutor. In 2019, just one case was brought forward.
These counties and more highlight an issue experts and research have noted: During COVID-19, criminal cases under Florida’s physical elder abuse statute, which were already low, appeared to stay low instead of rise.
Gali Weissberger and Duke Han, researchers from Israel’s Bar-Ilan University and the University of Southern California, combed through thousands of calls to the National Center on Elder Abuse’s resource line. Against their hypothesis, the number of calls had decreased by about 28% from March 2020 to March 2021.
A little over half those calls described abuse, showing the types of abuse reported had changed during the pandemic. The proportion of emotional abuse reports crept up, and calls describing physical abuse more than doubled. Calls reporting multiple types of abuse at once also increased.
Their research didn’t cover abuse motives, but it’s likely for the same reasons that domestic abuse rose during the pandemic, Weissberger said – elders were trapped at home with their caregivers during a trying time. Family members were the abusers in nearly 40% of the reports.
“There were increased tensions in the household all around. People have lost their jobs or [had] increased stress about catching COVID,” Weissberger said. “It was just a very high-stress time, which may have increased rates of those particular types of abuse.”
Current research is conflicted about whether elder abuse, not just its reports, rose or fell during the pandemic. Some studies determined that it rose – even as much as 83%, according to one that polled elders directly. Each study has different methods of collecting and analyzing data, making results difficult to pin down, Han said.
“There's no real standardized database that's collecting [elder abuse] data. Even the reporting of it is not uniform,” Han said. “It’s as people choose to report.”
Florida’s counties don’t collect elder abuse data consistently, either. Orange and Palm Beach counties’ clerk of courts said their systems aren’t designed to track cases under specific statutes, making it impossible to tell how many elder abuse cases happened at any given time.
The absence of consistent data is one of the many reasons elder abuse rates are hard to determine, especially during the pandemic.
Hubbard House, a nonprofit in Jacksonville, usually works with domestic violence victims, said CEO Gail Patin. But the organization has also educated the public about elder abuse for more than a decade, sharing a federal grant with the Women’s Center of Jacksonville.
The organization’s customary elder abuse awareness training at law enforcement agencies, nursing homes and other nonprofits never covered a pandemic. Years of working with victims taught Patin that abused elders are often under the control of a family member. It follows that quarantine forced them into even closer proximity, she said.
“Particularly at the beginning of the pandemic, people were isolating together. So [abusers] had more time with victims to victimize them, and victims had less resources to get out and get help,” Patin said.
Hubbard House launched a text helpline in April 2020. Texting is quieter than calling, which could help victims avoid tipping off abusers, Patin said. While a text line may work for many domestic violence victims, it could be difficult for seniors who aren’t comfortable using cell phones, she added.
Elder Options ran into the same problem, said Thomas, one of the group’s directors. The organization made available emergency services, including Zoom-based elder abuse training sessions and telephone check-ins with existing clients. Most of the services depended on technology, which many seniors either couldn’t access or understand, she said.
Circumstances improved in 2021 and 2022, but problems still abound, according to Thomas. Calls to the helpline remain low, and many elders are still wary of being exposed to COVID-19 in public, further shielding them from others who may notice and report abuse.
“We have a lot of work to do. All of us do,” Thomas said. “Being old doesn't mean that you accept everything that might be happening to you. We've got to check in on our neighbors and just be aware of what things look like with elder abuse. It can happen to anyone.”