We see them sometimes on the evening news-stories about another scam targeting the elderly or the discovery of an employee physically abusing residents of a long-term care facility. The images are sickening: seniors, often isolated from families and friends, are victimized by opportunistic strangers, caretakers, even family members.

But how widespread are these problems, really? How vulnerable are older people to these types of abuse? Unfortunately, the problem is more widespread than we would like to believe, although the data are not clear. And that's part of the problem. It's tough to combat a problem when you don't know its scope.

The tip of the iceberg

Definitions of elder abuse vary by state, but in general, it is defined as including physical abuse, sexual abuse, emotional abuse, financial exploitation, neglect, abandonment, and self-neglect.

Some estimates say these issues may affect as many as 4 to 6 percent of America's seniors, which translates into 1.7 to 2.5 million potential victims. Others place the yearly number of victims at anywhere between 500,000 and 5 million.

The fact that we don't even have definitive numbers on how many of our seniors are being abused makes it clear that there is much more work to be done.

"That's a big part of the issue," said Sara Aravanis, director of the National Center on Elder Abuse. She said that research is a top priority if we are going to identify the reach of the problem, as well as its sources and effective ways to combat it.

What we do know already, however, is shocking. Aravanis cited a study that found that only one in five cases of abuse is reported.

"The system is only serving the very tip of the iceberg.," she said.

Abuse is not always reported for many reasons, including fear of retribution and continued abuse, as well as shame and the inadequacy of the system for fighting the problem. People who report abuse may find themselves being victimized all over again by a system that avoids prosecution or pits them against their abusers.

Documents produced by the United States Senate Special Committee on Aging state that "older adults who are abused or mistreated are three times more likely to die within the next decade than the same age adults who were not mistreated."

A "scandal" goes unaddressed

These documents also reveal that, despite holding dozens of hearings over the past 20 years regarding elder abuse-hearings during which the issue of elder abuse was called a "disgrace," and a "burgeoning national scandal"-Congress has not passed a single federal law to address the problem.

It has been said that a society will be judged by how it treats its most frail. By this standard, the United States should be judged quite harshly. Elderly people are faced with issues of isolation and vulnerability that make many of them in need of protection and intercession. Yet the solutions to the problem of elder abuse remain sadly underfunded and understudied.

The issue is not that elder abuse has only recently come into the light. Congress has heard testimony about elder abuse since the 1980s, and has done little to address it. It has, however, taken steps to combat other categories of abuse, including child abuse and domestic violence. These efforts have trained local law enforcement, social service agencies, and prosecutors to deal with the problem effectively. They have provided funding and have underwritten research that provides solid data to quantify the problems and illustrate their prevalence in our society.

While these important family issues have been addressed at a governmental level, not one federal employee works on elder abuse full time. The federal government spends $520 million annually to fight domestic violence and $6.7 billion to fight child abuse, but only $153.5 million to help support the scattered agencies and state organizations that protect seniors.

Hope on the federal level

In September, Sen. John Breaux (D-La.), chairman of the Senate Special Committee on Aging, and Sen. Orrin Hatch (R-Utah) introduced the Elder Justice Bill, legislation that would establish an infrastructure to coordinate justice efforts, support research, and train state and local authorities.

In a speech presenting the bill to Congress, Sen. Breaux said, "A crime is a crime. Crimes against seniors need to be elevated to the level of child abuse and crimes against women - as both those statutes have revealed the seriousness and extent of the problems, and presented ways to address these abuses."

Scott Mulhauser, spokesman for Sen. Breaux, said that the senator will reintroduce the bill to the new Congress in January.

According to Aravanis, action is needed on not only a federal level, but at the state and local levels as well.

"State and local coalitions are essential," she said. "Not only public service agencies, but private organizations such as bankers, chambers of commerce. We need these people to get together to help make sure the community is a safe and protected environment in which to grow old."

What you can do:
• Contact your senators and representative and urge them to support the Elder Justice Act of 2002.
• Write or E-mail the White House to urge President Bush to sign this legislation when it arrives on his desk.
• Visit these websites:
  http://aging.senate.gov/links/elderjustice.html
  http://aging.senate.gov/tips/
  http://www.elderabusecenter.org/agenda/index.html
  

The Senate Special Committee on Aging and the National Center on Elder Abuse have good information and plenty of advice for local activism, including writing letters to the editor, writing to representatives, and helping to form coalitions on the community level.