When one hears about abuse it is often in cases concerning physical abuse of spouses or children -- but there is another type of abuse that is rarely spoken about and is unheard of to most people -- abuse against the elderly.

Even the people that should be the most respected, loved and cherished are being -- in some cases -- physically, and emotionally abused and neglected.

If you have ever restrained an elderly person when they did not necessarily require it, shouted or told them to shut up because they frustrated you, or pushed and shoved them because they were taking too long to move -- then you have committed elder abuse.

Department of Health coordinator of seniors and disabled Ms Corita Saunders stated that in Bermuda many seniors have recently become victims of elder abuse especially in the form of violent crimes.

"We are outraged and saddened by the alarming incidence of escalating violence, which happens every day to other vulnerable seniors,'' Ms Saunders said. "Perpetrators do not consider the status of their victims.'' Elder abuse can also be in the form of elders being forced to sign a will or turn over assets, or being forced to move out of their home into a nursing home, she added.

In most cases, a care giver, rest home attendant, or a family member looking after a senior may not even know they are being abusive.

"These behaviours are measured in terms of frequency, extent and severity, however, there is currently insufficient research to indicate its extent.

"A major source of difficulty in creating a useful definition is the fact that abuse and neglect are behaviours which are generally not observable by neutral bystanders, they come to light only when reported by those directly involved,'' Ms Saunders said. She added that neglecting an elderly person often resulted in the failure to provide adequate food, shelter, clothing or medical care.

"This may involve the refusal to permit other people to provide appropriate care.'' Ms Saunders also said self neglect was considered elder abuse, and it may be associated with health and medical problems such as vitamin deficiencies and chronic obstructive lung disease, which interferes with brain function.

Several senior citizen rest homes denied that any type of elder abuse took place in their facilities, but one assistant director of nursing from a senior citizen facility, who did not wish to be named, said that was not the case.

"There is elder abuse in the community and when we detect it we deal with it, it is common. I get phone calls from families who want family members removed from some of the rest homes because of abuse.

And she said: "Some relatives who deal with an elderly person, who is demented, can lash out or verbally abuse them and then they feel guilty, it does happen. Even restraining a person is a form of abuse especially when you keep them bedridden when they do not need to be.'' The woman added that the loss of calcium, broken skin on buttocks, and bedsores are indications that an elderly person has been kept in bed.

"I have had cases and I have had calls from families who perceive that their elderly family member is not being taken care of in a rest home. I have seen patients come from homes who are in situations where it is obvious that they have been abused. Rest home workers would never tell you that there is abuse.'' The woman also said she knew of cases where a patient's finances were being assessed and a family member claimed their relative had no money, even though they did.

Packwood Home administrator Mrs. Cecelly Simmons said she had never seen signs of elder abuse at the home.

"Physical or verbal abuse at Packwood will not be tolerated and they are grounds for instant dismissal,'' Mrs. Simmons said.

She added that the home also did not condone locking residents in their rooms or pulling their bed rails up when it is not needed.

One 68-year-old patient at Lefroy House said she had not seen any type of elder abuse around her and she added that the "majority of the assistants are very nice''.

"I think elder abuse is cruel, I really haven't seen any or heard of it going on, but you have to have proof.'' Ms Saunders added that health care professionals, who advocate for seniors, believe all people have a right to live in safety and security, and that the community has the responsibility to offer protection and choices to seniors who may be at risk of experiencing physical, emotional or even abuse of their resources.

"Physical abuse and neglect are perhaps the most visible tragedies of this phenomenon, but more permanent devastation may be caused by financial exploitation.'' To answer the question of what can be done about elder abuse, Ms Saunders said: "It is everyone's responsibility to be vigilant so that we can put a stop to elder abuse.

"Concerned citizens need to be a friend to seniors and help to provide transportation, home repairs, understanding, and report suspected cases of elder abuse to social service agencies or the Police. There is a need for greater public awareness of the problem as no programme will succeed unless concerned citizens become involved.

"Other actions include education, more therapeutic resources, research and new legislation to bring about major changes. Health professionals are primary referral sources for abuse and neglect situations. They have major roles with respect to elder abuse identification, prevention and treatment.'' Ms Saunders also said it was important to note that some people view seniors as a burden, as helpless and dependent people, but everyone must be cognisant of the fact that seniors have made an important contribution to our community.

"They have tremendous wisdom and experience, and these attributes must be valued.''