The best time to initiate a conversation about your concerns for an older adult is during a time of calm, in a private setting without interruptions.  Be sure that you have plenty of time for the conversation, as you don't want to halt the discussion because you have to attend to  another commitment.

Be direct but empathic in introducing the topic.  Ask for permission to talk about your concerns and reinforce that, if now's not the right time, you're there for them whenever they want to talk.  Starting out with "I statements", which focus on your own experiences and feelings, rather than on your perspective of what the other person has done or failed to do, can be helpful in opening a discussion in a non-judgmental way.  Some examples of good conversation facilitators:

• "I'm worried about you because..."

  1. • "I heard some concerning noises last night.  Is everything OK?"

     • "I haven't seen you out and about like usual.  Is everything OK?"

     • "I haven't seen your bright smile very much lately.  Is everything OK?"

     • "I've noticed that you've been getting hurt a lot lately.  Is everything OK?"

• "I'm concerned about your safety.  Is it OK if we talk about it?"

• "I know that this can be really hard to talk about.  I promise that I won't judge any of your choices or experiences.  I care about you and just want you to be safe."

• "If you ever want to talk about it, I'm am always here."

It's human nature to want to give advice - but resist the temptation and just listen.  Telling an older person experiencing harm what they should or shouldn't do is disempowering..and when we listen, the person about whom we are concerned will often tell us what they want and need.  Your priority in these kinds of conversations should be to support the person with what they need to make their own decisions, and that's only possible when we give them the space to do so.

Some of the words that we use when talking about harm to older adults - victim, abuser, violence - can be overwhelming to someone in the midst of the experience.  Unless the person uses these terms, it's best to avoid "labels" in your discussion.  This is especially true if the older adult doesn't recognize what's happening as a form of abuse or violence, which is a common situation.  If you are worried about the individual's safety, acknowledge this non-judgmentally, without disparaging the person causing harm:   "It sounds like you are in a dangerous situation, and I'm concerned about your safety."  Most importantly, let the older person know that what they are experiencing is not their fault.

Not only should you believe someone who discloses that their are being abused or neglected, but you should tell them that you do.  Coming forward and sharing one's experiences of EA is difficult, and it's critical that the person being harmed feels heard, understood, and validated.  This can be challenging when you know the individual who is causing the harm - it may seem difficult to believe that they are engaged in this behavior, but people often act very differently in public than they do behind closed doors.

As you talk with an older adult about a situation of abuse or neglect, it's important to support their decisions about who to tell, what steps they want to take, and what kind of help they are willing to accept....even if you don't agree with their choices.  The National Domestic Violence Hotline notes that when people experiencing abuse "feel supported, they are more likely to feel strong enough to take steps to keep themselves safer." 

It's a natural reaction for people to feel powerless when they are experiencing EA.  Yet even in the most challenging of circumstances, older adults demonstrate strengths that allow them to cope and solve problems.  In addition, there are likely a number of ways that the individual has shown courage and determination in their responses to the experience of abuse.  Identifying and highlighting these strengths can be particularly empowering, helping the older person to see themselves as resourceful and resilient even when they are in adverse conditions.

Ask what you can do to help and suggest helpful resources.  For example, you might:

• Encourage the person to reach out to people who can provide further support and guidance, like:

  • • Aroostook County's Hope & Justice Project (1-800-439-2323)

    • Legal Services for Maine Elders (1-800-750-5353)

    • Maine's Adult Protective Services  (1-800-624-8404)

All of these services offer free, confidential support to people experiencing EA.

• Offer to go with the person to a service provider who can provide medical attention, counseling or emotional support, help with safety planning, and other options

• Ensure that they have a support network ready to assist with needs like housing, food, access to health care, and transportation

• Help to facilitate their participation in activities outside of their home, away from the person causing harm, as reducing isolation decreases the risk of EA

A safety plan is a practical set of actions that help reduce the risk of ongoing abuse, neglect, or exploitation.  It includes personalized information that will increase an older adult's safety and well-being at home and other places that they may go on a regular basis.  The purpose of a safety plan is to have a clearly defined set of steps and resources identified so that someone experiencing harm can take action in high-stress situations.

The National Domestic Violence Hotline provides an easy-to-use interactive safety planning guide that can help to think through what actions to take in specific situations.  While it is geared toward domestic abuse (rather than EA), many of the questions are relevant to older adults who are in harmful relationships.  After completing the guide, there are options to print the plan, as well as a wallet-sized card with important phone numbers.

It's not uncommon for someone experiencing EA to ask you not to share anything about your conversation with others.  It's important to respect these wishes and for the older adult to be a part of any decision to report to the extent that they are able.  For many individuals involved in the helping professions, however, reporting suspected EA is a mandatory obligation - if you're uncertain about whether this applies to you or not, check the list of people who are mandated reporters in Maine.  In the interest of transparency and fostering a sense of control for the person experiencing EA, it is best to start out any conversation about their situation by disclosing this obligation:  "I am here for you and want to help in the ways that you feel are best, but I do have a legal obligation to report any concerns about elder abuse or neglect to people who can help.  I hope that you'll still feel comfortable sharing your story with me, because I want to make sure you have the support you need to be safe and well."

Power and control are at the heart of EA, so it's important to remember that unequal power dynamics in supporter relationships are also disempowering.  Never try to take control of the older adult's response to their situation - they are the expert on their own experience and know best how to respond to the abuse or neglect. 

Remember that you are not responsible for "rescuing" an older adult from a harmful situation, nor are you capable of doing so.  Your only job is to be caring and supportive.

Given the conflicting emotions and worries about what life will look like if there is a separation from the person causing harm, older adults may at first be reluctant to open up and disclose anything about their situation.  And even when they do, they may vacillate on what they want to do to address the abusive relationship.  Resist the temptation to pressure them into action.  Be patient in your interactions with the individual experiencing harm...and most importantly, don't give up on them.  Letting them know that you care, that they're not alone, and that when they want help, you'll be there for them is a powerful message.

Confronting a person who is causing harm to an older adult can be a risky proposition, both for you and for the person being harmed.  Don't put yourself in a dangerous position by offering to speak to the person causing harm or by creating the perception that you are a threat to their relationship with the older adult.  One of the most dangerous times for people who are experiencing abuse and neglect is when they begin reaching out for help; the abusive behavior often escalates at this point.  When the older adult is ready to take steps to change their situation, bring trained professionals - like those at Adult Protective Services - into a discussion to ensure that everyone remains safe during the transition.

If you feel that you need guidance on how best to support an older person experiencing EA, don't be afraid to reach out to one of the confidential and anonymous resources available to assist.  The National Center on Elder Abuse operates a hotline at 1-855-500-3537 that is available both to older adults and others concerned about their well-being.  In addition, the Elder Abuse Institute of Maine offers a service called A Helping Voice, which provides confidential phone support to individuals who have concerns about the mistreatment of an older adult and are uncertain about whether to make a report to Adult Protective Services.  A Helping Voice can be reached at 1-207-805-5555.  Finally, the National Domestic Violence Hotline is available 24 hours a day at 1-800-799-SAFE for crisis intervention, information and referral to people experiencing abuse and concerned others.

Providing support to an older person experiencing EA can be emotionally taxing work, and the key to maintaining your well-being in this process is to take good care of yourself.  We're all human, and it's hard not too worry about someone who is in harm's way, but it's important to find ways to take a step back from the situation.  Practice self-care: read a good book, go for a walk, bake cookies, meditate...do whatever makes you feel good.  You can't effectively support others if you're not taking care of you!