In old age, they absorb bruises, rage — even sexual violence.

Although society has awakened to the problem of domestic violence between younger people, an entire category of victims remains, for the most part, an afterthought.

Elderly victims of violence, typically targeted by spouses and adult children, are often vulnerable and socially isolated and must rely on a safety net designed for people many years younger, the Wisconsin State Journal found in an eight-month investigation of elder abuse.

Among the newspaper's findings:

• Police, jails and courts are poorly equipped to handle elderly suspects and victims. Despite mandatory arrest rules in domestic violence cases, some police officers are reluctant to arrest elder perpetrators.

• Doctors and nurses aren't required to routinely ask elders about possible abuse, and some lack the time or training to detect problems.

• No domestic violence shelter fully meets the needs of elderly victims in Dane County and most other parts of the state, which can make them reluctant to ask for help.

The elderly are the least likely of all domestic violence victims to seek out or accept services, said Jane Raymond, who coordinates elder abuse programs for the state Department of Health and Family Services.

Like their younger counterparts, elderly victims often don't speak up because they're ashamed, they fear making an abusive relationship worse, or they believe seeking help won't change anything. But elders often face further problems — an aversion to divorce late in life, dependence on an abusive spouse or adult child and fears about what it means to send their caregiver to jail.

While elder abuse in general has been increasing in Wisconsin, reports of physical or emotional abuse have remained relatively steady over the last 10 years, numbering 575 in 2006. But at its worst, unchecked abuse usually escalates and can eventually be deadly, experts say. Last year, the state got four reports of emotional or physical abuse in cases that involved a fatality.

"At some point, the community is going to have to step up," said Shannon Barry, director of Dane County Domestic Abuse Intervention Services. "It's getting to that critical place."

Unexpected abusers

Case study

Madison Assistant Fire Chief Paul Bloom, responding to a call about an elderly man being short of breath, saw bruises as he hooked up an intravenous tube. A granddaughter ended up admitting she'd tied him to the bed "to keep him safe." The victim never spoke up. Bloom reported the incident but believes no one sought charges.

Abusers of the elderly have many faces. They are husbands who control the money, domineer the home, isolate, mock and beat their wives or demand sex. They're adult sons returning home after a failed marriage or job. Sometimes, a long-abused wife turns the tables if a husband becomes disabled.

Hired caregivers may be rough or demeaning with elders. Residents in long-term care homes physically attack one another. Sometimes, family members abuse elders while visiting them in a care facility.

"I see it all — dirt poor with nothing to people who have a vast amount of resources," said Jill Sweeney, an advocate for victims of domestic violence in the Dane County district attorney's office.

For years, physical and emotional abuse of seniors has been associated with the stress of caregiving, and the efforts being made to provide respite are important. For instance, the United Way of Dane County is funding an effort to give emotional support to caregivers with a goal of reducing elder abuse 30 percent by 2012.

Training caregivers in how to deal with specialized illnesses such as Alzheimer's also could help.

But now, many experts say the desire for power and control motivates most abusers.

"The research shows it doesn't have to do with caregiver stress," Raymond said. "You're not beating your mother because you're stressed."

Reluctant reporters

Case study

An 89-year-old man who lived with his grandson and relied on his caregiving was taken to the hospital for bruising to the chest. The older man confided to a nurse that his grandson hit him, but later claimed he fell, Madison Police Detective Julie Rortvedt said. The home had multiple police calls, the grandson had a criminal record, and Rortvedt sought charges. But the district attorney's office declined for lack of evidence.

Reporting is hard for any abuse victim, but especially for frail elders, Sweeney said, because they fear even more what will happen next. A divorce may severely harm retirement savings or tap into generational anxiety about a marriage dissolving. Turning in an adult child who is your caregiver may mean you have to move into a long-term care facility.

"They want to make their marriages work," Sweeney said. "They want to stay in their home."

A long-suffering victim also may have no place to go. Elders may be reluctant to go to a traditional shelter, where they would be uncomfortable sharing space with younger women and their children or have concerns about bringing their medications or adaptive equipment, such as a walker, said Brenda Ziegler, an elder abuse investigator with Dane County.

One client struggled with physical abuse throughout her marriage, and occasionally sought refuge with a sister or adult children, but "she could never see herself in a shelter," Ziegler said.

In addition to sometimes uncooperative victims, police officers and prosecutors struggle to enforce laws involving physical abuse of the elderly because of training and other system gaps. Untrained officers may handle violence between elders differently. Jails and courts often don't meet special needs.

Under state law, police must make arrests in domestic violence cases if they believe a crime has been committed or a victim is in danger.

Earlier this year, at the first elder abuse training for Dane County sheriff's deputies, experts encouraged deputies to enforce that law.

"In some communities, it's not happening and it needs to happen," said Shelly Gillette, a domestic violence victim's advocate with the county district attorney's office. "Nobody wants to arrest grandma or grandpa. No one wants to take these people to jail. But that's when the intervention occurs."

Even if police act, prosecutors sometimes hesitate due to a reluctant witness or other reasons such as an elder victim's hardships with transportation, mental or physical problems, or the rigors of a court case.

The cases are "very difficult," Dane County Assistant District Attorney Judy Schwaemle said.

Sexual silence

Case study

A 78-year-old woman didn't resist her rapist but called 911 after the intruder left her Madison home, said Jill Poarch of Meriter Hospital's Sexual Assault Nurse Examiner Program. At the hospital, a special sexual assault nurse examiner met a female police officer who said, "I'm really sorry you were called in. I really think this woman has Alzheimer's or dreamed she was assaulted. Her story just doesn't make sense." The nurse's examination found the victim was hard of hearing and had genital and other physical traumas. A suspect was arrested and convicted of first-degree sexual assault.

Seniors who suffer sexual assault rarely report, Poarch said. In Wisconsin, there were 27 reports of sexual abuse of the elderly made to the state last year, the first time such data was kept.

Seniors are often uneasy talking about sexual issues, let alone abuse, said Lisa Rader, Dane County's elder victim advocate.

And often, seniors face more obstacles in the justice system than a younger sexual assault victim. Authorities may doubt a story because they don't believe an elderly woman would be a rape target, and many seniors recoil at the idea of opening up to police or testifying in court.

A case police detective Rortvedt described from August 2003 underscores the complications. It started when the adult children of a 75-year-old woman reported that she had been sexually assaulted by a neighbor, but the victim refused to pursue charges, Rortvedt said. Two months later, the neighbor did it again.

After the second assault, the victim cooperated with authorities. "I was resisting him, that's why I'm black and blue," she finally told officers.

Jose Gutierrez-Herrera, then 41, was charged with second- and third-degree felony sexual assault. In May, he pleaded guilty to third-degree felony sexual assault and bail jumping charges. He was sentenced to four years probation.

The second assault could have been prevented, but unless victims come forward, "we're stuck," Rortvedt said.

Intervention, "empowers (the victim)," she said. "It breaks the cycle of violence."