A Rotorua elder abuse expert says the issue is a problem in the community, but may not always be reported.
With Elder Abuse Awareness Week starting this Wednesday, Family Focus Rotorua Elder Abuse and Neglect Services co-ordinator Faith Tuhakaraina said the number of cases seen locally varied between about 20 and 40 cases a year.
Mrs Tuhakaraina said she dealt with 33 cases last year in the Rotorua area, which went out to Murupara and to the Mamaku Ranges, as far as Okere Falls.
She said elder abuse was out in the community and not always being reported, "and that's possibly because of the nature of the people abusing them, and that's often family members".
Abuse was an issue that had been silent for a long time and campaigns such as "It's Not OK" were hoping to say to people it was okay to come forward, she said.
"It can be quite difficult to get people to come forward and talk about it."
There were numerous forms of elder abuse, including financial, psychological, physical, sexual, neglect and institutional, although institutional was not high, she said.
Neglect could include both neglect by others and by themselves, Mrs Tuhakaraina said.
This could involve caregivers not giving elders their medication or cutting them off from their families, and elders not taking care of themselves or not being able to afford food because of bills.
Indicators to look out for included any unexpected bruises or marks, if the person looked thin or malnourished, if telephones were suddenly disabled, and if power was cut off, she said. However, it paid to be careful with unexpected bruises or marks, as the person could have simply fallen.
An elder appearing to be afraid of a particular person, saying they did not want to be somewhere because of someone, or an elder being active at home one day and then inactive for a few weeks were also indicators.
"It may not be abuse, but it's definitely something that needs to be investigated."
She said Family Focus ran a range of different programmes specifically targeted at carers or people who had found themselves caring for an elderly person.
As part of the awareness week, Family Focus will have an exhibition set up in the atrium of Rotorua Hospital on Wednesday from 11am to 1pm.
She said it was "to celebrate that we are making people aware that here we are and there is someone you can come to, and there are some supports for you".
Mrs Tuhakaraina said the catchment group she worked with was ages 65-plus and anybody could make a referral.
Sometimes she would review a person's situation and go as low as 56 years, mostly with Maori elderly, as Maori were over-represented in poverty, health and social issues, she said.
Age Concern New Zealand chief executive Stephanie Clare said Age Concern received 2000 referrals for elder abuse every year.
She said everyone needed to keep an eye out for elder abuse in their communities.
"Don't let fear of meddling in someone else's business stop you from voicing your concern.
"It is time to stop elder abuse in our communities and if we all pull together we can achieve this."
Enliven Coromandel/Bay of Plenty and Lakes service leader Alicia Adler said Enliven as a service was not in a position to deal with reports of suspected elder abuse entirely on its own.
However, if concerns were raised either by their support workers, clients or other parties connected to their clients, Enliven's service co-ordinators would proactively engage the help of external agencies trained and equipped to appropriately assess the reports of possible abuse, she said.
She said they would be alerted to between three to five reports of concern, and there would be on average two cases per year that would need to be referred on.
"As a community, there needs to be more education and awareness around it for carers, family members and the elderly themselves."
She said general practitioners could help people caring for an elderly family member in accessing help to reduce stress and the potential for burn out, which could unintentionally create an unhealthy environment.
"Elder abuse comes in many forms, but sadly it more often than not comes from within the family, and if we can assist in reducing the harm to our vulnerable elderly in the community then we are doing a good thing.
"We see so many elderly clients and their families who are unaware of what help and resources are available in the community for them."
Rotorua police family violence co-ordinator Detective Sergeant George Staunton said it was not often police saw elder abuse, but they did see it and in different forms.
Mr Staunton said people should always talk to someone and shouldn't be afraid to have "healthy conversations".
If people were unsure and wanted advice they could ring the likes of Mrs Tuhakaraina, the police or help lines.
"It's better to have asked a question and you know where you're at."
If people would like help, support or advice, Mrs Tuhakaraina is contactable on either (07) 346 2096 or (021) 223 5770 or via email at email@example.com