Abuse of an elderly person in many cases remains a silent affliction, as the victim is often kept quiet by growing dependence on his abuser for food, shelter and transportation. Such abuse may include neglect, hitting, stealing, restraint, inducement of mood-altering drugs and lack of sufficient food and hygienic care. Abuse and continued silence may perpetuate a cruel cycle of helplessness and guilt, which may be masked behind the walls of a family dwelling or nursing home. Often the perpetuators of elderly maltreatment are adult children with social, mental, drug or alcohol related problems. Money is often at the root of the problem, with old people being forced to sign cheques, having pensions or possessions stolen or forced to hand over their legacy before they die.
A 1991 USA report indicates approximately 2.5 million Americans over the age of 60 suffer psychological, physical or financial abuse. Some 86% of those abused in the USA were victims of their own family members.