A quarter of elderly Israelis living at home and being cared for by family members are neglected and abused, according to a study released this week by the University of Haifa's Department of Gerontology and School of Social Work. Most of the neglect, however, is unwitting and stems from a lack of professional support for families caring for elderly relatives. "Not all the signs of abuse are physical," said Dr. Miri Cohen, head of the Haifa University team that carried out the research with assistance from medical and social welfare personnel from Rambam Medical Center in Haifa and Hadassah University Hospital in Jerusalem. "In most cases, we are talking about some level of neglect, such as the failure to provide the individual with the correct medical care, missed doctor's appointments and taking advantage of the elderly person's financial income," she said. While there was a range of different reasons for the abuse, most of it arose from the pressure placed on the primary care givers, usually spouses or children, Cohen said. "It is a lot of responsibility and most of the time families are not getting the professional support they need," she said, adding that many families did not realize they needed help. "With advances in medical technology, people live longer even if they suffer from some type of disability, which means the care needed is more intensive," said Sara Alon, director of programs for elder abuse at Eshel, the Association for the Planning and Development of Services for the Aged in Israel, which is run jointly by the government and the American Jewish Joint Distribution Committee. "Many times the care givers are frustrated and tired [and] they take out their anger on the person they are caring for," she said. Close to 900 people over the age 70 who were admitted for a variety of reasons to either Rambam or Hadassah in recent months were questioned in depth; 6.5 percent said they were the victims of abuse by their families, another 20% were determined by social workers and professional staff caring for the patient to be suffering from abuse. "The goal of this study is to help hospital and medical staff recognize signs of elder abuse and neglect," Cohen said. "We can then pass those cases on to community social workers and other organizations that assist the elderly so they in turn can help the families." Alon said the failure of hospital medical staff and social workers to recognize the problem was one of the main reasons elder abuse had been able to continue unchecked for so long. "It is easy for professionals to blame [physical and mental] conditions on old age, "she said, adding that a screening tool to detect this kind of abuse would certainly improve elder care. Cases of elder abuse began to be noticed by professionals worldwide during the late 1980s and early 1990s, with Israel only becoming aware of the problem in the last eight years. Over the past five years, however, there have been multiple initiatives to raise social and professional awareness of the phenomenon. According to Cohen, this is only the second such study exploring elder abuse in Israel. A study conducted nearly two years ago produced similar figures.