Police and prosecutors say elder abuse cases are among the most difficult they handle.

"When you talk about elder abuse, people say, This is terrible. We need to protect the elderly," said Tim Kaltenbach, McCracken Count commonwealth's attorney. "When you get into the cases, you see why things happen the way they do. Even though they're horrible, it's not quite as simple as the term implies."

Perhaps the biggest problem handling these cases is that most of them involve family members. Kaltenbach said the cases resemble domestic abuse, in that victims often refuse to testify against a loved one, or do so only to later recant their testimony. The victims often cannot communicate, have diminished mental capacity or die.

The problem is growing.

Allison Martin, spokeswoman for the Kentucky Attorney General's office, said the state prosecuted about 10 cases last year. So far this year, more than 30 have been tried.

"As the population grows older, we are seeing more and more cases of elder abuse," Martin said. "The challenge we deal with as prosecutors across the state is getting people to report elder abuse."

According to the National Center on Elder Abuse, research indicates that of elder abuse cases in the home, as few as one in 14 is reported. In cases of financial exploitation, it might be as few as one in 25.

"If they lose three or four or six thousand dollars, a lot of times they don't even tell families, and they don't tell the police," said Jerry Jones, a detective at the Kentucky State Police post in Mayfield. "If they report it, it helps stop it before the next one."

The General Assembly mandated in 2005 that the attorney general's office train local prosecutors on elder abuse. Janet Graham, assistant deputy attorney general, said prosecutors face numerous challenges in elder abuse cases.

"No elderly person wants to believe a family member has exploited them," she said. "There's a lot of victimization that unless it's reported by the family, it goes unreported. And of course, prosecutors are dealing with the same budget constraints as everybody else in state government.

"Their case loads are increasing in various areas, which puts more strain on the system itself."

Todd Leatherman, executive director of the attorney general's office of consumer protection, said the office offers senior crime colleges across the state to raise awareness. The classes teach seniors what to watch out for to avoid abuse as well as how to recognize potentially abusive situations, he said.

Elder abuse falls into two main categories, and many cases are a combination of the two: financial and physical. Both generally fall under the same state criminal code: abuse or neglect of an adult.

Defense attorney Dennis Null said he believes the state should consider reclassifying the crimes under separate charges rather than combining both types of cases under the same charge. It's like vehicular homicide, he said, which is classified under heading as any other homicide, even though the circumstances differ widely.

Financial exploitation is much more common, investigators say, but often more difficult to prosecute.

"It's complicated because when you have someone in a caretaker role and there's a guardianship, they're the one spending the money," said George Johnson, a Paducah police detective sergeant. He said bank records can show patterns of behavior, but it's difficult to prove any wrongdoing. "Maybe they need cash every day, but where does it go?

"We have to use a lot of caution in those cases."

Kaltenbach said those familial bonds can dismantle a case.

"An elderly person enthusiastic about prosecuting a stranger is reluctant and oftentimes unwilling to prosecute a family member," he said. "They'll say, He's my grandson, I love him,' when it all comes down to going to court."

While the physical abuse and neglect cases may be less common, many of the same issues apply. Kaltenbach said it's not uncommon for an elderly husband or wife to wait too long to seek care for a spouse.

"By the time they get to the hospital, the medical condition has deteriorated to the point that it's hopeless," he said. "The question is what to do. A lot of times, we choose not to prosecute, because it's clear there's no intent."

He said societal changes have made many situations more difficult to deal with.

"Families are not staying close together like they did a hundred years ago," he said. "That means the court system ends up dealing with these problems, and usually not very well.