Imagine a weathered and wrinkled face, one that has seen nearly a century of life. Now watch as it recoils suddenly into a grimace of fear as another -- this one 70 years younger -- distorts to anger, draws back a wrinkle-free open hand and then uses it on the one that has been smiling almost since the Titanic sank.

And the younger one uses enough force that, tomorrow, there will be bruising.

It's a situation that police say played out last month at a Cape Girardeau nursing home, where a nurse's aide, no longer employed there, now faces charges of elder abuse.

Police say Sherri L. Sprenger, who was set to graduate with her licensed practical nursing degree this month, admitted to them that she hit the woman on the right side of her face with the back of her right hand. Sprenger told police she did so because she had lost her temper after the victim yelled at her, court records show. What the truth is will play out in court, with an arraignment set for Sept. 24 in Jackson.

Still, elder abuse is a sobering and blood-boiling thought, no doubt, for those with grandmothers, older aunts or special friends whose age stretches past a certain number. But it's also one that seldom is talked about in Cape Girardeau and surrounding communities. Records from the Cape Girardeau Police Department show that reports of elder abuse in all its guises is rare. For example, the report that Sprenger hit a 98-year-old resident at the Lutheran Home was the first such report of elder abuse made in 2012. In all of last year, there were two, the records show.

Rare reporting doesn't mean that the abuse is rare, said several local advocates for the aging and nursing home administrators. Much of the time, seniors stay silent. It is estimated that for every one case of elder abuse, about five more go unreported.

Viviane Rains, the administrator at the Missouri Veterans Home in Cape Girardeau, has worked in nursing home administration for nearly two decades. She worked with Sprenger, who worked at the veterans home in the past. Rains said labor laws forbid her from commenting about Sprenger's work record there -- or if there were other similar reports in Sprenger's file from her days there.

But Rains said she has made reports of elder abuse to the state as required by law. And every time she hears about even the possibility of such an incident, she said she is taken aback.

"Sometimes I just can't believe how wrong it is," Rains said. "I have dedicated my life, not only to serving veterans, but to serving the elderly. In my field, you take it personally every time. It hits close to home."

Rains is quick to point out that she believes that far and away most of the people who go into senior care are good at their jobs and never would dream of hurting the elderly. But she agrees that if it happens once, that's too much.

Since announcing that Sprenger no longer worked there, the Lutheran Home has declined requests for comment.

Rains and other advocates say that, as America grays at a more rapid rate, the issue of elder abuse could become even more problematic.

The number of people who live to age 90 has tripled in the last three decades to 2 million and is projected to quadruple by 2050, according to the Census Bureau. That means more of the country's seniors will be at the mercy of others. That presents more opportunities for elder abuse, which by definition in Missouri comes in more forms than the physical.

The Missouri Department of Health and Senior Services investigates abuse, neglect and exploitation of those 60 and older. These people may live on their own or in long-term care facilities. Missouri's Elder Abuse and Neglect Hotline responds to reports of abuse, neglect or financial exploitation, according to the department.

Such reports in 2011 for the state totaled 17,571, which showed little change from the previous year, when 17,718 were reported. Those reports have increased by an average of about 10 percent over the past five years, according to state statistics. Of that number last year, investigators found a "reason to believe" or "suspect" the allegations occurred in 57 percent of the reported cases. The state classifies those cases as substantiated.

But the majority of reports in long-term care facilities could not be verified.

The reports suggest some are physically abused, others are emotionally abused. Other forms of abuse are financial exploitation, physical neglect and financial neglect, among others. Reports also show that alleged abuse and neglect victims are all ages, but the likelihood of being abused increases with age.

Nationally, the numbers are worse. According to the best available estimates, between 1 million and 2 million Americans age 65 or older have been injured, exploited or otherwise mistreated by someone on whom they depend for care or protection, according to the National Center on Elder Abuse.

"It really just makes you sick," said Ruth Dockins, public information director for the Southeast Missouri Area Agency on Aging. "You can't believe someone would do something like that. You just hope that family members and loved ones would keep their eye out for this sort of thing and report it if they suspect it. Nobody deserves to be abused, but especially our elderly."

smoyers@semissourian.com

388-3642

Pertinent address:

2825 Bloomfield Road, Cape Girardeau, MO

2400 Veterans Memorial Drive, Cape Girardeau, MO