Honolulu Deputy Prosecutor Scott Spallina recalls a case about a man beating his ailing father whose diaper was heavily soiled about two years ago.

The father sustained a detached retina and died a month later of an unrelated heart attack.

Spallina said the son was thrust unprepared into the role of full-time caregiver and became part of the 60 percent of elder abusers in Hawaii who are related to their victims. The son was sentenced to five years’ probation for assault.

"Elder abuse is happening in Hawaii," said Spallina, captain of the Elder Abuse Justice Unit in the city prosecutor’s office. "Unfortunately, it’s a lot of family members."

For the past two years, the prosecutor’s office has seen increasing numbers of elder abuse cases. In 2008 — when former Prosecutor Peter Carlisle created the elder abuse unit — it had 37 cases; in 2009 it had 57; and last year it had 102. By the first half of February, the unit had 22 cases, putting it on track to double last year’s caseload.

Experts say the increase is probably related to drugs, the bad economy and the growing senior population.

Part of the problem, Spallina said, is people don’t like to talk about it. He compares the silence surrounding elder abuse to the silence around domestic violence about 30 years ago, before it was brought to the public’s attention with movies such as "The Burning Bed," the 1984 Farah Fawcett movie about an abused wife who set her husband on fire.

Under Hawaii laws, elder abuse involves neglecting or causing physical, financial, emotional or sexual harm to someone 60 years old and older, Spallina said.

But Spallina claims the prosecutor’s caseload is not even the "tip of the iceberg," with strangers increasingly targeting senior citizens who have wealth, might live alone or need help around the house.

Spallina said investigators found abuse cases are also largely unreported — only about 2 out of every 5 — because victims might depend on care from the abuser or fear retaliation. Some victims also feel too ashamed to report the abuse or fear family members will put them into a care home or take away access to their money if they learn about the abuse, he said.

Because of the rise in activity, Prosecutor Keith Kaneshiro expanded the unit to four deputy prosecutors from two, said former prosecutor’s spokeswoman Lynne Waters.

To improve the prosecution, Spallina said his unit is planning to pursue its own investigations, possibly as early as April, and already has deputy prosecutors handling cases from conferral with police officers through sentencing.

Spallina, who gave a presentation earlier this month in Wahiawa, is also trying to spread awareness about the abuse, hoping to prevent new cases.

Gary Powell, executive director of the Caregiver Foundation of America, said the growing senior population places economic and emotional pressure on family members and leads to resentment, abuse and neglect. He suggests family caregivers find resources available to them, such as his organization’s "boot camp" or the caregiver program at Kapiolani Community College.

"We can’t really change the work, but we can change the perception, which can make the stress so much less hard to deal with," he said. "Don’t try to do it all yourself."