One in 20 Indians over the age of 60 faces abuse, a new survey has found. Children, children-in-law, and grandchildren are often the primary caregivers and abusers.

The joint family culture is quite common in India with several generations of family members often staying together under the same roof. Yet, as the survey found, family members were often the ones responsible for the ill-treatment of their elderly. In fact, “elder abuse or ill-treatment is often perpetrated by those who are supposed to take care of the elderly.

The [survey] confirmed that the main caregivers are often the primary abusers,” the authors noted.

Experts suggest that the reason behind the prevalence of elderly abuse by primary caregivers could be a result of the elderly being reluctant to protest either out of stigma, or out of fear of losing the support of their caregivers.

Titled the “Longitudinal Survey of India,” the national survey was conducted by the International Institute for Population Sciences (IIPS), which is an autonomous organization of India’s health ministry. The survey encompassed 72,250 adults over the age of 45 across all Indian states and union territories.