Elder Abuse and Neglect

There are many different types of elder abuse. It is important to recognize the warning signs of elder abuse so you know what to watch for and be able to help immediately.

According to the National Council on Aging (NCOA), approximately 1 in 10 Americans aged 60 and older have experienced some form of elder abuse. In one study, it is estimated that only 1 in 14 cases of abuse are reported to the authorities. Elder abuse is defined as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.”

Elder abuse can happen to anyone and anywhere, whether the senior is living in their own home, a relative’s home, or a long-term care facility, such as a nursing home, assisted living community or hospital. Abusers can be either men or women, often adult children, or other family members including adult grandchildren, or spouses/partners of elders. Caregivers who are assigned to the care of an elder are also often perpetrators of elder abuse.

The National Center on Elder Abuse (NCEA) reports that those with a history of past or current substance abuse, mental or physical health problems, or of trouble with the police, those socially isolated, unemployed or have financial problems, and experiencing major stress are likely to be perpetrators of elder abuse.

Different Types of Elder Abuse and Warning Signs

Abuse of the elderly can occur in many different ways. The most common forms of elder abuse are:

Physical elder abuse

This involves any kind of non-accidental physical contact that causes the elderly person bodily pain, injury or physical impairment. Aside from physical assault, such as hitting or shoving, physical elder abuse also includes the inappropriate use of drugs, restraints or confinement.

Warning signs can include:

  • Bruises
  • Broken bones
  • Burns
  • Dislocations
  • Sores
  • Welts
  • Abrasions
  • Pressure marks
  • Odd explanations for the elder’s injuries
  • Unexplained injuries
  • Delay between the time of injury and when they are given assistance or care
  • Bringing the elderly to different hospitals or doctors in order to prevent detection of the abuse

Emotional/psychological elder abuse

This type of abuse involves speaking to or treating the elderly in such a way that inflicts emotional or mental anguish. It can include:

  • Yelling at or threatening the elderly in order to intimidate them
  • Ignoring the elderly or isolating them from others
  • Humiliating and ridiculing the elderly person
  • Terrorizing the elderly person
  • Frequently blaming the elderly, or using them as a scapegoat

Warning signs can include:

  • Confusion and depression
  • Difficulty sleeping
  • The elder becomes nervous around, or expresses fear of the perpetrator
  • The elder becomes agitated, non-responsive or withdrawn
  • Unexplained weight loss or weight gain
  • The elder experiences high blood pressure or other stress-related disorders
  • The elder displays unusual and age-inappropriate behavior such as rocking, biting or sucking
  • The perpetrator isolates the elder from friends and family

This type of abuse is one of the hardest forms to detect, mainly because the victim might not be able to express what’s being done to them due to illness, dementia, or fear of being neglected.

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Elder neglect or abandonment

Elder neglect and abandonment is a failure of the caregivers to fulfill their obligation to the elderly. There are two types of neglect: active and passive. When a caregiver withholds assistance or necessities from the elder, it is considered active neglect. When a caregiver is untrained, lacks the resources to care for the elder, or is also sick or disabled, it is considered passive neglect.

Warning signs include:

  • The elder looks dirty or unkempt
  • Dehydration and lack of adequate food
  • Sever pressure ulcers or bed sores which indicates the elderly person is left in bed for an extended period of time without supervision or care
  • The elderly person is dressed inappropriately for the time of year
  • The residence lacks basic necessities such as heating, electricity, plumbing, or such amenities as refrigerator
  • The home looks unusually messy and unclean
  • Necessary medical aids are missing or absent – such as eyeglasses, cane, hearing aids, dentures, walkers, or braces
  • Worsening dementia or chronic diseases despite medications and a defined care plan

Elder sexual abuse

Any type of sexual contact with an elderly person without consent is sexual abuse. However, other activities can also be considered sexual abuse, such as forcing the elderly person to watch sex acts, showing them pornographic material, or compelling an elder to undress.

Warning signs include:

  • Bruises on thighs and/or external genitals
  • Bruises around the breasts
  • Vaginal or rectal bleeding, pain and irritation
  • Unexplained STDs
  • Inappropriate relationship and behavior between the victim and perpetrator
  • The elder displays unusual, improper or aggressive behavior

Seniors are vulnerable and are seen as easy targets by perpetrators. They are less likely to report the sexual abuse due to dementia, or their dependency on others for care.

Elder financial abuse

This type of abuse involves the unauthorized use of an elderly person’s funds, resources or property. Financial abuse of an elder can be committed by a family or paid caregiver, or a scam artist unrelated to the victim and their kin.

Warning signs:

  • Utilities and other bills are unpaid
  • There are unusual purchases recently made that the elderly has no history of making
  • The elderly’s money has disappeared or becomes unaccounted for
  • Increased withdrawals of cash
  • A new person has been added to the elderly person’s bank accounts or credit cards
  • Increased use of credit cards

There are various ways in which an unscrupulous caregiver might commit elder financial abuse, such as outright stealing of cash, checks or household goods, forging the elder’s signature, or misusing their personal checks, credit cards, or accounts. In some cases, a caregiver might also steal the elderly person’s identity.

Scammers, on the other hand, can entice the seniors to give to phony charities, or dupe them into investing in fraudulent companies. Some can also lure elders by giving a ‘prize’ that they allegedly won, with the condition that they pay first in order to claim.

Recognizing Elder Abuse

Sometimes, people tend to look for the good in others and find it hard to believe that they are capable of committing horrific acts against the elderly. We may not be able to recognize signs of elder abuse at first, as they may look like signs of deterioration of the elderly person’s physical and mental capacity. We might also be too trusting of the caregiver and take his or her word for it when they explain irregularities and injuries away. It is entirely possible for the signs of elder abuse to overlap with symptoms of psychological decline. However, you shouldn’t dismiss your observations, especially if you are seeing a combination of physical and behavioral warning signs in the elderly and caregiver.

If you suspect that an elder is being abused, neglected or exploited, don’t hesitate to report the situation to the authorities.

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