Elder Abuse

Overview

What is elder abuse?

Elder abuse is the mistreatment of an older person. It can be physical abuse, emotional abuse, or neglect. The person who does it may be a caregiver, a family member, a spouse, or a friend.

Elder abuse can include:

  • Acts of violence. Examples are:
    • Hitting, kicking, or beating.
    • Pushing, choking, or burning.
    • Physical restraints.
  • Forced sexual contact or sexual contact without consent. This includes:
    • Unwanted touching.
    • All types of sexual assault.
  • Emotional or psychological abuse. This includes:
    • Name-calling.
    • Threats, intimidation, or humiliation.
  • Neglect. Examples are:
    • Not providing food, clothing, or personal shelter.
    • Not paying nursing home or assisted-living facility costs if you are legally responsible to do so.
  • Abandonment. This includes deserting an older person when you are physically or legally responsible to provide care.
  • Illegal or improper use of an older person's funds, property, or assets. Examples are:
    • Forging an older person's signature.
    • Stealing money or possessions.

What are the types of abuse?

The 1987 Amendment to the Older Americans Act identified three types of elder abuse. They are:

Domestic elder abuse.

It usually takes place in the older adult's home. Or it may take place in the home of the caregiver. The abuser is often a relative, close friend, or paid companion.

Institutional abuse.

This is abuse that takes place in a residential home (such as a nursing home), a foster home, or an assisted-living facility. The abuser is paid or contracted to care for the older adult.

Self-neglect.

This is behavior of an older adult that threatens his or her own health or safety. It happens when an older adult refuses or fails to provide himself or herself with enough food, water, clothing, shelter, or medicine. It can also include not being clean or safe.

What are the signs of abuse?

Signs of elder abuse depend on the type of abuse.

Signs that an older person is the victim of violence may include:

  • Bruises, black eyes, welts, lacerations, and rope marks.
  • Cuts, punctures, or untreated injuries in various stages of healing.
  • Broken bones, including the skull.
  • Sprains, dislocations, or internal injuries.
  • Broken eyeglasses or dentures.
  • Signs of being restrained.
  • Reports of overdose or underuse of medicines.
  • Reports from the older adult of being physically mistreated.
  • A sudden change in behavior.
  • A caregiver's refusal to allow visitors to see an older person alone.

Signs of possible sexual abuse include:

  • Bruises around the breasts or genital area.
  • Venereal disease or genital infections that can't be explained.
  • Vaginal or anal bleeding that can't be explained.
  • Underclothes that are torn or stained.
  • Reports from the older person of being sexually assaulted.

Emotional or psychological abuse is possible if the older person:

  • Seems upset or agitated.
  • Acts withdrawn, doesn't talk or respond, or is paranoid.
  • Shows unusual behavior, such as sucking, biting, and rocking.
  • Reports being verbally or emotionally mistreated.

Signs of neglect may include:

  • Dehydration.
  • Malnutrition.
  • Untreated health problems.
  • Pressure ulcers.
  • Poor personal hygiene.
  • Unsafe or dirty living conditions.
  • Reports from the older person of being mistreated.

Signs of abandonment include leaving an older person at a hospital, nursing facility, shopping center, or other public location.

Signs of financial abuse include:

  • Sudden changes in a bank account or banking practice. For example there may be withdrawals of large sums of money that can't be explained.
  • Names added to an older person's bank card.
  • Abrupt changes in a will or other financial document.
  • Missing funds or valuable possessions.
  • Unpaid bills or substandard care even though funds are available.
  • Evidence of the older person's signature being forged.
  • Sudden appearance of relatives who have not been involved before.
  • Payment for services that aren't needed.
  • Reports from the older person of financial abuse.

What factors can make abuse more likely?

Elder abuse is a complex problem, and many things can contribute to it. Risk factors include:

  • Domestic violence carried over into the elder years. A large number of elder abuse cases are abuse by a spouse.
  • Personal problems of caregivers. People who abuse older adults (often their adult children) may depend on the older person for financial help and other support. This is often due to personal problems such as mental illness. The risk of abuse seems highest when these adult children live with the older person.
  • Social isolation. Caregivers and family members who live with an older person have the chance to abuse. They often try to isolate the older person from others to prevent the abuse from being seen.

How can you get help?

If you are worried that someone you know might be a victim of elder abuse, talk to your doctor. Ask him or her what to look for, what the risks are, and what help is available.

To report elder abuse or to get help, call Adult Protection Services (APS) in your state.

  • You can find the telephone number for APS by calling directory assistance and asking for the number for the Department of Social Services or Aging Services.
  • If you can't find the telephone number for APS , call Eldercare Locator toll-free at 1-800-677-1116. They can help you find resources in your area. Eldercare is sponsored by the U.S. Administration on Aging.

Credits

Current as of: June 16, 2021

Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Gayle E. Stauffer, RN - Registered Nurse
Kathleen Romito MD - Family Medicine