Understanding Elder Abuse

Elder abuse involves physical, emotional, financial, or sexual harm inflicted upon an elderly adult by someone who is responsible for their care — and sadly, it’s more common than you may think. Approximately one in 10 people over 60 years old who live at home experience abuse, according to the Centers for Disease Control and Prevention. And general consensus says that number is likely to be much higher, as most cases of elder abuse go unnoticed or unreported.

Societal attitudes within different communities and cultures can also play a role. In societies where older people are not valued or are seen as a burden, abuse often goes unnoticed or unreported. And the same goes for cultures that believe family problems are private and should not be interfered with, allowing elder abuse to continue unchecked.

Over time, abuse can significantly impact a person’s physical and mental health, erode relationships and community bonds, and create undue financial burden — research even suggests that people who suffer from long-term abuse are at an increased risk of mortality.

Types of Elder Abuse

Elder abuse is a complex issue that can manifest in various ways. Understanding different types of elder abuse and being able to identify the warning signs early on is critical to preventing abuse.  

1. Physical abuse includes the intentional use of force against an elderly person to inflict physical pain, injury or impairment. This could be slapping, shoving, hitting, or pushing. It also involves inappropriate restraining, withholding drugs or medical care, or any physical punishments such as confinement.
2. Verbal, emotional, or psychological abuse is the treatment of an older adult in a way that could cause emotional or psychological distress. This can range from yelling, swearing, threatening, insulting, humiliating or repeatedly ignoring someone. It can also include isolating someone from loved ones or habitually blaming them for conflicts. 
3. Sexual abuse is any sexual contact or advances made toward an elderly person without their consent. Sexual abuse also consists of photographing someone in suggestive poses, forcing the person to look at pornography, or any other unwanted sexualized behavior.
4. Caregiver neglect can be intentional or unintentional, and involves failing to meet the physical, social, or emotional needs of the older person — including failure to provide food, water, clothing, medications, assistance with daily activities or help with personal hygiene.
5. Financial abuse is unauthorized use of an elderly person’s money or property by a caregiver or outside scammer. Seniors lose at least $2.6 billion a year due to financial abuse from forged checks, embezzled retirement or Social Security benefits, or unauthorized use of bank accounts, credit cards or personal checks. A more in-depth study by the AARP estimates that number could be as high as $28.3 billion. Financial abuse could also look like changing names on a will, life insurance policy, or title to a house without permission, as well as investment frauds, and false prize scams.
6. Healthcare fraud is abuse by unethical healthcare providers, including double-billing or charging for services that were not provided, getting kickbacks, falsifying Medicare claims, overmedicating and recommending unnecessary procedures or remedies. 

Warning Signs of Elder Abuse

Many of the signs of elder abuse can seem similar to the symptoms of dementia or mental deterioration. Frequent arguments or tension between the caregiver and older adult or changes in the personality of the elder can signal abuse.

If you suspect abuse, but aren’t sure, look to see if the older adult:

• Seems depressed, confused, or withdrawn.
• Isolates from friends and family.
• Has unexplained bruises, burns, or scars.
• Appears dirty, underfed, dehydrated, over-or undermedicated, or not receiving needed care for medical problems.
• Has a sudden change in weight or behavior
• Has bed sores or other preventable conditions.
• Shows signs of insufficient care or unpaid bills despite adequate financial resources
• Has large withdrawals from bank accounts or other unusual ATM activity
• Is wearing unsuitable clothing or covering for the weather
• Has suspicious changes in wills, power of attorney, titles, or policies

If you notice any of signs, speak to the person at risk as soon as possible, and enlist the help of their primary care physician who can do a more in-depth assessment (or point you in the direction of a trained professional who specializes in elder abuse).

Who Is At Risk of Suffering Abuse

Anyone can be vulnerable to elder abuse. Elder abuse affects people across all socioeconomic groups, cultures, races, and ethnicities. However, some people are considered to be at higher risk. Those at highest risk of suffering from elder abuse include:

• Adults over the age of 80
• Women, who have been found to be more likely to suffer from elder abuse, and suffer from more severe types of abuse over longer periods of time, according to the NIH
• Those with other physical and mental health conditions, including nearly 50% of people with dementia
• Elders who live alone or are withdrawn
• Seniors who are heavily dependent on caregivers for their basic needs

While these factors increase the risk of elder abuse, it’s important to remember that elder abuse can affect anyone.  

In fact, most elder abuse takes place at home. While the media has raised awareness about elder abuse in nursing homes, 6 out of 10 cases of elder abuse actually occur at home by a family member, according to the National Council on Aging. 

What to Do If You Suspect Abuse

‍If you suspect someone you know is being abused, the first step is to try to find an opportunity to talk to them alone. You can tell them you are worried about them and think something could be wrong. Let them know you are there to support them and offer to get them help.  

Once you’ve spoken to them, report the suspected abuse to Adult Protective Services (APS) so they can assess the situation and develop a long-term care plan. APS is a mandated service available in all U.S. states that can:

• Investigate abuse and risk of harm
• Counsel both the adult suffering from abuse and their family 
• Manage local case-related services like mental health assessments, meal deliveries, home health care, and housekeeping
• Find alternative living arrangements
• Identify available resources
• Manage finances

You can also enter the zip code of the older adult in the Eldercare Locator created by the U.S. Administration on Aging to find the appropriate local agency to report the incidents of abuse to. 

If you think you are being abused or neglected, help is available to you. Remember it is not your fault. Try to talk to someone you trust, if you feel safe enough to do so — whether it’s a family member, friend, doctor, or another member of your community — who can remove you from the unsafe situation or separate you from your abuser. 

Contact APS as soon as you have a chance to do so to report the abuse, or enter your zip code in the Eldercare Locator to find an agency near you that can help. You can also reach out to a hotline for additional support. The Institute on Aging's Friendship Line (1-888-670-1360) is available toll-free, 24/7 for people over the age of 60 and adults living with disabilities. Other available hotlines for seniors include the National Domestic Line (1-800-799-SAFE) and the National Elder Fraud Hotline (1-833-FRAUD-11).

If you think you could be at risk of being abusive or neglecting someone in your care, the first step is to find a way to give yourself a break and ensure there is someone else that can help take care of your care recipient. Enlist the help of their loved ones or arrange respite care to make sure they are being taken care of. Seek out counseling for yourself to identify the underlying causes of your actions and find ways to change the harmful behavior with the help of a professional.

How to Prevent Elder Abuse

The key to preventing elder abuse is education and a strong community network. Adults over the age of 65 and their loved ones should make it a point to learn and identify the signs of abuse, and put systems in place to navigate the transitions that come with aging. 

A strong community network and social support consisting of family, friends, caregivers, healthcare professionals, counselors, and community members eases the stress of caregiver burnout on one person, increases the number of people checking in on and monitoring the mental and emotional well-being of the older adult, and reduces the risk of abuse.

Everyone, regardless of age, deserves to live with safety, dignity, and respect and be free from harm from those responsible for their care. If you see or think you see a suspected case of elder abuse, don’t wait. Contact Adult Protective Services right away, and take the necessary steps to remove the person from the unsafe environment.