How to Recognize and Address Elder Abuse

Elder abuse: An intentional act or failure to act by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult (defined as someone age 60 or older).
–The Centers for Disease Control & Prevention

According to the CDC and the National Council on Aging, elder abuse, including neglect and exploitation, is experienced by 1 out of every 10 seniors, age 60 and older, who live in a private home (their own or someone else’s). Using that stat, approximately 5 million elders are abused each year. But that just tells part of the story since one study by the National Research Council estimated that only 1 in 14 cases of abuse in private homes is ever reported to authorities. Suffice it to say, the numbers are staggering.

Types of elder abuse

“Elder abuse” is a fairly general term and can encompass many different sub-categories including:

Abandonment – leaving a senior by themselves without making provisions for their care.
Confinement – an older person is restrained or intentionally kept in isolation, other than for medical reasons.
Emotional abuse, also called psychological abuse – a caregiver using hurtful words, yelling, threatening or intimidation, harassing, or repeatedly ignoring the older person. Keeping a senior from seeing close friends and family is another type of emotional abuse.
Financial exploitation – the misuse or withholding of a senior’s resources.
Passive neglect – the caregiver does not attempt to respond to the senior’s needs or reasonable requests.
Physical abuse – inflicting physical harm by hitting, pushing, or slapping a senior.
Sexual abuse – a caregiver forcing an older adult to watch or be part of sexual acts, often when the older adult is unable to understand or consent.
Willful deprivation – denying medication, medical care, shelter, food, a therapeutic device, or other physical assistance; there is an exception when a competent senior has expressed a desire to go without such care (such as in the case of advance directives).

Victims and the impact

The most common form of elder abuse is financial exploitation, followed by physical abuse, neglect, and emotional abuse. The severity of abuse can vary greatly, but studies have shown that victims of even mild elder abuse are at a 300 percent increased risk of dying in the three years after mistreatment (as compared to non-abused seniors). This fact may be attributable to the already-vulnerable state of many abuse victims.

It is important to emphasize that almost 90 percent of all elder abuse cases take place in a private home, most often perpetrated by a caregiver. The abuser may be a hired home health worker or a “friend,” but statistically, elder abuse is most likely to be committed by a family member. In fact, two-thirds of all elder abuse is committed by the senior’s own spouse or adult child.

Women and the elderly (seniors over the age of 80) are at the greatest risk for being abused. Other important risk factors to consider include dementia or other neurodegenerative conditions, social isolation, and poor physical health, as well as mental health and substance abuse issues of both the abuser and the victim. Learn more about elder abuse risk factors.

What to look for

Elder abuse can be challenging to recognize, especially when it is of the emotional variety. The Administration on Aging suggests looking for these signs of potential elder abuse:

Any change in personality or behavior including unexplained withdrawal from normal activities, a sudden change in alertness, or unusual depression
Bruises, pressure marks/bedsores, broken bones, abrasions, or burns
Bruises or injury around the breasts or genital area
A sudden change in financial situation (for either the senior or the suspected perpetrator)
Unaddressed medical needs, poor hygiene, or unusual weight loss
Belittling or threatening language, or other uses of control by a caregiver
Strained or tense relationships including frequent arguments between caregiver and senior

What to do if you suspect elder abuse

If you believe your loved one is being mistreated in their home by a caregiver, it is imperative that you speak up and become their advocate. You should report any suspected case of abuse in the home to adult protective services or law enforcement. Then–it is time to consider other care options.

Abuse in senior living communities is less common than in a private homes, although 7 percent of all complaints regarding institutional facilities reported to the Long-Term Care Ombudsman advocacy group were about abuse, neglect, or exploitation. Most facilities have internal and external oversight protocols to ensure residents are treated with compassion and dignity. In the event a resident is mistreated, most retirement facilities have clear procedures in place for employees to report their suspicions, as well as a zero tolerance policy towards elder abuse.

>> Learn about retirement communities in your area

You should also consider getting support to heal the emotional wounds suffered by the victim of the abuse, especially if they are acting fearful or depressed, or if they believe they are at fault for the abuse. Your local protective services agency can suggest support groups and counseling options.

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