Elder Abuse
What is elder abuse?
As elders become more physically frail, they are less able to stand up to intimidation or fight back if attacked. They may not see, hear, or think as clearly as they used to, leaving openings for unscrupulous people to take advantage of them. Mental or physical ailments may make them difficult companions for the people who live with them.
Tens of thousands of seniors across the United States are being abused, often by people who are directly responsible for their care.
More than half a million reports of abuse against elderly Americans reach authorities every year, and millions of other cases go unreported.
Where does elder abuse take place?
Elder abuse tends to take place where the senior lives: most often in the home where abusers are apt to be adult children; other family members such as grandchildren; or spouses/partners of elders. Institutional settings, especially long-term care facilities can also be sources of elder abuse.
What are the different types of elder abuse?
At first, you might not recognize or take seriously signs of elder abuse. They may appear to be symptoms of dementia or signs of the elderly person’s frailty — or caregivers may explain them to you that way. In fact, many of the signs and symptoms of elder abuse do overlap with symptoms of mental deterioration, but that doesn’t mean you should dismiss them on the caregiver’s say-so.
General signs of abuse
The following are warning signs of some kind of elder abuse:
- Frequent arguments or tension between the caregiver and the elderly person
- Changes in personality or behavior in the elder
Signs and symptoms of specific types of abuse:
Physical abuse
- Unexplained signs of injury such as bruises, welts, or scars, especially if they appear symmetrically on two sides of the body
- Broken bones, sprains, or dislocations
- Report of drug overdose or apparent failure to take medication regularly (a prescription has more remaining than it should)
- Broken eyeglasses or frames
- Signs of being restrained, such as rope marks on wrists
- Caregiver’s refusal to allow you to see the elder alone
Emotional abuse
In addition to the general signs above, indications of emotional elder abuse include
- Threatening, belittling, or controlling caregiver behavior that you witness
- Behavior from the elder that mimics dementia, such as rocking, sucking, or mumbling to oneself
Sexual abuse
- Bruises around breasts or genitals
- Unexplained venereal disease or genital infections
- Unexplained vaginal or anal bleeding
- Torn, stained, or bloody underclothing
Neglect by caregivers or self-neglect
- Unusual weight loss, malnutrition, dehydration
- Untreated physical problems, such as bed sores
- Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
- Being left dirty or unbathed
- Unsuitable clothing or covering for the weather
- Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards)
- Desertion of the elder at a public place
Financial exploitation
- Significant withdrawals from the elder’s accounts
- Sudden changes in the elder’s financial condition
- Items or cash missing from the senior’s household
- Suspicious changes in wills, power of attorney, titles, and policies
- Addition of names to the senior’s signature card
- Unpaid bills or lack of medical care, although the elder has enough money to pay for them
- Financial activity the senior couldn’t have done, such as an ATM withdrawal when the account holder is bedridden
- Unnecessary services, goods, or subscriptions
Healthcare fraud and abuse
- Duplicate billings for the same medical service or device
- Evidence of overmedication or undermedication
- Evidence of inadequate care when bills are paid in full
- Problems with the care facility:
- Poorly trained, poorly paid, or insufficient staff
- Crowding
- Inadequate responses to questions about care
Risk factors for elder abuse
It’s difficult to take care of a senior when he or she has many different needs, and it’s difficult to be elderly when age brings with it infirmities and dependence. Both the demands of caregiving and the needs of the elder can create situations in which abuse is more likely to occur.
Risk factors among caregivers
Many nonprofessional caregivers — spouses, adult children, other relatives and friends — find taking care of an elder to be satisfying and enriching. But the responsibilities and demands of elder caregiving, which escalate as the elder’s condition deteriorates, can also be extremely stressful. The stress of elder care can lead to mental and physical health problems that make caregivers burned out, impatient, and unable to keep from lashing out against elders in their care.
Among caregivers, significant risk factors for elder abuse are
- Inability to cope with stress (lack of resilience)
- Depression, which is common among caregivers
- Lack of support from other potential caregivers
- The caregiver’s perception that taking care of the elder is burdensome and without psychological reward
- That taking care of the elder is burdensome and without psychological reward
Even caregivers in institutional settings can experience stress at levels that lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited to caregiving, or work under poor conditions. The elder’s condition and history
Influences that place an elder at high risk:
- The intensity of an elderly person’s illness or dementia
- Social isolation; i.e., the elder and caregiver are alone together almost all the time
- The elder’s role, at an earlier time, as an abusive parent or spouse
- A history of domestic violence in the home
- The elder’s own tendency toward verbal or physical aggression
In many cases, elder abuse, though real, is unintentional. Caregivers pushed beyond their capabilities or psychological resources may not mean to yell at, strike, or ignore the needs of the elders in their care.
Reporting elder abuse
If you are an elder who is being abused, neglected, or exploited, tell someone such as a doctor, a friend, or a family member whom you trust. Other people care and can help you.
You can also call Domestic Violence Office Line: 615-896-7377 for the Domestic Violence CrisisLine: 615-896-2012
The person who answers the phone will refer you to a local agency that can help. The Eldercare Locator answers the phone Monday through Friday, 9 am to 8 pm, Eastern Time.
What you can do as a concerned friend or family member
- Watch for warning signs that might indicate elder abuse. If you suspect abuse, report it.
- Take a look at the elder’s medications. Does the amount in the vial coordinate with the date of the prescription?
- Watch for possible financial abuse. Ask the elder if you may scan bank accounts and credit card statements for unauthorized transactions.
- Call and visit as often as you can. Help the elder consider you a trusted confidante.
- Offer to stay with the elder so the caregiver can have a break — on a regular basis, if you can.
How you can protect yourself, as an elder, against elder abuse
- Make sure your financial and legal affairs are in order. If they are not, enlist professional help to get them in order, with the assistance of a trusted friend or relative.
- Keep in touch with family and friends and avoid becoming isolated, which increases your vulnerability to elder abuse.
- If you are unhappy with the care you’re receiving, whether it’s in your own home or in a care facility, speak up. Tell someone you trust and ask that person to report the abuse, neglect, or substandard care.