According the National Council on Aging (NCOA), 6 out of 10 elders, defined as anyone 60 and over, have experienced some form of abuse. 

The World Health Organization estimates an even higher number. Studies cited by the NCOA, find that victims of elder abuse are more likely to die prematurely than other older adults. To protect our aging population from abuse, we need to understand what elder abuse is and how to recognize the symptoms when it occurs. 

Elder abuse is the infliction of harm, of any kind, on a person 60 years old or older. Abuse can be physical, psychological, sexual or financial. Elders can also suffer abuse through neglect, abandonment, harassment or exploitation. 

Elder abuse can include any of the following: 

Physical Abuse – Hitting, kicking, pinching, burning, inappropriate physical restraint, ignoring behavior and neglect 

Psychological or Emotional Abuse – Bullying, name calling, verbal abuse, intimidation, controlling behavior, persistent ignoring 

Sexual Abuse – Inappropriate touching, involuntary engagement in sexual acts, or exposure to pornographic acts or materials 

Financial Abuse – Stolen cash, unauthorized use of credit cards, embezzlement schemes, harassment by scammers or medical insurance fraud, including Medicare or Medicaid fraud 

Who are the Victims of Elder Abuse? 

Any senior experiencing a loss of independence with increasing reliance on others for care, is at risk for elder abuse. Seniors suffering from alzheimer’s disease, dementia, mental illness, significant physical disabilities, and elderly social isolation, are especially vulnerable to abuse. 

Although both women and men suffer from elder abuse, women are victimized more often. A woman who has been abused by her husband throughout her marriage, is likely to continue to be abused once she has difficulty caring for herself. Because some marriages have a long history of conflict or even domestic abuse, complications of aging may increase the temptation to abuse or abandon an ailing spouse. 

Who Abuses the Elderly? 

Elder abuse can be inflicted by anyone who interacts closely with an older adult, including relatives, caregivers, nursing home staff, friends, neighbors and medical or mental health professionals. Additionally, seniors can be victims of exploitation or harassment by scammers or other fraudulent actors. 

Some elder abuse is unintentional. It is not uncommon for problems to develop when elderly caregivers attempt to take on the care of a loved one. When a senior needs help at home, spouses often, voluntarily or involuntarily become the designated caregivers of a husband or wife. As the dependent elder’s condition deteriorates, their spouse may not have have the skills, strength, or stamina needed to provide the level of care needed. In these cases, the elderly caregiver may also need protection. 

What are the Signs and Symptoms of Elder Abuse? 

If you work with elders, have elderly parents, or other relatives, friends or neighbors, who depend on day-to-day help, it is crucial to know how to recognize the signs of elder abuse. 

Symptoms of abuse come in many forms: 

Physical Abuse 

  • Unexplained bruises, bone fractures or other injuries
  • Cuts or burns
  • Repetitive injuries
  • Reluctance to see a medical professional for injuries

Psychological and Emotional Abuse 

  • New onset of depression, anxiety, or trouble sleeping
  • Addiction or substance abuse
  • Loss of interest in activities
  • Emotional withdrawal and isolation
  • Unexplained changes in behavior

Sexual Abuse 

  • Unexplained tears in clothing
  • Blood in the genital area or on clothing
  • Bruising around the genitals or breasts
  • Bleeding in the genital area
  • Sexually transmitted diseases or vaginal infections

Financial Abuse 

  • Unusual bank withdrawals
  • Unusual medical or credit card charges
  • Missing papers, such as financial statements or other documents
  • Unpaid bills, shut-off or warning notices from utilities and other service providers
  • A new, overly-involved friend or “helper”
  • Someone pushing for power of attorney

Seniors and their families should be on their guard for identity theft, and follow-up if they suspect financial fraud. Scams in Medicare and Medicaid billing have grown tremendously over the past decade, and can affect the level of care elders receive. Medical providers may bill for procedures not performed or perform expensive procedures that aren’t necessary. Medicare or Medicaid might also be charged for more expensive drugs or equipment than were ordered by the health care provider. The senior may also be furnished with inferior medical equipment, while Medicare is billed for newer, more expensive versions. 

Other Types of Abuse: Neglect and Abandonment 

Symptoms of neglect may surface when a caregiver either ignores an elder’s needs or refuses to help the elder with basic care, such as bathing and other hygiene needs, putting on clean clothes, and making sure the elder is taking adequate nourishment. Disregard for household or financial upkeep and carelessness about medical appointments or prescriptions are also forms of abuse. Caregivers, guilty of physical neglect of a person in their care, are also guilty of emotional neglect, which often increases social isolation. Persistent physical neglect, as well as emotional neglect, can be serious threats to an older adult’s safety. 

Be Alert for These Signs of Neglect: 

  • Unkempt appearance 
  • Unsanitary living conditions
  • Bedsores or bruising
  • Appetite changes or weight loss, depression 
  • Broken or missing glasses or dentures
  • Caregivers not arriving or completing shifts as scheduled

Elder abandonment may happen when a caretaker no longer feels able to cope with the level of care the dependent elder needs. Elders have been abandoned in hospitals, nursing homes, and even in public locations. In some cases, a caregiver may abandon their dependent spouse for another relationship. Abandonment can also occur when an elder is isolated from other family members through physical distance or ongoing family conflicts. In these cases, family members may not even realize their loved one is at risk. If you are concerned about a case of elderly abandonment, you can call adult protective services for help. 

How Does Abuse Get Reported? 

An elderly abuse victim may be too fearful of their abuser to seek help, or may try to hide their situation because of embarrassment or shame. The victim may also want to protect the abuser if he or she is a close family member, such as a spouse or an adult child. 

Limited communication ability may prevent some victims of abuse from getting help. A patient in recovery after a stroke, or an elder suffering from dementia or alzheimer’s or another cognitive impairment, may be unable to verbally report abuse. Abusers will sometimes even consciously engineer the loss of regular social contact for the vulnerable adult to hide the signs and symptoms of their abuse.

Concerns about abuse can come from several sources; caregivers may suspect family members of inflicting abuse in their absence, or family members may suspect that one or more hired caregivers are guilty of abuse. Physicians, nurses, and other medical care professionals may spot symptoms of abuse that need to be followed up on. 

If you suspect your elderly friend, relative or patient is being abused, talk to them, explain that you are concerned about their well-being, and invite them to confide in you. If the elder is reluctant to talk and you feel uncomfortable sharing your concerns with others close to the situation, you can ask Adult Protective Services to get involved and make an assessment. 

If the at-risk individual lives in an assisted living facility or nursing home, the suspected abuse can be reported to a long-term care ombudsman. The federal Older Americans Act  requires every state to have an Ombudsman Program. A long-term care ombudsman is trained to assist with complaints and advocate for residents of any long-term care facility. 

If you recognize a truly dangerous situation, alert law enforcement right away. 

If you are a victim of elder abuse yourself, it is crucial that you tell someone you trust, and get help immediately. Continued abuse can lead to serious health and safety issues. Senior aid organizations, staffed by specially trained professionals, are standing by to offer help. 

Financial Issues and Care 

Many families do not have the financial means to hire the high-skilled help they need and try to manage without professional help for much too long. Added stress on the family can create the risk of an abusive situation for the dependent elder. Hiring help, while expensive, does not always guarantee excellent care. In most states, while training is recommended for agency caregiver jobs, usually about 8 hours, it is not required. In-home care can be a demanding and challenging job at times. It is crucial to obtain the most dependable care possible.

For situations where an elder is in need of social interaction, or help with errands and help at home with light household chores, caregiver jobs can be filled by senior helpers. There are agencies throughout the United States that train and provide senior helpers eager to help elders in need. 

Most states or counties have additional agencies and elder services with the resources to handle cases of elder abuse. These include: the National Center on Elder Abuse (NCEA), Area Agencies on Aging, and Medicaid Fraud Control Units (MFCU) 

If you suspect an elder is in imminent danger, call 911 immediately.