Elder abuse is a tragic and underreported crime affecting more older adults than the statistics reflect. It is important to recognize signs of elder abuse in the case that your loved one (or anyone), whether living at home or in a long-term care facility, is being victimized. There are various types of elder abuse.
Physical abuse is the use of physical force that may result in bodily injury, physical pain or impairment. Examples may include: hitting, striking (with or without an object), beating, pushing, shoving, shaking, slapping, kicking, pinching, burning, inappropriate use of physical restraints, being kept isolated from seeing others, force-feeding and physical punishment of any kind.
Sexual abuse is non-consensual sexual contact of any kind with any person, including persons incapable of giving consent. Examples may include: unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing.
Emotional abuse is the inflection of anguish, pain or distress through verbal or nonverbal acts. Examples may include: verbal insults, threats, intimidation, humiliation, harassment, infantilism, isolation and the “silent treatment.”
Neglect is the refusal or failure to fulfill any part of a person’s obligations or duties to an elder including failure of a person who has financial and in-home responsibilities to provide necessary care. Examples may include: refusal or failure to provide food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety or other agreed upon services.
Financial abuse is the illegal or improper misuse of an elderly or disabled person’s resources, property, funds, or assets for personal or monetary benefit. Examples may include: cashing Social Security or any other types of checks without permission, abusing joint checking accounts, forging signatures, coercing or deceiving a person to sign a document, improper use of conservatorship, power of attorney, or stealing or misusing money or possessions.
Self-neglect is the behavior of an elderly person that fails to provide for themselves with whatever is necessary to prevent physical or emotional harm and pain and provide for their own health or safety. This excludes situations where mentally competent older persons, who understand their decision consequences, make conscious and voluntary choices. Examples may include: refusal or failure to provide personal hygiene or shelter, pay bills, purchase food, do laundry, and comply with medical instructions.
Signs and Symptoms
Physical abuse: suspicious bruises or other injuries, rope burns or other signs of restraints, sudden change in behavior, caregiver’s refusal to allow visitors, welts, fractures or broken bones, sprains, dislocations, internal injuries, punctures, cuts, open wounds, injury inconsistent with an explanation, broken eyeglasses, medication overdose or underutilization of prescribed drugs, “doctor shopping”.
Sexual abuse: physical evidence of sexual trauma such as bruises around the breasts or genital area, unexplained sexually transmitted disease, genital infections, genital or anal bleeding, torn, stained, or bloody underclothing, hesitation to talk openly, contradictory statements, implausible stories, flirtation or coyness between caregiver and elder.
Emotional abuse: caregiver preventing elder from speaking or seeing visitors, withholding affection, agitation, withdrawal, resignation, non-responsiveness, unusual behavior usually attributed to dementia such as biting, sucking, rocking.
Neglect: dehydration or malnutrition without illness-related cause, unattended health problems, poor color, sunken cheeks and eyes, unsanitary and unclean living conditions that include dirt, lice, fleas, soiled clothing or bedding, fecal/urine smell, lack of necessities, lack of personal effects, hazardous or unsafe living conditions, inappropriate administration of medicine.
Financial abuse: unpaid bills, missing papers and credit cards, caregiver’s refusal to spend money on the elder, elder unaware of monthly income, sudden changes in bank account or banking practice, abrupt changes in a will or other documents, frequent expensive gifts to caregiver, provision of unnecessary services, inclusion of additional names on accounts, unexplained disappearance of funds, sudden appearance of uninvolved relatives.
Self-neglect: malnutrition, poor personal hygiene, dirty and unkempt clothing, excessive fatigue and listlessness, unmet medical or dental needs, lack of food in the home, hazardous and unsafe living conditions, home in a state of filth or disrepair, and depression.
Reporting abuse is beneficial for many reasons. It is empowering to the older person being mistreated, it links the older person to appropriate community resources, it prevents further harm to the older adult and it results in the situation being assessed by a professional.
National Center on Elder Abuse (NCEA): www.elderabusecenter.org
Adult Protective Services (APS): 877-477-3646