Preventing Elder Abuse and Neglect in Older Adults
Tools and Tips
As adults grow older they may become more physically frail, may not see or hear as well as they used to, and may develop cognitive problems such as dementia. As a result, they become increasingly vulnerable to abuse and neglect.
The mistreatment of older adults takes many forms, including physical, verbal, emotional and sexual abuse, financial exploitation, and neglect. According to the National Center on Elder Abuse, the number of older adults who are mistreated each year is close to 5 million and is rising.
This is the case even though incidents of abuse often go unreported. Why aren’t they reported? Victims of elder abuse and neglect may feel ashamed of their abusive experiences. Those who consider reporting abuse often choose not to because, in the majority of cases, they are abused by a family member, loved one, or trusted caregiver. It can be extremely difficult to tell others that someone you trust and love is abusing or neglecting you. Making matters worse, abusers often blame their victims, telling them that the abuse is their “fault,” and threatening them if they reveal the abuse to anyone. If the older person is dependent on the abuser for care, he or she may feel as if he or she has no option but to live in fear and pain. An older person who is new to this country or who has difficulty speaking English may not know how to get help.
If you are experiencing abuse or suspect that an older adult you know is a victim of abuse, seek help. No one, regardless of age, should be exploited or subjected to harm or abuse by another; it is never “deserved.” It is against the law, and immediate and long-term help is available to victims. If you are unsure if you or an older loved one is being neglected or abused by a caregiver or family member, but suspect that this might be the case, don’t turn your back on an older adult who needs your help. You might be afraid to get involved, but it is important to speak up about suspected abuse. Rest assured that trained experts who investigate charges of abuse and neglect will examine the situation carefully and then take action to protect the safety of the older adult if necessary.
Here, from the American Geriatrics Society’s Foundation for Health in Aging, is advice that will help you recognize, report, and stop elder abuse.
Recognize the warning signs
- In an older adult: Be on the lookout for an older friend or acquaintance who seems to be in a troubling situation but is reluctant to answer questions about it. If he or she appears hungry, unclean, frightened of his or her caregiver, is frequently bruised, ill, neglected, or often confused, this may indicate abuse. Changes in personality—such as a lack of interest in activities that he or she used to enjoy, or unusual nervousness—may also be signs of a problem such as abuse. If you can’t get more information, trust your gut: if something doesn’t feel right, it probably isn’t.
- In a caregiver: If you see a caregiver attempting to dominate an older adult that may be a warning sign of abuse. If the caregiver is verbally or physically abusive to the older person, to you or anyone around you; if there is evidence of substance abuse or mental health problems in the caregiver; or if the caregiver is financially dependent on the older adult and expresses continual concern about money, this is cause for concern.
- In the home: If an older adult or caregiver won’t let others into the home there may be a problem. Signs that something is wrong in and around the home include an accumulation of newspapers and mail; a lack of attention to the home or a home that is in a state of disrepair; large numbers of people using the home; and odd noises or bad odors coming from the home.
Look for the following signs of elder mistreatment
- Neglect: An older adult who is wearing soiled clothing, is dirty, looks malnourished, has untreated physical problems, or is wearing inappropriate clothing for the weather should draw your attention.
- Financial abuse: Unusual patterns of spending or withdrawals from an older adult’s account; frequent purchases of inappropriate items; bank account withdrawals made in spite of penalties; bills going unpaid; utilities being turned off; or the presence of a “new best friend” who is accepting generous “gifts” from the older adult may all be signs that he or she is being taken advantage of financially.
- Physical abuse: Look for bruises, especially on the head or torso, and those shaped like a hand, finger or thumb. Pressure or “bed” sores – a painful breakdown of the skin that can cause anything from mild redness and swelling to deep wounds and infections – may be evidence of neglect. Look for unexplained burns or other signs of harm. Giving older adults unnecessary tranquilizers or sleeping pills, confining an older person, or tying him or her to a bed or a wheelchair are all forms of physical abuse. So is denying an older person adequate food and water, needed medications, and helping devices such as canes, walkers, hearing aids, and glasses.
- Emotional/psychological abuse: Intimidating, yelling, threatening, humiliating and ridiculing are all forms of emotional abuse. Isolating an older adult from friends and keeping him or her from activities he or she enjoys for no good reason, is a form of abusive control.
- Sexual abuse: If an older adult suffers from unexplained anal or vaginal bleeding, has torn or bloodied underwear or bruises around the breasts or genitals, be concerned. An unexplained genital infection warrants a conversation with the older adult’s healthcare provider. If you don’t know the name of the healthcare provider, try to get more information about the infection from the older adult and contact the authorities.
Know who is most likely to abuse an elder Don’t assume that a loved one couldn’t possibly be abusing an older adult. Ninety percent of abusers are, in fact, family members. Of family members who abuse seniors, 50% percent are adult children and 20% are intimate partners. Other abusers include friends, neighbors, and service providers. Men and women abuse older adults almost equally: 48% of abusers are women; 52% are men. One-third of abusers are themselves seniors.
Understand which elders are most vulnerable to mistreatment More than half of older victims are older than 80. Two-thirds are women. Sixty percent of abuse victims show signs of dementia or confusion and more than 40% show signs of depression.
Get help If you are an older adult who is being abused, neglected or exploited, tell at least one person – your healthcare provider, a friend or a trusted family member and give them this information so that they can help you. If you suspect that an older neighbor, acquaintance, friend, or relative is being abused, neglected or exploited, tell someone you know who can help, call Adult Protective Services, (APS), or both. You don’t have to have proofof abuse or neglect; if you’re concerned that this is happening, you should call.
When you call for help, your name remains confidential. A representative from APS will then come to the home and interview the older adult to determine if he or she needs assistance or needs to be rescued. Call 911 or the local police for immediate help or if you or a loved one is in immediate danger.
Get more information Contact the National Center on Elder Abuse (NCEA) at 1-800-677-1116.
You can call Monday through Friday, 9 a.m. to 8 p.m., Eastern Time. You can also visit the NCEA’s website, at www.ncea.aoa.gov
You can find more information and resources on the University of California, Irvine Center of Excellence on Elder Abuse and Neglect, at www.centeronelderabuse.org