Topic Overview

Elder abuse refers to any of several forms of maltreatment of an
older person by a caregiver, family member, spouse, or friend.

Categories of elder abuse

The 1987 Amendment to
the Older Americans Act identified three separate categories of elder abuse:

  • Domestic elder abuse
    usually takes place in the older adult’s home or in the home of the caregiver.
    The abuser is often a relative, close friend, or paid
    companion.
  • Institutional abuse refers to
    abuse that takes place in a residential home (such as a nursing home), foster
    home, or assisted-living facility. The abuser has a financial or contractual
    obligation to care for the older adult.
  • Self-neglect is behavior of an older adult that threatens his
    or her own health or safety. Self-neglect is present when an older adult
    refuses or fails to provide himself or herself with adequate food, water,
    clothing, shelter, personal hygiene, medicine, and safety precautions.

Acts of elder abuse

Elder abuse can
include:

  • Acts of violence, such as hitting, beating,
    pushing, shoving, shaking, slapping, kicking, pinching, choking, or burning.
    The inappropriate use of medicines or physical restraints, force-feeding, and
    physical punishment of any kind also are examples of physical
    abuse.
  • Forced sexual contact or sexual contact with any person
    incapable of giving consent. It includes unwanted touching and all types of
    sexual assault or battery, such as rape, sodomy, forced nudity, and sexually
    explicit photography.
  • Emotional or psychological abuse, such as
    name-calling, insults, threats, intimidation, humiliation, and harassment.
    Treating an older person like a baby, giving an older person the “silent
    treatment,” and isolating him or her from family, friends, or regular
    activities are examples of emotional or psychological
    abuse.
  • Neglect, such as failing to provide an older person with
    food, clothing, personal shelter, or other essentials, such as medical care or
    medicines. Neglect can also include failing to pay nursing home or
    assisted-living facility costs for an older person if you have a legal
    responsibility to do so.
  • Abandonment or desertion of an older
    person by a person who has the physical or legal responsibility for providing
    care.
  • Illegal or improper use of an older person’s funds, property,
    or assets. This includes forging an older person’s signature, stealing money or
    possessions, or tricking an older person into signing documents that transfer
    funds, property, or assets.

Risk factors for elder abuse

Abuse of elders is a
complex problem with many contributing factors. Risk factors include:

  • Domestic violence carried over into the elder
    years. A substantial number of elder abuse cases are abuse by a
    spouse.
  • Personal problems of caregivers. People who abuse older
    adults (particularly their adult children) are often dependent on the older
    person for financial help and other support. This is often due to
    personal problems such as mental illness or other dysfunctional personality
    traits. The risk of elder abuse seems highest when these adult children live
    with the older person.
  • Social isolation. Caregivers and family
    members who live with an older person have the opportunity to abuse and often
    attempt to isolate the older person from others to prevent the abuse from being
    discovered.

Signs of elder abuse

Signs and symptoms of elder
abuse vary widely depending on the type of abuse.

  • Signs that an older person is the victim of
    acts of violence may include:

    • Bruises, black eyes, welts, lacerations,
      rope marks, cuts, punctures, or untreated injuries in various stages of
      healing.
    • Broken bones, including the skull.
    • Sprains,
      dislocations, or internal injuries.
    • Broken eyeglasses or
      dentures.
    • Signs of being restrained.
    • Laboratory reports
      of overdose or underuse of medicines.
    • Reports from the older
      adult of being physically mistreated.
    • An older person’s sudden
      change in behavior.
    • A caregiver’s refusal to allow visitors to see
      an older person alone.
  • Symptoms of possible sexual abuse include
    bruises around the breasts or genital area, unexplained venereal disease or
    genital infections, unexplained vaginal or anal bleeding, underclothing that is
    torn or stained, and reports from the older person of being sexually
    assaulted.
  • Emotional or psychological abuse is possible if the
    older person appears emotionally upset or agitated; acts withdrawn or is
    noncommunicative, nonresponsive, or paranoid; exhibits unusual behavior
    including sucking, biting, and rocking; or if he or she reports being verbally
    or emotionally mistreated.
  • Signs of neglect may include
    dehydration, malnutrition, untreated health problems, pressure injuries, poor
    personal hygiene, hazardous or unsanitary living conditions, and reports from
    the older person of being mistreated.
  • Abandonment includes the
    desertion of an older person at a hospital, nursing facility, shopping center,
    or other public location.
  • Signs of financial exploitation include
    sudden changes in a bank account or banking practice, such as unexplained
    withdrawals of large amounts of money; additional names on an older person’s
    bank card; abrupt changes in a will or other financial document; disappearance
    of funds or valuable possessions; unpaid bills or substandard care despite the
    availability of funds; evidence of the older person’s signature being forged;
    the sudden appearance of previously uninvolved relatives; payment for
    unnecessary services; and reports from the older person of financial
    exploitation.

Help for elder abuse

If you are worried that someone you know might be a victim of elder abuse, talk to your doctor about what to look for, what the risks are, and what help is available.

To report elder abuse or to
get help, call Adult Protection Services (APS) in your
state.

  • You can find the
    telephone number for the APS office by calling directory assistance and
    requesting the number for the Department of Social Services or Aging
    Services.
  • If you cannot find the correct telephone number, call
    Eldercare Locator toll-free at 1-800-677-1116 for assistance in locating
    resources. Eldercare is sponsored by the U.S. Administration on Aging.

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
Adam Husney, MD – Family Medicine
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Gayle E. Stauffer, RN – Registered Nurse
Kathleen Romito, MD – Family Medicine

Current as ofOctober 6, 2017