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
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
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
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
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
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
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
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
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
Broken bones, including the skull.
dislocations, or internal injuries.
Broken eyeglasses or
Signs of being restrained.
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
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
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
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
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.
ByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP – Emergency Medicine Adam Husney, MD – Family Medicine Kathleen Romito, MD – Family Medicine Specialist Medical ReviewerGayle E. Stauffer, RN – Registered Nurse Kathleen Romito, MD – Family Medicine