How to Detect Signs of Elder Abuse

Mar 28, 2016

How to Detect Signs of Elder Abuse

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Every year, approximately 5 million elderly Americans are victims of various forms of abuse. It is possible that the statistic is understated, as only 1 in 23 cases of abuse is reported. This is alarming because the quality of life in abused older individuals is endangered. Victims of abuse may experience feelings of helplessness and loneliness along with increased psychological distress. These victims may be subject to worsened functional or financial status and increasing dependency.

Contrary to popular belief, the majority of elder abuse does not happen in nursing homes or other assisted living communities. The majority of abuse or neglect happens at home. About 90% of abusers are family members, including adult children, spouses, partners, and others. Research has shown that abused elders have a 300% higher risk of death compared to those who have not been abused. Abused individuals are more likely to die before non-abused older persons, even if they don’t have chronic conditions or life-threatening diseases.

What is Elder Abuse?

Elder abuse is a knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk or harm to a vulnerable adult. There are many different forms of elder abuse including physical assault, financial exploitation, and neglect. The most common forms are described below.

Physical abuse

Physical elder abuse is the use of force against a senior to inflict unnecessary pain or injury. This can include physical assault, physical restraints, or inappropriate use of medications.

Emotional or psychological abuse

Emotional or psychological abuse can range from ignoring the elderly person to intimidation or threatening of the individual.  Speaking or treating the senior in a way that causes emotional pain or distress is abuse.

Sexual abuse

Sexual elder abuse is any type of non-consensual sexual contact of any kind. This includes any physical act as well as forced sexual acts. Forcing a senior to view pornography, photographing the individual in suggestive poses, or coerced nudity are all forms of sexual abuse.

Financial abuse and exploitation

This type of abuse includes the unauthorized taking, misuse or concealment of funds, property, or the assets of a senior.  Other forms of this abuse include forging elder signatures, denying them access to their funds or property and identity theft.

Healthcare fraud or abuse

Unethical doctors, nurses, hospital personnel and other professional care providers can carry out this type of abuse. Examples of abuse include not providing care but charging for it, overcharging for services or recommending fraudulent remedies for illness or conditions.

Caregiver neglect or abandonment

Elder neglect is the failure to fulfill caretaking obligations and can be intentional or unintentional. There is a difference between elder abuse and neglect. Neglect includes abandonment or desertion of a senior by the person responsible for their care. Failing to meet physical, social or emotional needs of a senior are classified as abuse. Other forms of this type of abuse include not providing food, water, clothing, medications, or not helping with elder hygiene.

How do you detect elder abuse?

Some people do not recognize the signs of elder abuse or think that the symptoms they are witnessing are signs of senior frailty, or getting older. While it is true that many of the signs of abuse do overlap with symptoms of mental deterioration, you should not dismiss them just because a caregiver says so. If you observe signs of elder abuse, it should be taken seriously.

In general, frequent arguments or tension between the elderly person and caregiver, or changes in the personality or behavior of the senior may indicate abuse. If you suspect elder abuse, look for the following signs and determine their cause:

Physical abuse:

  • Bruising, grip marks, or restraint marks around the neck, arms, wrists or ankles
  • Repeated unexplained injuries
  • Caregiver’s refusal to allow you to see the elder alone

Emotional or psychological abuse:

  • Witnessing threatening or controlling caregiver behavior
  • Uncommunicative or unresponsive
  • Unreasonably fearful or suspicious
  • Unexplained changes in behavior
  • Isolated or lack of interest in social contact

Sexual abuse:

  • Bruising around breasts or genitals
  • Torn or bloody undergarments
  • Unexplained vaginal or anal bleeding
  • Unexplained venereal disease or infections

Financial abuse or exploitation:

  • Sudden changes in elder’s financial condition
  • Unpaid bills or lack of medical care though the senior has enough money for them
  • Suspicious financial activity including significant withdrawals from the elder’s account, or signatures on checks that don’t match the elder’s signature

Healthcare fraud and abuse:

  • Duplicate billings for same medical device or service
  • Evidence of overmedication or under medication
  • Evidence of inadequate care though bills are paid in full
  • Problems with care facility including poorly trained or insufficient staff members

Caregiver neglect or abandonment:

  • Lack of basic hygiene, clean or appropriate clothing, or food and water
  • Unsanitary living conditions
  • Person with dementia left unsupervised
  • Untreated bedsores
  • Lack of medical aids including glasses, walkers, teeth, hearing aids or medications.

If you suspect abuse and recognize any of these symptoms, investigate why they are happening. For various reasons, many seniors will not report their abuse, even if they are able to do so. If you suspect or witness elder abuse, do not hesitate to report it.  No matter how frustrating for caregivers, elder abuse is never okay. Older adults still deserve dignity and respect, so if you believe that a senior is being abused, do not be reluctant to report and stop the abuse, and get the abuser the help they need.

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Frequently Asked Questions

Who are usually the elder abuse offenders?

Elder abuse offenders can be family members, friends, neighbors, service providers, professionals, or strangers. However, 90 percent of abusers are family members which may include adult children, spouses, or partners. If you are concerned that an elder you know is being abused, find your state elder abuse hotline. If it is an emergency, call 911.

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Who usually fields elder abuse reports?

In most cases, the Adult Protective Services (APS) will field any elder abuse complaints. There are a variety of ways to contact APS including phone, email, and text messaging. Their website has a list of state elder abuse hotlines, but if it is an emergency, call 911.

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