Signs of Elder Abuse

A Guide for Family, Spouses, and Caregivers

According to the National Institute on Aging, hundreds of thousands of older adults suffer from elder abuse each year throughout the U.S. This abuse comes in many forms, including physical abuse, emotional abuse, caregiver neglect, and financial exploitation. Often hidden from loved ones and caregivers, elder abuse is a serious problem that deserves our attention. It is our responsibility to know the signs of elder abuse and take action when we suspect something is not quite right. Understanding the warning signs and knowing what to do is crucial for protecting our older adults from harm.

What Constitutes Elder Abuse?

Elder abuse can take many different forms, often occurring simultaneously. Recognizing these different types is the first step in prevention and intervention:

• Physical abuse – The intentional use of force that results in bodily injury, pain, or impairment. This includes hitting, pushing, inappropriate restraint, and force-feeding.
• Emotional/psychological abuse – Causing mental anguish through verbal or nonverbal acts. This includes intimidation, humiliation, isolation, threats, and treating an older adult like a child.
• Sexual abuse – Any nonconsensual sexual contact with an older adult, including those who cannot give consent due to cognitive impairment.
• Neglect – Failure to fulfill caregiving obligations, such as providing adequate food, clothing, shelter, medical care, or hygiene assistance.
• Self-neglect – When an older adult neglects their own care, sometimes due to cognitive decline, depression, or other health issues.
• Financial abuse/exploitation – The improper use of an older adult’s assets, property, or resources. This includes theft, fraud, coercion related to wills or assets, and unauthorized use of funds.
• Abandonment – Desertion of an older adult by someone who has assumed responsibility for their care.

Where Does Elder Abuse Occur?

Elder abuse isn’t limited to any single environment. It can happen in various settings, which is why vigilance is necessary across all locations where older adults spend time.

The American Psychological Association reports that home environments are often where abuse goes undetected the longest. Contrary to popular belief, most elder abuse occurs in the home, often perpetrated by family members, spouses, or trusted caregivers. The familiarity and privacy of home settings can sometimes mask ongoing abuse.

Other common locations include:

• Long-term care facilities – These include nursing homes and assisted living centers, where abuse occurs by staff or other residents.
• Medical settings – Elder abuse sometimes occurs in hospitals and outpatient facilities.
• Community settings – Older adults may experience abuse in public spaces, religious organizations, or senior centers, often in the form of financial scams or emotional manipulation.

Warning Signs of Elder Abuse

If you are a concerned family member, spouse, or caregiver, it is imperative to be alert to possible indicators of abuse. Warning signs often fall into several categories:

Physical Signs

• Unexplained bruises, welts, or fractures.
• Broken eyeglasses or other assistive devices.
• Signs of restraint, such as rope marks on wrists.
• Laboratory findings of medication overdose or underuse.
• Pressure sores or poor hygiene.

Behavioral Changes

• Withdrawal from normal activities.
• Depression or anxiety.
• Unusual changes in sleep patterns.
• Fear or nervousness around certain people.
• Hesitation to speak openly.
• Contradictory statements or implausible explanations for injuries.

Pay particular attention to the relationship dynamics you observe. Concerning caregiver behaviors might include:

• Preventing the older adult from speaking to or seeing visitors.
• Displaying indifference or aggressive behavior toward the older adult.
• Having a history of substance misuse, mental illness, or abusing others.
• Portraying the older adult as incompetent or crazy.
• Expressing excessive concern about costs despite adequate resources.

The physical environment can also provide important clues:

• Unsafe living conditions (no heat, running water, etc.).
• Clutter, filth, or hoarding conditions.
• Missing medical aids (glasses, walkers, dentures, hearing aids).
• Unpaid bills despite adequate finances.

Why Older Adults May Hide Abuse

Understanding why older adults might conceal abuse is crucial for intervention. Many complex factors can prevent older adults from disclosing abusive situations.

Fear often dominates the decision to remain silent. Many older adults worry that reporting abuse will result in worse treatment or more severe abuse. This fear can be especially pronounced when the older adult is dependent on their abuser for essential care.

Emotional barriers also play a significant role:

• Shame and embarrassment – Victims often feel humiliated that someone they trusted has victimized them, especially if the abuser is a family member.
• Protection of the abuser – When the abuser is a loved one, such as an adult child, the older adult may wish to protect them from legal consequences.
• Dependency concerns – If the older adult relies on the abuser for care, housing, or financial support, they may fear losing this assistance.

Additional factors that contribute to hidden abuse include:

• Cognitive impairment – Conditions like dementia may limit an older adult’s ability to recognize or report abuse.
• Isolation – Abusers often deliberately isolate victims, making it difficult for them to seek help or support.
• Cultural or generational factors – Some older adults come from generations or cultures where family problems were considered private matters.

How To Help

If you suspect elder abuse, taking thoughtful, deliberate action is essential:

1. Maintain open communication with your older loved one in a private, safe setting.
2. Document observations, including dates, times, and specific incidents.
3. Report suspected abuse to Adult Protective Services in your area or call the Eldercare Locator at 1-800-677-1116.
4. In emergencies, contact local law enforcement immediately.
5. Consult with professionals such as doctors, social workers, or elder law attorneys who can provide guidance.
6. Offer ongoing support to the older adult, regardless of whether they choose to take action about the abuse.

Early intervention is key to preventing further harm. By staying vigilant and responsive to the signs of elder abuse, you can help ensure that older loved ones live with the dignity, respect, and safety they deserve.

How Right at Home Can Help

Right at Home’s professional in-home care services help aging loved ones. Professional caregivers assist clients with personal care, health care management, and general daily tasks. They provide watchful supervision for frail seniors and those with dementia. They lessen the workload for family caregivers and liaise with family members who live at a distance. All Right at Home caregivers are thoroughly screened, supervised, and trained to ensure clients’ well-being and safety. To find out more, use our office locator and ask for a free in-home consultation.

Interested in receiving monthly tips, information, and advice about caring for an aging loved one? Subscribe to our Caring Right at Home e-newsletter today.