How to Identify Elder Abuse

Learn to spot the warning signs of elder abuse or neglect to protect loved ones in nursing home care

According to the National Center on Elder Abuse (NCEA), elder abuse is a growing problem. Concerned people can spot the warning signs of a possible abuse problem and make a call for help if an elder is in need of assistance. Following are the main kinds of elder abuse to watch for. Not all elder abuse is physical abuse, some is psychological or financial/fraud.

 

Physical Abuse

Physical abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include but is not limited to such acts of violence as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. In addition, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse. Signs and symptoms:

  • bruises, black eyes, welts, lacerations, and rope marks;
  • bone fractures, broken bones, and skull fractures;
  • open wounds, cuts, punctures, untreated injuries in various stages of healing;
  • sprains, dislocations, and internal injuries/bleeding;
  • broken eyeglasses/frames, physical signs of being subjected to punishment, and signs of being restrained;
  • laboratory findings of medication overdose or under utilization of prescribed drugs;
  • an elder’s report of being hit, slapped, kicked, or mistreated;
  • an elder’s sudden change in behavior; and
  • the caregiver’s refusal to allow visitors to see an elder alone.

 

Sexual Abuse

Sexual abuse is defined as non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. It includes, but is not limited to, unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing. Signs and symptoms:

  • bruises around the breasts or genital area;
  • unexplained venereal disease or genital infections;
  • unexplained vaginal or anal bleeding;
  • torn, stained, or bloody underclothing; and
  • an elder’s report of being sexually assaulted or raped.

 

Emotional / Psychological Abuse

Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an elderly person from his/her family, friends, or regular activities; giving an older person the “silent treatment;” and enforced social isolation are examples of emotional/psychological abuse. Signs and symptoms:

  • being emotionally upset or agitated;
  • being extremely withdrawn and non communicative or non responsive;
  • unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking); and
  • an elder’s report of being verbally or emotionally mistreated.

 

Neglect

Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder. Neglect may also include failure of a person who has fiduciary responsibilities to provide care for an elder (e.g., pay for necessary home care services) or the failure on the part of an in-home service provider to provide necessary care.

Neglect typically means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to an elder. Signs and symptoms:

  • dehydration, malnutrition, untreated bed sores, and poor personal hygiene;
  • unattended or untreated health problems;
  • hazardous or unsafe living condition/arrangements (e.g., improper wiring, no heat, or no running water);
  • unsanitary and unclean living conditions (e.g. dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing); and
  • an elder’s report of being mistreated.

 

Financial / Material Exploitation

Financial or material exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. Examples include, but are not limited to, cashing an elderly person’s checks without authorization or permission; forging an older person’s signature; misusing or stealing an older person’s money or possessions; coercing or deceiving an older person into signing any document (e.g., contracts or will); and the improper use of conservatorship, guardianship, or power of attorney. Signs and symptoms:

  • sudden changes in bank account or banking practice, including an unexplained withdrawal of large sums of money by a person accompanying the elder;
  • the inclusion of additional names on an elder’s bank signature card;
  • unauthorized withdrawal of the elder’s funds using the elder’s ATM card;
  • abrupt changes in a will or other financial documents;
  • unexplained disappearance of funds or valuable possessions;
  • substandard care being provided or bills unpaid despite the availability of adequate financial resources;
  • discovery of an elder’s signature being forged for financial transactions or for the titles of his/her possessions;
  • sudden appearance of previously uninvolved relatives claiming their rights to an elder’s affairs and possessions;
  • unexplained sudden transfer of assets to a family member or someone outside the family;
  • the provision of services that are not necessary; and
  • an elder’s report of financial exploitation.

Most important is to be alert. The suffering is often in silence. If you notice changes in personality or behavior, you should start to question what is going on.