Elder or Dependent Adult Abuse
Whether it's physical, sexual, or emotional, elder abuse is a serious crime. A frail or disabled elderly person can also be abused through neglect and financial exploitation. Each year hundreds of thousands of elderly people who depend on others to meet their most basic needs are abused, neglected, or exploited.
Elder abuse can fall under several categories:
- Physical abuse is the willful infliction of physical pain or injury, such as slapping, bruising, sexually molesting, or restraining.
- Psychological abuse is the infliction of mental or emotional anguish, such as humiliating or threatening.
- Financial or material exploitation is another form of abuse, in which the resources of an elderly person are used without his or her consent.
- Neglect is the failure of a caretaker to provide goods or services necessary to avoid physical harm, mental anguish, or illness.
While it is hard to estimate how many older persons are abused each year, one study suggests that 500,000 Americans are abused, neglected and exploited by family members and others. The study also estimates, however, that only about 16 percent of abuse cases are reported. The Senate Special Commission on Aging estimates that there may be as many as 5 million victims of elder abuse a year.
Another study found that the one-year prevalence for abuse was the following:
- Emotional abuse, 4.6 percent
- Physical abuse, 1.6 percent
- Sexual abuse, 0.6 percent
- Potential neglect, 5.1 percent
- Current financial abuse by a family member, 5.2 percent
- Overall, 10 percent of respondents report emotional, physical, or sexual mistreatment, or potential neglect in a given year.
In addition:
- 551,011 people, age 60 and over, experience abuse, neglect, and/or self-neglect in a one-year period.
- The perpetrator was a family member in 90 percent of cases. Two-thirds of the perpetrators were adult children or spouses.
Legislatures in all 50 states have passed some form of elder abuse prevention laws. Laws and definitions of terms vary considerably from one state to another, but all states have set up reporting systems. Generally, adult protective services (APS) agencies receive and investigate reports of suspected elder abuse.
Symptoms vary depending on the nature of the abuse. Symptoms may include:
- Bruises and lacerations
- Broken or fractured bones
- Untreated injuries in various stages of healing
- Sprains, dislocations and internal injuries
- Laboratory findings of medication overdose or under-utilization of prescribed drugs
- Elder's report of being hit, kicked, or mistreated
- Elder's sudden change in behavior, including becoming depressed, agitated, withdrawn, or non-communicative
- Dehydration, malnutrition, untreated bedsores, and poor hygiene
- Unattended or untreated health problems
- Unsafe or unclean living conditions
- Elder's report of mistreatment
- Caregiver's refusal to allow visitors to see an elder alone
Abuse can take different forms. Five general categories of elder abuse are: Physical abuse (hitting, slapping, punching, shoving, pinching, and burning), sexual abuse (unwanted sexual touching, sexual assault, sexual nudity, and forcing elders to witness nudity), psychological abuse (name calling, yelling, swearing, insulting, and making threats), financial abuse and exploitation (embezzlement, misuse of funds, taking money under false pretenses, and forgery) and neglect or abandonment (failure to provide food, water, and clothing).
According to the National Institutes of Health, common signs of elder abuse include:
• Unexplained bruises, cuts, or injuries
• Broken eyeglasses
• The development of bed sores or other preventable conditions
• A dirty or messy appearance
• Unclean or hazardous living conditions
• Lack of participation in typical activities
• Unexplained withdrawal, irritability, or agitation
• Weight loss
• Trouble sleeping
• Unpaid bills despite financial resources
• An eviction notice
Spouses and adult children are often the perpetrators of elder abuse, but caretakers in nursing homes and scammers prey on the elderly as well. Generally, a combination of psychological, social, and economic factors, along with the mental and physical conditions of the victim and/or the perpetrator, contribute to the occurrence of elder maltreatment. Although the factors listed below cannot explain all types of elder maltreatment because it is likely that different types (as well as each single incident) involve different casual factors, some of the causes researchers cite as important are:
- Caregiver stress
- Impairment of dependent elder
- A family history of violence and substance abuse
Cognitive impairment is a key factor that increases the likelihood of elder abuse, because the senior may be more vulnerable or family members may be overwhelmed by the responsibilities of caregiving. On the part of the perpetrator, factors associated with elder abuse include mental illness, substance abuse, chronic employment, and stress due to caregiving.
Many cases of elder abuse go unreported. The reasons why include feelings of embarrassment and shame, being unaware that abuse is occurring, believing that they are somehow responsible for the abuse, thinking that others won’t believe their allegations, and fears of retaliation or being moved from their home.
In most jurisdictions, the APS, the Area Agency on Aging, or the county Department of Social Services is the agency designated to receive and investigate allegations of elder abuse and neglect. If investigators find abuse or neglect, they make arrangements for services to help protect the victim. The Area Agency on Aging operates an information and referral line for a wide range of services; if an elder is in immediate danger, call 911.
Older adults can take the following precautions to help keep themselves safe from abuse:
- Maintain a social life. Stay in touch with old friends and neighbors if you move in with a relative or change your address. Have a buddy outside the home check in with you at least once a week. Invite friends to stop by your house, even if they only stay for a brief period.
- Stay open to opportunities. Make new friends. Continue participating in community activities.
- Retain control over your telephone and mail. If your mail is being intercepted, discuss the problem with postal authorities.
- Organize your belongings so you can keep track of everything. Make sure others are aware that you know where everything is kept.
- Try to be in control of attending to your personal needs. Keep regular appointments with your doctor, dentist, barber, or hairdresser.
- Maintain financial control. Arrange to have your Social Security or pension check deposited directly to a bank account in your name.
- Maintain legal control. Obtain legal advice about possible future disability, including power-of-attorney, guardianship, or conservatorship. Be sure to keep records, accounts, and property available for examination by someone you trust, as well as by the person you or the court has designated to manage your affairs. Review your will periodically. Only give up control of your property or assets at a time when you decide you cannot manage them.
- Be sure to ask for help when you need it. Discuss your plans with your attorney, physician or family members.
Other precautions:
- Don't live with a person who has a background of violent behavior or alcohol or drug abuse.
- Don't leave your home unattended, or if you do, don't leave signs that you are not home, such as a note on the door. If you must be away for a long period, notify the police.
- Don't leave cash, jewelry, or other valuables.
- Don't accept personal care in return for the transfer or assignments of your property or assets, unless a lawyer, advocate or another trusted person acts as a witness to the transaction.
- Don't sign a document unless someone you trust has reviewed it, and don't allow anyone to keep details of your finances or property management from you.
Elder abuse is generally investigated by Adult Protective Services. A case worker will begin by asking the older adult or a legal guardian permission to investigate. (If permission is denied but there is evidence that someone is at risk of being harmed, a case worker may get a court order or involve the police.) After collecting proof of abuse, action may be taken to remove the perpetrator or move the elderly person to a safer setting. In cases of financial, physical, or sexual abuse, criminal charges may also be laid.
Individuals responsible for caring for an older family member can take steps to ensure reliable care. They may want to work with a licensed caregiver agency rather than an independent contractor and check if the agency has liability insurance and conducts background checks. They can interview prospective caregivers and seek references from past clients. Throughout the process, communication is key: Family members and caregivers should discuss the schedule and needs of the caregiver and monitor tasks that need to be done.