by Audrey Demmitt, R.N.

How is Abuse Defined?

Physical elder abuse is non-accidental use of force that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.

Emotional or psychological abusewhen people speak to or treat elderly persons in ways that cause emotional pain or distress, including:

  • Intimidation through yelling or threats
  • Humiliation and ridicule
  • Habitual blaming or scapegoating
  • Ignoring the elderly person
  • Isolating an elder from friends or activities
  • Terrorizing or menacing the elderly person

Sexual elder abuseis contact with an elderly person without the elder’s consent. Can involve physical sex acts, showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress.

Elder neglect or abandonmenta failure to fulfill a caretaking obligation which constitutes to more than half of all reported cases of elder abuse. It can be intentional or unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as he or she does. An example of this which is happening all too often recently is abandoning an older adult at the ER or hospital.

Financial exploitationinvolves misuse, mismanagement, or exploitation of property, belongings, or assets. This includes using an older adult’s assets without consent, under false pretense, or through intimidation and/or manipulation, usually by a caregiver or outside scam artist.

Healthcare fraud and abuse – carried out by unethical doctors, nurses, hospital personnel, and other professional care providers, examples of healthcare fraud and abuse include:

  • Not providing healthcare, but charging for it
  • Overcharging or double billing for medical care or services
  • Getting kickbacks for referrals to other providers or for prescribing certain drugs
  • Overmedicating or under medicating
  • Recommending fraudulent remedies for illnesses or other medical conditions
  • Medicaid fraud

Signs of Possible Abuse: The Victim May…

  • Stop taking part in activities once enjoyed
  • Be isolated from family and friends
  • Look messy, with unwashed hair or dirty clothes
  • Seem under or over medicated; under fed, dehydrated
  • Have trouble  sleeping
  • Become withdrawn or act confused, agitated or violent
  • Display signs of trauma, like rocking back and forth
  • Have unexplained bruises, burns, cuts, or scars
  • Have broken eyeglasses/frames, or physical signs of punishment or being restrained
  • Develop bed sores or other preventable conditions
  • Lack medical aids (glasses, walker, dentures, hearing aid, medications)
  • Have an eviction notice for unpaid rent, notice of late mortgage, or home eviction
  • Have hazardous, unsafe, or unclean living conditions
  • Display signs of insufficient care or unpaid bills despite adequate financial resources
  • Have a change in banking or spending patterns

What Factors Increase the Caregiver’s Risk to Abuse?

  • Inability to cope with stress; overwhelmed with responsibilities
  • Depression, which is common among caregivers
  • Lack of support from other potential caregivers
  • The caregiver’s perception that taking care of the elder is burdensome and without psychological reward
  • Substance Abuse

What Factors increase the Elder’s Risk for Abuse?

  • The intensity of an elderly person’s illness, dementia, or disability
  • Social isolation – the elder and caregiver are alone together almost all the time
  • The elder’s role, at an earlier time, as an abusive parent or spouse
  • A history of domestic violence in the home
  • The elder’s own tendency toward verbal or physical aggression

Reporting and Referral

As good neighbors, we can educate and build awareness among others in the community to help prevent elder abuse. And most importantly, we can get victims and their families the help and support they need. If you or someone you are concerned about is experiencing possible abuse, there are actions you can take:

1. Call the police or 911 immediately if someone you know is in immediate, life-threatening danger.

2. Contact the Eldercare Locator to locate services in your area which support elders and their families. Call on weekdays and talk to an information specialist at 800-677-1116.

3. Call Adult Protective Services for your state if elder abuse is suspected. You do not need to prove it or investigate it further. Let the professionals investigate and intervene. They can offer the victim many services and supports.

4. Call the Long Term Care Ombudsman Program if the victim is a resident of an eldercare living center.


National Institute on Aging Elder Abuse Information

Caregiving Challenges During the Holidays

Elder Abuse and Domestic Violence: A Growing Concern