Eye-Opening Facts About Elder Abuse, and How to Effectively Report It

The National Center on Elder Abuse (NCEA) recognizes seven main types of senior abuse. Some, such as neglect or emotional abuse, may be more difficult to notice or prove than physical abuse.

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1. Physical abuse is “the use of physical force that may result in bodily injury, physical pain, or impairment,” according to the NCEA. This includes hitting, kicking, shaking, burning, and other violent acts. More commonly overlooked manifestations of physical abuse include forced restraints, starvation or force-feeding, and inappropriate administration of drugs. Consider reporting elder abuse if you notice any of these warning signs:
   • Bruising on the face or trunk, as most accidental elderly bruising occurs on limbs and extremities
   • Broken bones, sprains, or serious injury, especially without a reported fall
   • Signs of being restrained, like strap or rope marks
   • Sudden changes in behavior
   • Direct reports of physical abuse from the elderly victim
2. Sexual abuse includes any type of nonconsensual sexual action toward a senior. This means anything from rape to inappropriate touching, forced nudity, or photography. Seniors with significant cognitive impairment cannot give sexual consent.
3. Emotional abuse is “the infliction of anguish, pain, or distress through verbal or nonverbal acts,” according to the NCEA. This can include insults, threats, verbal abuse, and harassment. Infantilizing behavior, forced social isolation, and gaslighting — manipulating someone into questioning their sanity and judgment — are also forms of emotional abuse.
4. Financial or material exploitation is when an abuser steals or mismanages a senior’s money or possessions. This includes cashing checks without permission, forging signatures, coercion, and gross misuse of guardianship or power of attorney. Elder financial abuse can come from strangers and scammers as well as caregivers.
5. Neglect is the refusal to provide a dependent senior with necessities like food, water, appropriate shelter, hygiene, and medicine. Neglect can also be financial if the family member responsible for a senior’s finances refuses to pay for appropriate care.
6. Abandonment is a more extreme version of neglect, in which a caregiver who’s assumed responsibility for a senior deserts them. Most often, seniors are abandoned in their own homes or after a hospital stay, but they can also be left in public locations or with law enforcement. Abandoned seniors will be referred to Adult Protective Services (APS) if contact with family members can’t be made.
7. Self-neglect is when a senior engages in behaviors that are harmful to their health or safety, like refusing to eat, drink, take prescribed medicine, or perform regular hygiene. This is most common in seniors with mental illness or cognitive decline. It’s important to note that self-neglect doesn’t include a mentally stable senior’s voluntary decision to commit actions that threaten their own life or safety.

The majority of senior abuse victims are female, whereas the majority of the perpetrators are male, according to the American Psychological Association. Adult children are the most common perpetrators of elder abuse, followed by spouses and other family members. Abuse of the elderly in hospitals, long-term care homes, and nursing homes is also a concern, despite strict regulations. 

Abuse by family members often goes unreported, since seniors don’t want to get their adult children or relatives in trouble. If you suspect a sibling or family member is abusing an elderly loved one, bring up the topic calmly with the senior; don’t start by making a direct accusation. They’ll be more likely to share their experiences if they don’t feel like they’re condemning someone they care about.

Older adults — especially those with dementia — can experience severe behavioral changes as they age. Abuse could come from a partner who never had violent tendencies, or it could even be self-inflicted.

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These health conditions and social circumstances increase the risk of senior abuse in the health care system and at home.

• Poor cognitive function. Seniors with mental health problems or mental disorders have a higher risk of abuse, with up to 50% of patients with dementia worldwide suffering from some form of abuse at the hands of their caretakers, according to the World Health Organization (WHO).
• Increased physical dependency. The more reliant a senior is on caregivers or family members for everyday tasks, the more susceptible they are to abuse. Inability to manage money independently can lead to financial abuse, while constant proximity increases the likelihood of emotional abuse.
• Social and family environment. Socially isolated seniors are more likely to experience undetected abuse, according to the WHO. This commonly affects widows, seniors without family, and elderly adults aging at home alone. Seniors with strained family relationships are also at higher risk of abuse from family members.
• Economic status. Seniors from lower-income backgrounds are at significantly greater risk of elder abuse, according to the NCEA. Elderly people without financial resources often have to age in place without appropriate modifications or rely on lower-quality housing or care.
• Race. People of color are more likely to experience elder abuse from non-family/professional caregivers in the U.S. than white people are. This is primarily due to geographical location and economic disparity, which lead to a higher likelihood of lower-quality care.

Some of the consequences of elder abuse are:

• Anxiety
• Depression
• Isolation
• Over or under medication
• Poverty
• Other financial, medical or psychological issues

In some cases, elder abuse can even result in death, malnourishment or serious injuries.

The best way to fight back against elder abuse is to know the different types of abuse and their warning signs. Remember to ask questions and look out for vulnerable seniors.

Seniors are prone to falls and accidents, as well as changing behaviors due to medication or cognitive decline. These signs don’t necessarily indicate elder abuse, but they are red flags that should be carefully recorded.

• Bruises, cuts, abrasions, burns, and other physical signs of trauma
• Confusion or depression, or sudden social withdrawal
• Senior’s finances suddenly changing for the worse
• Bedsores, poor hygiene, and weight loss
• Unexpected negative reaction to physical contact
• Unexplained venereal diseases or injury to private areas
• Self-doubt or unwillingness to speak

If you notice any of these signs, take detailed notes or photographs of injured areas. Also record any behaviors you witness or testimonies from the senior. These records can be vital in reporting elder abuse and prosecuting an abuser to keep your loved one safe.

CDC developed vetoviolence.cdc.gov to provide grantees and partners with an innovative portal for training and resources to bridge the gap between science and practice, and focus on stopping violence before it starts. They’ve set up a VetoViolence Facebook Page that is dedicated to sharing information and resources, and they host “Ask the Expert” Facebook forums on focused topics there.

Some ways to preemptively protect elders from abuse and neglect include:

• Coordinating resources and services among organizations that serve the elderly population
• Having several strong relationships
• Having strong sense of community

The Elder Justice Act of 2009 made legal advancements to combat elder abuse, exploitation, and neglect. Because of laws like this, elder abuse and mistreatment is taken more seriously, and reporting resources are available in all 50 states.

• If you believe a senior is in immediate danger, dial 911. Explain the situation to the best of your ability, including detailed descriptions of the senior and their caregiver.
• For all types of elder abuse, you can contact Adult Protective Services (APS). They have trained professionals to investigate claims of abuse. Find your local APS department’s number and other resources using this state-by-state list from the NCEA. If you prefer to receive information by phone, call the national elder abuse hotline at (800) 222-8000 for a local number.
• For elder physical or emotional abuse, you can also call the National Domestic Violence Hotline at (800) 799-SAFE.
• If you’re reporting abuse or neglect in a nursing home or senior living, contact your local ombudsman. This is a person who resolves complaints and advocates for resident rights in senior living facilities. You can find the number for your local ombudsman here.