Hardly a week goes by without an atrocity of elder abuse or neglect appearing in the national news. Every family has a loved one — a parent or grandparent — who may become susceptible to the same horrors.

In 2015, the global population of people aged 60 years and older was 900 million. By 2050, this number will more than double to 2 billion.

As countries face rapidly aging populations, elder abuse is predicted to increase as well, making this a critical and rapidly-evolving concern we must address.

What is elder abuse?

Elder abuse occurs when a person intentionally brings harm or distress to an older adult or fails to take the appropriate intervention. This abuse can take various forms.

• Physical abuse: physical pain or bodily injury
• Sexual abuse: any sexual contact where the older adult is unable to understand (as in dementia), unwilling to consent, threatened, or forced
• Emotional abuse: verbal assaults, harassment, or solitary confinement for non-medical reasons that inflict mental anguish or pain
• Financial exploitation: non-consensual usage of an elder’s funds and assets
• Neglect: failure to provide life necessities (ie. food, clothing, hygiene, medication)

Scope of the Problem

Elder abuse is a pervasive problem, and recent studies suggest that 10% of Americans aged 60 and older were subjected to some form of elder abuse. This is approximately 5 million cases each year. Furthermore, this is likely to be a gross underestimation because only 1 in 14 abuse incidents is reported to authorities.

Recent studies sought to obtain the actual rates of abuse in both institutional (ex. hospitals, nursing homes, and long-term care facilities) and community settings (ex. adult day-cares at churches or community centers), as indicated in the below table.

The data was collected from 9 studies in 6 countries based on self-reports by caretakers and elders, many of whom experienced various types of abuse. Analyses revealed that abuse rates are significantly higher in institutions than in community settings (64% versus 16%).

Warning Signs

Elder abuse is a prevalent issue that can have detrimental effects on victims, but fortunately, there are identifiable warning signs. Depending on the type of elder abuse, the specific symptoms can vary.

Physical Abuse

In most cases, physical abuse has the most visible symptoms, including bruises, cuts, sores, broken bones, burns, and head injuries.

If elders live in nursing homes or other facilities, family members should regularly visit to ensure there are no signs of physical injuries. If there are, loved ones should use their best judgment because some staff members may cover up abuse injuries by claiming they were caused by other accidents.

In 2018, for example, an elder in Colorado was sent to the hospital for deep cuts and broken bones in her hand. The nursing home initially faulted the woman for scratching herself with a coat hanger. However, prosecutors later discovered that a staff member — who was a convicted felon — had beaten her.

Sexual Abuse

Seniors with dementia or physical disabilities are often susceptible to sexual abuse, which can be devastating.

Loved ones must be vigilant to identify unexplained sexually transmitted diseases; bruises, bleeding, and irritation on the thighs or genitals; and unconventional interactions between an elder and caregiver.

In addition to physical suffering, an elder who is sexually abused can also experience emotional suffering.

Emotional Abuse

Despite not manifesting physical symptoms, emotional abuse can be just as scarring, causing an overall decline in an elder’s happiness and mood.

Signs include isolation and withdrawal from friends and family, hesitation to freely talk, depression, and anger.

Elders may also fabricate stories to cover up injuries because they fear that exposing their perpetrator will result in further consequences and abuse.

Financial Abuse

Unlike other types of abuse, financial exploitation may not immediately affect an elder’s physical and emotional health.

It may go unnoticed over extended periods, but financial abuse can leave elders unable to afford essential medication and health care later on. To avoid these occurrences, a trusted financial expert or family member should monitor the elder’s accounts.

If there are large sums of transactions or unexplainable expenses, the elder may be a victim of financial fraud. Family members should also be mindful if an elder pays money or provides gifts in exchange for companionship.

Elder Neglect

So far, all the mentioned types of abuses stem from intentional maltreatment. The final type — neglect — can stem from insufficient care. However, the extent of the consequences can be just as grave, especially if neglect continues for months.

These symptoms include bedsores or pressure ulcers; lack of basic hygiene, food, and hydration; missing medical aids, such as hearing devices, medication, and eyeglasses; unsafe and unsanitary living spaces; and extended periods of being unsupervised.

Caregiver Signs of Abuse

Loved ones should also monitor signs in abusive caregivers to prevent mistreatment from occurring in the first place.

Possible signs include being indifferent, demeaning, or aggressive towards elders; giving conflicting explanations of physical injuries; having a history of mental illness, violence, substance abuse, or criminal behavior; preventing the elder from speaking with visitors alone; and using flirtatious language with the elder.

Effects of Elder Abuse

Some physical wounds can heal with time, but the ramifications of elder abuse could permanently destroy family ties, damage mental and physical health, and lead to early death. Victims become fearful and depressed, and they often blame themselves.

There is an appalling 300% higher risk of death for victims of elder abuse.

The financial devastation from monetary exploitation can also lead to the inability to pay for essential healthcare, leading to deteriorating health. Estimates of financial loss range from $2.9 billion to $36.5 billion annually for Americans. Thus, the destructive effects of elder abuse infiltrate far beyond the immediate act.

Risk Factors

At the individual level, elders with physical disabilities and mental impairments are more susceptible. In fact, 50% of those with dementia suffer from abuse and neglect.

A 2014 study by Northwestern University and Rush University found that adults aged over 80 were more vulnerable to elder abuse. Loved ones should also be aware if a caregiver has a history of mental disorders, alcohol, and substance abuse. Furthermore, in cultures where women have inferior social status, they are more vulnerable to financial exploitation and neglect, especially when they become widowed.

In terms of relationships, a history of poor familial relationships may further deteriorate once an elder becomes a dependent. Families may view them as financial and time burdens, particularly for those who work full-time. This may increase the risk of impatience and neglect, thus elder abuse.

Lastly, elders have traditionally been cared for by their children. However, increasing numbers of young couples have left their parents alone, increasing their vulnerability to neglect and abuse.

Prevention

Various strategies can be implemented to prevent elder abuse and mitigate the consequences.

These include the screening of potential victims and abusers, improved standards of care at nursing homes and hospitals, and public awareness campaigns. Seniors can also attend support groups and stay connected with the community to reduce social isolation, which is known to increase the risk of elder abuse.

To prevent financial exploitation, elders can use the power of attorney or a living will by seeking professional and trustworthy advice. They should also periodically review their legal documents to ensure there are no unwarranted changes. To protect their personal data, elders should send and open their own mail, avoid giving personal information on the Internet or phone, and use direct deposits for all checks.

Legal Implications

Federal and state governments and have created numerous statutes to protect elders from financial, mental, physical, and sexual abuse. In recent years, law enforcement officers and prosecutors have been increasingly trained to bring justice for victims.

On March 23, 2010, the Elder Justice Act — the first comprehensive federal legislation — was signed to address elder abuse, neglect, and exploitation. It established the national Elder Justice Coordinating Council to identify and propose solutions to problems surrounding elder abuse.

Further, the Act authorized grants to improve Adult Protective Services and Long-Term Care Ombudsman programs, forensic centers that investigate elder abuse, and long-term care staffing.

Victim Recovery

Ultimately, to ensure elder abuse victims recover physically, emotionally, and financially, attorneys and victim specialists can help.

• For ongoing abuse, elders can file a protection order.
• In the case of financial exploitation, they can file a legal claim against the perpetrator.
• Victims can also receive therapy to overcome the psychological hurdles of depression, shame, and anxiety.

In addition to support groups, victims of elder abuse can reach help by contacting hotlines, including:

• Victim Connect Hotline (855-4-VICTIM)
• Senior Intervention Hotline for Crisis Support Services: Institute of Aging’s Friendship Line (415-750-4111)

How to Report Elder Abuse

Even the slightest suspicions of elder abuse must be reported because your loved ones should not suffer. If the situation is urgent, call 911 immediately.

Another way to report abuse is to connect with Adult Protective Services. To connect with the local agency in your state, call the Elder Locator at 800-677-1116.

For further information and reliable support, call an expert attorney at the Peck Law Group toll-free at 866-999-9085.

Works Cited

“Elder Abuse Statistics & Facts: Elder Justice.” National Council on Aging, 15 June 2020, www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts/.

“Elder Abuse.” World Health Organization, World Health Organization, 15 June 2020, www.who.int/news-room/fact-sheets/detail/elder-abuse.

“Federal Laws.” National Center on Elder Abuse, 2020, ncea.acl.gov/About-Us/What-We-Do/Policy/Federal-Laws.aspx.

Merrilees, Annika. “’83 Years Old, Unable to Speak, Unable to Fight Back.’ Daughters Share Heartbreaking Stories of Abuse in Nursing Homes.” ABC News, 6 Mar. 2019, abcnews.go.com/Politics/83-years-unable-speak-unable-fight-back-daughters/story?id=61504444.

“Resources to Help Older Survivors.” The United States Department of Justice, 14 Oct. 2020, www.justice.gov/elderjustice/resources-help-older-survivors.

About the Author

Angelina Xu is the winner of our 2020 elder abuse and neglect article scholarship.