It Is Imperative and Essential That The Incidences of Elder Abuse and Neglect Be Discussed and Understood

Written by Adam Peck Category: Elder Law January 26th, 2013 5 min read

As the number and percentage of individuals 65 and over has increased in this country, so has the incidence of elder abuse. Unfortunately, the prevalence and nature of this growing problem has generally remained hidden from public view. It is imperative that both professionals and lay persons become more aware of the scope and many issues surrounding this sensitive topic. This Blog is designed to address many of the concerns surrounding elder abuse ranging from information concerning the incidence of abuse to a discussion of intervention strategies. It is essential that the incidence of abuse and awareness of the range and breadth of various types of abuse be discussed and understood. However, an awareness of the problem of elder abuse is not enough. Therefore, issues surrounding detection of abuse and strategies for prevention and intervention will also be addressed.

Types of Abuse:

Passive and Active Neglect: With passive and active neglect the caregiver fails to meet the physical, social, and/or emotional needs of the older person. The difference between active and passive neglect lies in the intent of the caregiver. With active neglect, the caregiver intentionally fails to meet his/her obligations towards the older person. With passive neglect, the failure is unintentional; often the result of caregiver overload or lack of information concerning appropriate caregiving strategies.

Physical Abuse: Physical abuse consists of an intentional infliction of physical harm of an older person. The abuse can range from slapping an older adult to beatings to excessive forms of physical restraint (e.g. chaining).

Material/Financial Abuse: Material and financial abuse consists of the misuse, misappropriation, and/or exploitation of an older adults material (e.g. possessions, property) and/or monetary assets.

Psychological Abuse: Psychological or emotional abuse consists of the intentional infliction of mental harm and/or psychological distress upon the older adult. The abuse can range for insults and verbal assaults to threats of physical harm or isolation.

Sexual Abuse: Sexual abuse consists of any sexual activity for which the older person does not consent or is incapable of giving consent. The sexual activity can range from exhibitionism to fondling to oral, anal, or vaginal intercourse.

Violations of Basic Rights: Violations of basic rights is often concomitant with psychological abuse and consists of depriving the older person of the basic rights that are protected under state and federal law ranging from the right of privacy to freedom of religion.

Self Neglect: The older person fails to meet their own physical, psychological, and/or social needs.

Evidence that personal care is lacking or neglected
Signs of malnourishment (e.g. sunken eyes, loss of weight)
Chronic health problems both physical and/or psychiatric
Dehydration (extreme thirst)
Pressure sores (bed sores)
Physical Abuse: Overt signs of physical trauma (e.g. scratches, bruises, cuts, burns, punctures, choke marks)
Signs of restraint trauma (e.g. rope burns, gag marks, welts)
Injury – particularly if repeated (e.g. sprains, fractures, detached retina, dislocation, paralysis)
Additional physical indicators – hypothermia, abnormal chemistry values, pain upon being touched
Repeated “unexplained” injuries
Inconsistent explanations of the injuries
A physical examination reveals that the older person has injuries which the caregiver has failed to disclose
A history of doctor or emergency room “shopping”
Repeated time lags between the time of any “injury or fall” and medical treatment

Material or Financial Abuse
Unusual banking activity (e.g. large withdrawals during a brief period of time, switching of accounts from one bank to another, ATM activity by a homebound elder)
Bank statements (credit card statements, etc.) no longer come to the older adult
Documents are being drawn up for the elder to sign but the elder can not explain or understand the purpose of the papers
The elders living situation is not commensurate with the size of the elder’s estate (e.g. lack of new clothing or amenities, unpaid bills)
The caregiver only expresses concern regarding the financial status of the older person and does not ask questions or express concern regarding the physical and/or mental health status of the elder
Personal belongings such as jewelry, art, furs are missing
Signatures on checks and other documents do not match the signature of the older person
Recent acquaintances, housekeepers, “care” providers, etc. declare undying affection for the older person and isolate the elder from long-term friends or family
Recent acquaintances, housekeeper, caregiver, etc. make promises of lifelong care in exchange for deeding all property and/or assigning all assets over to the acquaintance, caregiver, etc.

Psychological Abuse: Psychological Signs: Ambivalence, deference, passivity, shame
Anxiety (mild to severe) Depression, hopelessness, helplessness, thoughts of suicide
Confusion, disorientation

Behavioral Signs:
Trembling, clinging, cowering, lack of eye contact
Evasiveness
Agitation
Hypervigilance
Sexual Abuse:Trauma to the genital area (e.g. bruises)
Venereal disease
Infections/unusual discharge or smell
Indicators common to psychological abuse may be concomitant with sexual abuse
Violation of basic rights

Caregiver withholds or reads the elder’s mail
Caregiver intentionally obstructs the older person1s religious observances (e.g. dietary restrictions, holiday participation, visits by minister/priest/rabbi etc.)
Caregiver has removed all doors from the older adult’s rooms.
As violation of basic rights is often concomitant with psychological abuse the indicators of basic rights violations are similar indicators as those for psychological abuse.
Self Neglect – to be discussed in greater depth below.

Additional Indicators of Abuse or Neglect

Elder is not given the opportunity to speak without the caregiver being present.
Caregiver exhibits high levels of indifference or anger towards the older adult
Overmedication or oversedation.

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Written by Adam Peck

Expertise: Personal Injury

Adam J. Peck, ESQ is a principal with Peck Law Group, APC. In 2008, Mr. Adam Peck received his Juris Doctorate from Whittier Law School where he graduated Cum Laude. His practice is primarily dedicated to representing Elders, Dependent Adults, along with their loved ones and family members, who have suffered horrific personal injuries.