Every year, tens of thousand of seniors fall victim to some type of senior abuse. It can happen in their home or in a care facility like a nursing home. This horrible crime my be committed by family members, caregivers, or by strangers trying to take advantage of a senior's weakness. Abuse can be

  • Physical
  • Emotional
  • Financial
  • Sexual
  • It can be done with malice or it can be done through neglect. Senior abuse takes many forms so it is important to recognize some the signs of abuse and know who you can turn to for help.

What is Elder Abuse?

As we grow older, we become more frail and dependent on others for our survival. As a sandwich generation couple, my wife and I could really see the similarities between caring for a baby and caring for a senior. Both rely on other for their care and both have the potential for abuse. Lucky for babies, they are really cute and innocent so they bring out the caregiver in most people. Senior, depending on their mental condition and personality, may or may not bring out the nurturing feelings in caregivers.

Since some seniors have mobility, mental, hearing and vision limitation, senior caregiving creates opportunities for caregiver to take advantage, whether it be intentional or accidental. Up to half a million cases of elder abuse are taken to authorities each year and these are only the reported ones. It is estimated that there may be millions of unreported nursing home abuses and home care abuses every year.

Where Does Elder Abuse Happen?

Elder care abuse can take place in nursing homes, Alzheimer's care centers, assisted living facilities or any other types of long-term care facilities. Nursing home abuse is the one type of abuse that gets the biggest headlines because these seniors are the weakest and most in need to quality care.

The disturbing fact is that a large percentage of abuse happen in the family home. Elder abuse can happen anywhere that a weak senior is under the control of a caregiver and senior abuse comes in many different types.

Types of Senior Abuse

Elder abuse can take many forms and be inflicted in many different levels. As a caregiver or senior, all these type of abuse are unacceptable.

Physical Abuse

Any non-accidental use of force that results in physical pain, injury, or impairment is considered physical abuse. Most people think of physical assault as the main source of physical abuse but it can also include inappropriate use of force such as shoving or use of restraints, or confinement. Inappropriate use of drugs is a another form of physical abuse.

Emotional Abuse

In emotional abuse or psychological abuse, the caregiver or stranger causes emotional pain or distress in an elder.

Emotional Abuse can include:

  • Verbal intimidation through yelling or threats
  • Humiliating and ridiculing an elder
  • Habitual blaming or scapegoating of an elder
  • Ignoring an elder ( also considered neglect)
  • Isolating an senior from activities or friends
  • Scaring, terrorizing or menacing the elderly person

Financial Exploitation

Financial exploitation includes any activity that involves unauthorized use of an elderly person's funds or property. Financial exploitation may be performed by a caregiver or by a stranger like a con artist. Inappropriate activities can include:

  • Misuse an elders credit cards, personal checks, or financial accounts
  • Stealing cash, income checks like SS checks, or household goods
  • Forging the elder's signature for financial gain
  • Identity theft

Some of the most common elder scams that target elders include

  • Telling an elder that they won a "prize" but must they must pay money to claim it.
  • Charities (real or phony) that put mental pressure on seniors to give
  • Fraudulent investments like ponsy schemes

Sexual Abuse

Sexual abuse of elders is a difficult subject to think about. Because it is so difficult, many caregivers and family members choose to ignore potential signs of abuse. Elder sexual abuse is any contact with an elderly person without the elder's consent. Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse. Elder sexual abuse is more common with seniors that have some dementia or other physiological reason for not reporting the abuse.

Neglect

Neglect is one of the most common form of elder abuse. Many caregivers will neglect an elder that frustates them. Not giving good care is called neglect and it is abuse.

Symptoms and Signs of Abuse

Physical abuse
  • Unexplained signs of injury such as welts, bruises, or scars
  • symmetrically marking both sides of the body are a major sign
  • Sprains and broken bones, or dislocations
  • Reports of drug overdose
  • Failure to take medication on a regular basis (check the prescription level, if there is more remaining than there should, it could be problem)
  • Broken eyeglasses or frames
  • Any signs of being restrained or tied down, such as pressure marks on wrists
  • Caregiver's refusal to allow you to see the elder alone
Emotional abuse

In addition to the general signs above, indications of emotional elder abuse include

  • Any Threatening, belittling, or controlling behavior by caregivers
  • Behavior from the elder that mimics dementia, such as sucking, rocking, or mumbling to oneself
Sexual abuse
  • Bruises around genitals or breasts
  • Unexplained genital infections or venereal diseases
  • Unexplained anal or vaginal bleeding
  • Stained, Torn, or bloody underwear

Neglect by caregivers

or self-neglect

  • Unusual weight loss, malnutrition, or dehydration
  • Untreated physical problems, such as bed sores or pressure sores
  • Unsanitary living conditions: bugs, excess dirt, soiled bedding and clothes
  • Dirty or un-bathed appearance
  • Unsuitable clothing for the weather ( No jacket on a cold day)
  • Unsafe living conditions (insufficient heating or cooling, no clean water; faulty electrical wiring, other fire hazards)
  • Abandonment or desertion of the elder at a public place
Financial exploitation
  • Suspicious changes in a seniors legal paperwork including wills, power of attorney, titles, and policies
  • Significant financial activity like withdrawals from the elder's accounts
  • Significant changes in the elder's financial condition ( lost investments)
  • Possessions or cash missing from the senior's household
  • Addition of names to the senior's financial signature card
  • Unpaid bills or lack of medical care, although the elder has enough money to pay for them
  • Unusual financial activity that could not have been performed by an elder (like ATM withdrawals from a bedridden elder
  • Unnecessary goods, services ,or subscriptions
Healthcare fraud and abuse
  • Duplicate billings for the same medical device or service
  • Overmedication or under-medication
  • Evidence of inadequate care when bills are paid in full
  • Problems with the care facility including crowding, poorly trained, poorly paid, or insufficient staff or Inadequate responses to questions about care.


Risk Factors For Senior Abuse

Many nonprofessional caregivers like spouses, adult children, relatives and friends find being a caregiver to be a satisfying and enriching life. Some people are natural born caregivers and do not feel that caregiving is stressful. These people are blessed. The average person has a limited reserve for caregiving and the demands of elder caregiving, especially when an elder's condition deteriorates, can be extremely stressful. The stress of elder care can lead to mental and physical health burned out. Many times continuous caregiving make people impatient, grumpy and unable to keep from lashing out against the elders in their care.

There are several significant risk factors that contribute to burnout that can result in elder abuse

  • Substance abuse (drug or alcohol)
  • The inability to cope with stress (lack of resilience)
  • Depression, which is common among caregivers
  • A perception that taking care of the elder is a burden
  • Lack of a support group like other caregivers

If you are a caregiver and have any of these problems, contact your local ombudsman to discuss your options.

Institutional caregivers can also experience burnout and high stress levels that may lead to elder abuse. Nursing home staff that exhibits some the the symptoms above should consider a change before it leads to elder abuse.

Preventing Abuse and Neglect

Everyone can help reduce elder abuse. Reducing elder abuse requires that caregivers/families:

  • Intervening when you suspect elder abuse
  • Listening to elders and their caregivers
  • Help educate others about how to recognize and report elder abuse

What you can do as a caregiver to prevent elder abuse

If you're overwhelmed by the demands of caring for an elder, do the following:

  • Get help from friends, relatives, or local respite care agencies when you need a break.
  • Find an adult day care or activity program.
  • Keep yourself healthy and get medical care for yourself when necessary.
  • Reduce your stress.
  • Seek counseling is you suffer from depression
  • Find a support group in your area .
  • Get help if you're having problems with drug or alcohol abuse.

Many elder abuse help lines offer confidential help for caregivers. Call a help line before you cross the line into elder abuse.

What you can do as a concerned friend or family member

  • Watch for warning signs listed above. If you suspect abuse, report it.
  • Call and visit elders as often as you can. Help the elder understand that you a trusted source for help.
  • Offer to stay with an elder so the caregiver can have a break.

How you can protect yourself, as an elder, against elder abuse

  • Make sure your financial and legal affairs are in order before you are in a condition where you can not help yourself. Hire a certified professional to help you get them in order.
  • Keep in frequent touch with family and friends. Avoid becoming isolated.
  • Expect the best. If you are not happy with the care you're receiving, whether it's in your own home or in a care facility, speak up. Tell someone you trust and ask that person to help you find better care. If you feel like your are a victim of abuse, neglect, or substandard care contact your state's elder abuse help line or long term care ombudsman.

Finally, if you aren't in a position to help an elder personally, you can volunteer or donate money to the cause of educating people about elder abuse, and you can lobby to strengthen state laws and policing so that elder abuse can be investigated and prosecuted more readily. Here is a list of non-profits that focus on improving the standards for long-term care:

  • NCCNHR - The National Consumer Voice for Quality Long-Term Care
  • ALFA is a professional assisted living association that embraces an assisted living philosophy of choice for seniors
  • NCAL - National Center for Assisted Living
  • CANHR - California Advocates for Nursing Home Reform is a statewide nonprofit 501c advocacy organization that is dedicated to improving the choices, care and quality of life for California's long term care consumers.

Reporting Senior and Elder Abuse

In most areas, the main governmental organization that works with victims of elderly abuse is the Adult Protective Services ( or APS). Adult Protective Services investigates abuse cases, performs interventions, offers support and helps elder with the transition to better care. The level of help that the APS provides varies by area.

You can get more information by contacting Eldercare Locator at 1-800-677-1116

If you are an elder who is being neglected, abused, or exploited, tell at least one person.This person could be your doctor, a friend, or a family member whom you trust. If you do not have a caregiver or contact that you can trust, contact your local ombudsman.

If you are a caregiver or family member who suspects that a elder is being abused, contact your states elder abuse helpline or long term care ombudsman.

Getting Legal Help

Across the country, there are many lawyers that specialize in nursing home abuse and caregiver abuse. Many of them will handle the case for free if the accused abuser has financial resources to justify that case. These lawyer usually have a very high success rate in making a convicted abuser pay. Although the wounds caused by the abuse may never heal , legal action is often an appropriate response to elder abuse. This is especially true where the abuse is implicated in a caregiving facility. After speaking to many local Ombudsmen, I know that abuse happens in both small and large institutions. Unlike abuse that happens by family members, abuse inflicted by a paid caregiver may be somewhat offset by legal action. Once of the best ways to stop future habitual abuse by an institution or individual is aggressive legal actions. The following is a list of legal resources for those who feel that their abuse would warrant a legal actions.