Each year hundreds of thousands of older persons are abused, neglected, and exploited (The National Council on Aging states that one in 10 Americans over the age of 60 have experienced abuse. Some estimates suggest that as many as 5 million seniors experience abuse each year.) . Many victims are people who are older, frail, and vulnerable and cannot help themselves and depend on others to meet their most basic needs. Abusers of older adults are both women and men, and may be family members, friends, or “trusted others.”

What is Elder Abuse?

According to the Administration on Aging, elder abuse is “a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult”.

Types of Elder Abuse

The U.S. Department of Health and Human Services has identified seven types of elder abuse:

• Physical abuse – inflicting physical pain, injury or impairment on an elderly person
• Sexual abuse – non-consensual sexual contact of any kind with an elderly person
• Neglect- the failure by those responsible to provide food, shelter, health care or protection for an elderly person
• Exploitation – the illegal taking, misuse or concealment of funds, property or assets of an elderly person
• Emotional abuse- inflicting mental pain, anguish or distress on an elderly person through verbal or nonverbal acts
• Abandonment- desertion of an elderly person by anyone who has assumed the responsibility for care or custody of that person.
• Self-neglect–also acknowledged as a form of elder abuse but is distinguished from other types of elder abuse where there is a third party perpetrator. Self- neglect is characterized as the failure of a person to perform essential self-care tasks where such failure threatens his/her own health or safety.

Warning Signs

Elder abuse comes in many forms. Although one sign does not necessarily indicate abuse, the presence of certain signs may indicate a problem. Typical signs and symptoms may include but are not limited to the following:

• Fractures, bruises, burns, abrasions, signs of being restrained
• Sexually transmitted diseases, bloody underclothing or bruises around breasts or genital area can occur from sexual abuse
• Uncharacteristic changes in behavior (i.e., withdrawal from normal activities) and threatening or controlling behavior by the caregiver
• Sudden changes in financial situation, significant withdrawals from bank accounts, unpaid bills, suspicious changes in wills, policies, and power of attorney documents
• Bedsores, unattended medical needs, poor hygiene, dehydration, malnutrition, unsanitary living conditions, and unusual weight loss
• Desertion of an elderly person at a hospital, nursing facility or public location
• Stanford Medicine , US Department of Justice , and National Adult Protective Services Association provide lists of other various forms of elder mistreatment. The ABA summarizes the types of abuse in each state’s laws.

Who are the Abusers?

The majority of abusers are family members, most often an adult child or spouse. Abuse can also occur at a long term care facility, such as a nursing home or assisted living residence by employees who have direct contact with residents. Other offenders may include other family members, old friends, and “new” friends who intentionally prey on older adults.

Advocates for the Elderly

Adult Protective Services (APS) is the public agency responsible for receiving, investigating, and responding to allegations of elder abuse and neglect and for providing victims with treatment and protective services. The Long Term Care Ombudsmen (LTCO) investigates and resolves complaints having to do with the elderly who reside in a nursing home, assisted living and board and care facilities.

Reporting Elder Abuse

If you suspect elder abuse, report it to your local APS or LTCO office. You do not need to prove that abuse is occurring to make a report. It is up to the professionals to investigate the suspicions. To find a local APS agency in your state, go to the National Adult Protective Services Association. To find a local Long Term Care Ombudsman or other long-term care resources in your state, check out The Consumer Voice.

How to Prevent Elder Abuse

Awareness is a major key toward preventing or minimizing the incidence of elder abuse. Here a few suggestions:

• Remain informed and aware of any and all changes, whether physically, emotionally or behaviorally
• Keep an open line of communication with your loved one and her caregivers
• Maintain social contact and support to keep the senior from getting isolated
• Respite care for the caregiver to reduce stress and tension
• Education about the nature and demands of the caregiving

This article has been updated in November 2023 since it originally published in December, 2015.