How To Identify and Report Elder Abuse

Posted by jrupenski@medbest.com
August 20, 2024
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How To Identify and Report Elder Abuse

People among vulnerable populations are often the most susceptible to abuse. When people think of vulnerable populations that experience abuse, they may think of children, women of color, the LGBTQ+ community, or people with disabilities. Although these populations do experience abuse, there is another vulnerable population that experiences abuse that often goes unreported: older adults.


Elder abuse is often unreported because people are less familiar with it. Still, the reports that do exist on its prevalence are bleak. According to a 2024 report published by the National Council on Aging (NCOA), one in ten older adults experience abuse. However, these cases rose during the pandemic when one in five older adults reported abuse. With the older population increasing, these statistics may rise if we don’t take action. 

Like any other kind of abuse, the only way to stop it from occurring is to break the stigma around elder abuse. The first step? Education. This guide will break the stigma of elder abuse by walking you through the different kinds of elder abuse, how to recognize the signs of elder abuse, and how to report it if you see it. With this education, you can do your part to prevent this type of abuse from spreading. 

What Is Elder Abuse?

According to the Center for Disease Control, elder or older person abuse is any kind of act — intentional or otherwise — that harms an older person. It can happen to anyone who is 65 years or older but commonly affects those who may be socially isolated, lack a community, or have an Alzheimer’s, dementia, or cognitive disorder diagnosis. 


All of these factors can make it easy for abusers and perpetrators to take advantage, manipulate, or harm seniors. Perpetrators can take various identities, but one 2020 study of reported elder abuse cases to the National Center on Elder Abuse (NCEA) found that 46.8% of elder abuse calls pointed toward the family member as the abuser. In comparison, only 13% of medical caregivers were perpetrators, and the last 5% of cases indicated no relation between the victim and the abuser. 


In these circumstances, older people will often trust their abuser initially due to their close status. Once the abuse starts, they may not have the mental or physical faculty or resources to reach out. Because of this, many experts believe that reported cases are only a fraction of the actual abuse that occurs among seniors. 

Types of Elder Abuse

Elder abuse takes a variety of forms, but each one can cause immense damage to seniors. Let’s take a look at common sources of abuse. 

Physical Elder Abuse

Physical elder abuse is when an abuser inflicts an injury or pain upon an older adult. These acts may include hitting, slapping, pushing, kicking, burning, or using external objects to inflict pain. People who experience physical abuse may experience anything from minor scrapes and bruises to severe fractures, breaks, internal injuries, and even death.

Emotional Elder Abuse

Emotional or psychological elder abuse is any verbal or non-verbal act that causes mental distress to an older person. Although a person is typically not physically harmed when experiencing psychological abuse, it can cause an older person’s mental health to deteriorate. In addition, emotional abuse can be a precursor to physical abuse and other forms of abuse. 


Emotional elder abuse can take various forms, such as:

  • Verbal assaults: The abuser yells or uses insults and derogatory language to belittle or degrade the elder.
  • Intimidation: The abuser threatens to harm or displays threatening behavior to create fear and instill compliance.
  • Harassment: The abuser repeatedly criticizes, blames, or demeans the older person, often causing them to feel worthless or isolated.

Although many forms of emotional abuse may exist beyond this list, you can recognize most if the abuser manipulates an older person to feel afraid, belittled, or depressed.

Financial Elder Abuse

Financial elder abuse is when an abuser uses an older adult’s funds, assets, or property for their own gain, causing financial instability and emotional distress for the older person. Financial abuse can include: 

  • Misusing finances: Unauthorized use of an elder's bank accounts or credit cards, forging their signature, or stealing money or possessions.
  • Exploiting assets: Coercing or deceiving an older adult into signing financial documents, such as wills, deeds, or powers of attorney, that benefit the abuser.
  • Withholding funds: Intentionally depriving an older adult of their financial resources, preventing them from accessing funds needed for daily living expenses, medical care, or other essentials.

In many cases, a family member who is an abuser can do this more easily with the use of a conservatorship. This legally appointed status enables a guardian to manage and handle an incapacitated person’s finances and personal affairs. According to the 2024 NCOA report, financial elder abuse has culminated in over $28 billion in losses amongst older populations.

Neglect

Neglect is a form of abuse that is often unintentional but still causes harm to an older adult. Abusers will fail to meet the needs of an older person, such as not providing enough food, medical care, shelter, or means for personal hygiene, which will then cause an older person’s health and well-being to deteriorate. Those who do this intentionally may also be participating in emotional abuse, causing even more harm to an older person.

Deprivation

Similar to neglect, deprivation involves failing to meet the needs of an older adult. The abuser may isolate the older person from social activities or the community, which may further feelings of loneliness and isolation. They may also fail to provide medical necessities such as medication and therapy or even refuse to provide physical assistance when getting out of bed, going to the bathroom, etc. 


Compared to neglect, deprivation is often more intentional in controlling and manipulating an older person’s actions. 

Sexual Abuse

Sexual elder abuse occurs when an abuser commits a sexual act upon an older adult without their consent, such as groping, fondling, touching, forced penetration and nudity, and other sexual activity. Often, abusers continue these acts without being reported because the older person has dementia, Alzheimer’s, or a cognitive disorder that prevents proper communication with others who may be able to help. These acts have profound effects on an older person’s mental and physical well-being and may even lead to a stress disorder as they cope with the trauma.

What Is the Most Common Type of Elder Abuse?

The most common type of elder abuse reported is psychological or emotional abuse. Out of all reported cases, the World Health Organization (WHO) found that over 33% were psychological abuse cases, which were reported initially by peers, and 32.5% were reported by medical staff. The next highest reported case was physical elder abuse, which consisted of 14%. 


Not only does this indicate how common emotional abuse is among all kinds of elder abuse, but also how important it is for witnesses to recognize and report abuse when they’re uncertain about an older person’s well-being.

How To Recognize Signs of Elder Abuse

In many cases of elder abuse, friends, loved ones, caregivers, and medical professionals are those who are capable of preventing the acts of abuse from continuing. Before they report it, though, they have to receive training and education on what elder abuse might look like, such as:


  • Physical elder abuse: The older person has unexplained bruises, cuts, fractures, or broken bones. They may frequently visit the emergency room or show fearfulness, such as flinching during conversations.
  • Emotional elder abuse: An older person may show signs of depression, anxiety, and distress. They may also withdraw from their previously beloved activities or communities or change their personality and mood.
  • Financial elder abuse: An older person may suddenly be unable to pay for necessities or have missing money or possessions. 
  • Neglect: An older person may have poor hygiene, dirty clothing, experience malnutrition or dehydration, have untreated medical conditions, or live in an unsanitary environment. 
  • Deprivation: Older people may isolate themselves from family, friends, and community. They may not have access to medical care and may be left alone for long periods.
  • Sexual elder abuse: An older person may have unexpected sexually transmitted infections, avoid certain people, or have damaged clothing. 

These signs might be subtle, and the older person may try to provide a reason for these signs of abuse that don’t implicate the abuser. Either way, you must keep your eye out — whether you’re a medical health professional, a loved one, or a community member. 

How To Report Elder Abuse

Once you recognize the signs of abuse, the best way to keep yourself and the older person receiving the abuse safe is to report it. Your avenue for reporting may vary depending on who you are and your relationship with the older person. 

As a Family Member

If you are a family member and you are worried that your loved one is being abused by another family member, a caregiver, a community member, or another culprit, you can take immediate action by contacting Adult Protective Services (APS). APS operates similarly to Child Protective Services (CPS) but primarily removes older people and other adults from situations that involve abuse, neglect, and exploitation. 


APS often operates in specific locations, which you can find by accessing the National Adult Protective Services Association (NPSA). They also have a hotline you can call if you have any suspicions of abuse. When reporting, include any observations or evidence of the abuse. Regardless of whether you have concrete evidence, it’s better to report rather than wait until you do. Doing so can prevent the abuse from continuing. 

As a Caregiver

As a caregiver, if you suspect that abuse is occurring to the older person you care for, you can turn to the following sources to report the incident:


  • APS: Just like family members, caregivers can also call the APS hotline if they suspect the older person they care for is experiencing abuse.
  • Assisted Living Administrator: If you are a caregiver working in an assisted living community, you can reach out to an assisted living administrator, as they protect all residents and can take further action.  
  • Nursing Home Administrator: If you work in a nursing home, you can also report to the nursing home administrator who is tasked with maintaining the health and safety of all residents, and will have connections to the authorities. 
  • Healthcare providers: Since healthcare providers are mandatory reporters, if you tell them about suspected abuse when taking an older person to appointments, they will be obligated to report the incident to the authorities. 

As a caregiver, your duty is to care. Finding ways to report suspected abuse, no matter how you do, is within the realm of your responsibilities. 

As a Healthcare Provider

As mentioned, healthcare providers are often mandatory reporters as they are responsible for ensuring their patients' health and well-being, including reporting acts of abuse that they witness. This also includes personanel in the following facilities:

Assisted Living Communities

Continuing Care Retirement Communities
Nursing Homes
Skilled Nursing Facilities
Memory Care Facilities
Hospice 


You can take further action as a healthcare provider by reporting to your superior. For example, if you are a nurse, you can reach out to the director of nursing, who will then turn to the authorities. Essentially, turn to anyone who is a leader at your facility, as they will likely have the resources and training to handle the situation. 

As a Senior

As a senior, whether you are experiencing the abuse yourself or you suspect one of your loved ones is experiencing abuse, you can seek similar reporting channels as those mentioned above. In particular, reaching out to a healthcare provider may be especially helpful, as they often provide discreet ways to report. For example, many telehealth tools will help connect you with counselors or mental health providers, who are also mandatory reporters for abuse. These same tools can help you process through any trauma you experienced in the process.

What Happens When You Report Elder Abuse?

Once you report a case of elder abuse, it will often go through the following stages: 

  • Initial report: The case begins when an assisted living administrator, hospital administrator, caregiver, or family member contacts Adult Protective Services (APS) to report the suspected abuse.
  • Investigation and assessment: APS will initiate an investigation to gather information and assess the situation. They may interview the older adult, caregivers, family members, and potential witnesses. They will also evaluate the older adult's living conditions, physical and mental health, and overall well-being to determine the extent of the abuse and the immediate needs of the victim.
  • Intervention: If necessary, APS will make arrangements to protect older adults, relocating them to a safer environment, providing medical care, or arranging for counseling services.
  • Contacting law enforcement: If APS confirms the case of elder abuse, they will contact local law enforcement to conduct a criminal investigation and take appropriate legal action against the abuser.
  • Providing legal assistance: APS and other agencies will provide legal assistance to the victim, helping them navigate the legal system and obtain any necessary restraining orders or other protections.
  • Ongoing support: APS will continue to monitor the situation and provide ongoing support to ensure the older adult's safety and well-being, including follow-up visits and additional services as needed.

As a reporter of the case, you can involve yourself as much or as little as you’d like. The most important thing is to follow through with the report if no one else does. If the report fails to pass, you can start the process again to prevent further abuse. 

How To Support Seniors in an Abusive Situation

As important as it is to report abuse, it’s equally important to ensure that the older person receives support. Your support especially can go a long way in their mental and physical well-being, no matter your relationship with them, what trauma they’ve experienced, or your training on the type of abuse. 


You can provide support by:


  • Validating their emotions and encouraging communication: Many older people in older situations may try to downplay the abuse or shut down from any kind of communication afterward. Validating their emotions and letting them know it’s safe to talk about their feelings can help an older person in their healing journey against the trauma. 
  • Removing them from the situation: If you haven’t already, find ways to physically remove them from the abusive situation, as long as it’s safe. You could contact a trusted family member, arrange temporary housing, or seek assistance from social services like APS. 
  • Connecting them with mental health assistance: A counselor or a mental health professional can provide any emotional support you may not feel qualified to provide.
  • Providing practical assistance: Amid an abusive situation and subsequent reporting, the older person may be unable to keep up with daily tasks like grocery shopping, getting to their appointments, or doing their laundry. Helping with these tasks can ease a small but influential burden in their lives.
  • Staying involved: Staying involved can indicate to the older person that you care for them, regardless of their abusive situation. 

Elder abuse isn’t a “one solution fixes all” situation. Your response may vary depending on the situation. Ultimately, stepping in, no matter what that looks like, is paramount. By reporting and supporting older adults facing elder abuse, we can conquer this growing epidemic, one case at a time. 

Resources About Elder Abuse

If you or a loved one would like help for elder abuse or would like to learn more, use these resources: 

National Resources

  • Eldercare Locator: This site is useful if you’re looking for social services, temporary housing, or other resources.
  • National Domestic Violence Hotline: You can also connect with the National Domestic Violence Hotline if you or a loved one is experiencing any kind of abuse, including elder abuse. 

Legal Resources

  • Probono.net: This site is a network that can help connect you to attorneys who can provide pro bono legal assistance when seeking help against an abuser. 

Counseling Resources

  • AARP: AARP is a nonprofit organization that advocates for the interests of older people. This resource, in particular, provides educational resources on mental health issues and how to seek treatment. 
  • FindTreatment.gov: This resource helps you find the closest mental health professional near you.

Online Education

  • National Institute on Aging (NIA): The NIA is funded by the U.S. Department of Health and Human Services to publish research on aging and associated mental and physical health conditions. Inevitably, this includes elder abuse.



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