Elder Abuse & Neglect
“ It Happens At Home”
WHAT IS ELDER ABUSE?
Elder abuse is the mistreatment or
neglect of an elderly person, usually by
a relative or other caregiver. At
greatest risk are the frail and/or
isolated.
Elder abuse may include physical
violence, threats of assault, verbal
abuse, financial exploitation, physical
or emotional neglect, or sexual abuse.
Domestic violence among our older
population is a reality
as the population continues to age, the problem
not likely to just disappear.
1990 - 4% of the population was 65 or older
2020 - 22% of the population will be 65 or older
As baby boomers age, the need for services for
abused individuals is likely to increase.
Many people believe that elder abuse
happens in ( to quote elders) “one of
those places” meaning of course, nursing
homes or skilled nursing facilities. While
some abuse does exist in these facilities,
the majority of elder abuse, neglect and
exploitation, occurs in the home.
Elder abuse is often compared to child abuse
rather than spousal abuse.
Certain symptoms can appear, such as changes
in depth perception, confusion over when an
event occurred, loss of control over bodily
functions, and hearing loss.
These can result in behaviors that some will
want to identify as “”childlike.” Along with this
attitude can come the imposition of the same
kind of control used on children, including
physical discipline.
Many older women do not identify themselves as
abused. Some may see their relationship as
normal.
Many older women believe that battered women
are exclusively young with children.
Many older women were raised in a time when
they were expected to stay at home and care for
their children. Divorce was not considered
socially acceptable.
Older women who have internalized rigid gender
roles may be less willing to talk about their
abuse or to seek help from community services.
She doesn’t want to “air dirty laundry.”
Adult children are often not supportive of change
in their parents’ relationship. If the abuse has
been hidden from the children for years, they
may often refuse to believe it when they are told.
In some cases the children have seen the
mother suffering the abuse, have become
accustomed to it, and resent the sudden
rebellion.
Who are the Abusers?
In 35% of the elder abuse cases in 30
states surveyed, the abuse was
perpetrated by the victim’s adult children.
The National Aging Resource Center on
Elder Abuse estimates the incidence of
abuse in domestic settings (not
institutions) at approximately 2.5 million
cases per year.
Prevalence
According to the best available estimates,
between 1 and 2 million Americans age 65
or older have been injured, exploited or
otherwise mistreated by someone on
whom they depended for care or
protection.
Estimates of the frequency of elder abuse
range from 2% to 10% based on the
survey methods and case definitions.
Data on elder abuse in domestic settings
suggest that 1 in 14 incidents, excluding
incidents of self neglect come to the
attention of authorities.
Current estimates put the overall reporting
of financial exploitation at only 1 in 12
cases suggesting that there maybe at
least 5 million financial abuse victims each
year.
Facts and Figures
The U.S. has 44 million persons age 60 or older, and 36 million
people with disabilities.
In the most recent year studied, Adult Protective Services completed
364,512 investigations of abuse, neglect, or exploitation involving
older persons living at home (in private, non-institutional settings).
Of these, an estimated 43% were confirmed.
In the last decade, the number of domestic elder abuse reports
investigated by Adult Protective Services across the nation has
increased by more than 150 percent.
Almost 62% percent of all cases of abuse, neglect, or exploitation of
adults living at home involve mistreatment by other people and 38%
involve self-neglect.
Domestic elder abuse is a family problem – almost 90% of abusers
were family members.
Men were the abusers in over half of elder abuse cases.
Risk Factors For Abuse
Physical or cognitive impairment of the victim
The most likely victims are 75 and older
Dependent on others for care and protection
Isolation of the victim
• Gradually preventing access to the telephone
Barring visitors or service providers
Elder lives alone
No family or friends
Not known to any community agency
Caregiver stress
Lack of skill in handling a frail person
Unaware of community resources and
respite programs
Work outside the home
Caring for children
Fulfilling household duties
Caregivers own frailty
Dependence of the abuser on the victim
Financial dependence forcing families to
live together
Psychopathology or mental incapacity of the
abuser
Unresolved issues from childhood
that affects personality and behavior
Mental illness or mental retardation
Alcohol or drug abuse
Types of Elder Abuse
1. Financial or Material Exploitation: the illegal or improper
use of an elderly person’s funds, property or assets.
Unusual or inappropriate activity in bank accounts.
Signatures on checks, etc. that do not resemble the
older person’s signature or signed when the older person
cannot write.
Power of attorney given, or recent changes or creation of
a will, when the person is incapable of making such
decisions.
Unusual concern by caregiver that an excessive amount
of money is being expended on the care of the older
person.
Numerous unpaid bills, overdue rent, when someone is
supposed to be paying the bills for a dependent elder.
Lack of amenities, such as TV, personal
grooming items, appropriate clothing, that
the estate can well afford.
Missing personal belongings such as art,
silverware, or jewelry.
Deliberate isolation, by a housekeeper of
an older adult from friends and family,
resulting in the caregiver having total
control.
2. Emotional /Psychological
The infliction of anguish, pain or distress through
verbal or non-verbal acts such as: humiliating,
insulting, name calling or threatening, treating
like a child
Helplessness
Hesitation to talk openly
Withdrawal
Depression
Implausible stories
Fear
Agitation
Confusion
Denial
Anger
3. Neglect
the refusal or failure to fulfill any part of a person’s
obligations or duties to an elderly person; failure
to provide necessary care
Dirt, fecal/urine smell, or other health and safety
hazards in elder’s living environment.
Rashes, sores, lice
Elder is inadequately clothed
Elder is malnourished or dehydrated
Elder has an untreated medical condition
4. Physical & Sexual
any physical pain or injury which is willfully inflicted upon an
elder by a person who has care or custody of, or who
stands in a position of trust with that elder. This includes
direct beatings, sexual assault, unreasonable physical
restraint, and prolonged deprivation of food or water.
Cuts, lacerations, puncture wounds
Bruises, welts, discoloration
Any injury incompatible with history
Injuries not properly cared for
Poor skin condition, poor hygiene
Absence of hair and/or hemorrhaging
below scalp
Dehydration and/ or malnourished without
illness-related cause
Loss of weight
Burns, which may be caused by
cigarettes, caustics, acids, friction from
ropes or chains
Soiled clothing or bed
Genital bruising or irritation
5. Abandonment
desertion or willful forsaking of an elder by
any person having the care and custody of
that elder, under circumstances in which a
reasonable person would continue to
provide care of custody.
6. Self Neglect
behavior of an elderly person that threatens his or
her own safety or health
Inability to manage personal finances, e.g.
hoarding, squandering, giving money away,
failure to pay bills
Inability to manage ADLs
Suicidal acts, wanderings, refusing medical
attention, isolation, substance abuse
Lack of toilet facilities or animal infested living
quarters
Rashes, sores, fecal/urine smell,
inadequate clothing, malnourished,
dehydration
Changes in intellectual functioning, e.g.
confusion, inappropriate or no response,
disorientation to time and place, memory
failure, incoherence, etc.
Not keeping medical appointments
Refusal of medication
Interviewing The Victim
Denial is an important element in elder
abuse both for the victim as well as the
offenders.
Many victims blame themselves and
minimize the extent of the abuse.
Feelings of victims:
Shame or embarrassment
Fear of retaliation
Powerlessness
Interview all clients in private without the
caregiver’s presence. The client should:
Be treated with respect
Be asked for permission to ask questions,
examine injuries
Be told that the person’s situation is one
that you have seen before
Be told that in many cases injuries are
caused by someone in the elder’s family
Be asked if the injuries were caused by
someone that the victim knows
If the client has the capacity to understand the
dangers of the abuse and the consequences of
remaining in the abusive situation, efforts should
be made to educate him or her about:
The fact that assault is a crime
The likelihood that the abuse will increase in
frequency and intensity
The abuser needs help that the victim cannot
provide
The need for a safety plan to get away the next
time the situation becomes dangerous
The need for a safety plan to get away the
next time the situation becomes
dangerous
The fact that the abuser is responsible for
the violence not the victim
The need for support from others
Indicators of Abuse from the
Caregiver
Elder not given opportunity to speak for
him/herself or see others without the presence of
the caregiver
Attitudes of indifference or anger toward the
dependent person, or the obvious absence of
assistance
Family member or caregiver blames the elder
(e.g. accusation that incontinence is a deliberate
act)
Aggressive behavior by caregiver toward the
elder
Previous history of abuse to others
Problems with alcohol or drugs
Inappropriate displays of affection by
caregiver
Flirtations, coyness, etc as possible
indications of inappropriate sexual
relationship
Social isolation of family or isolation or
restriction of activity of the older adult
within the family unit by the caregiver
Conflicting accounts of incidents by family,
supporters or victim
Unwillingness or reluctance by the
caregiver to comply with service providers
in planning for care and implementation
Inappropriate or unwarranted
defensiveness by caregiver
OLDER ABUSE VICTIM PROFILE
Female - Older women are less likely to
resist abusive behavior and are more
vulnerable to sexual molestations.
Advanced Age - As people age they lose
the capacity of physical strength to resist
or defend themselves.
Dependent - Older persons who depend
on others for their care are more
vulnerable.
Excessive loyalty - If the victim has a
strong sense of loyalty to the care giver,
he/she will probably not seek help.
Stoicism - Some persons accept their
troubles without seeking relief based on a
philosophy, job, tolerance, resignation, or
fear.
Substance abusers - Older substance
abusers are very susceptible to abusive
behavior and are frequently self-neglectful
Impairment - the greater the infirmities of
the one needing care, the greater the
demand on the care giver. If the person’s
infirmity includes mental impairment, it
exacerbates the stress for the care giver.
Poverty - Poverty is common among
elderly which adds stress to the care giver.
WHAT CAN YOU DO?
Elder Abuse is a serious offense.
Report it to the Abuse Hotline at
1-800-96ABUSE
ACT SERVICES
ALL SERVICES ARE FREE TO VICTIMS AND
THEIR CHILDREN
24-HOUR HOTLINE
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CONTACT THE LEGAL DEPARTMENT
24 HOURS A DAY
239-334-5382
IMPORTANT NUMBERS
ABUSE COUNSELING AND
TREATMENT, INC. (ACT)
HOTLINE
(239) 939-3112
ADMINISTRATION (239) 939-2553
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