Abuse of Older Adults

What is abuse of older adults?

Abuse is anything someone does or does not do that ends up harming someone else's health and well-being. The mistreatment can be physical, mental, or financial.

Every year millions of older adults are abused or neglected. It can happen to anyone anywhere. It can happen:

• in the older adult's own home
• in someone else's home
• in a hospital or nursing facility.

The abuse may be done on purpose or by mistake by someone caring for the older adult. It could be a family member, friend, or paid caregiver.

There are many kinds of abuse. More than one kind of abuse can happen at the same time.

Physical neglect is the type of abuse that happens most often. Neglect is when the caregiver does not give the older adult the things needed for his or her health. This may happen when the caregiver does not know what the person needs. The older adult may:

• Not have safe and adequate housing.
• Not get enough food or water.
• Not be allowed to wear hearing aids, eyeglasses, or dentures, purposely or accidentally (for example, when the dentures are stored out of reach).
• Not get needed medicine or care.
• Not have suitable clothing for the weather conditions.

Physical abuse is anything someone does to cause pain, injury, or disease. Among other things, an older adult could be:

• burned, shaken, or beaten
• attacked sexually
• physically restrained, such as being tied to a bed or wheelchair
• purposefully given too much or too little medicine.

Emotional abuse causes stress or emotional harm. This can include:

• insults or threats
• being ignored
• being treated like a child.

Financial abuse is misuse of the older adult's money and property. The abuser may:

• Spend money without the older adult's knowledge or consent.
• Sell the older adult's property.
• Steal money, food stamps, or checks.
• Misuse assets.

A violation of personal rights happens when older adults are not allowed to make their own decisions even though they are able to do so. This includes:

• not having privacy
• not being allowed to attend important activities, such as voting or going to church
• having their mail opened without their permission, or not being allowed to read their mail.

Why does abuse happen?

There are many reasons why abuse happens. Examples are stress, drugs, resentment, or past abuse.

A caregiver may be feeling stressed because he or she is tired, angry, or frustrated. Worries about money can cause stress. The caregiver may not be able to deal with his or her feelings. The abusive caregiver may use drugs or alcohol. He or she may be mentally ill.

The caregiver may feel resentful because she or he depends on the older adult for housing, money, or child care. The caregiver may also feel stuck in the role of taking care of the older adult.

Abuse may happen as part of a cycle of family violence. The abuser may have been hurt in childhood by the older adult or by someone else and in turn has become an abuser him or herself.

How do you know when abuse is happening?

Older adults often do not report abuse. They may:

• Be ashamed of what is happening.
• Want to protect the abuser if that person is their spouse, child, or grandchild.
• Be afraid the abuser will get back at them.
• Be afraid of being moved to a nursing facility.
• Worry that no one will believe them.

Sometimes abuse is not reported because doctors, nurses, and social workers do not know what to look for or because older adults may have no contact with people who might report it.

Everyone needs to be aware of the signs of abuse and help stop it.

Doctors or nurses may find signs of physical abuse, such as:

• bruises, broken bones, or burns
• marks on wrists or ankles
• signs that the older adult is taking too much or too little medicine
• unexplained weight loss
• dehydration (loss of too much fluid from the body).

Signs of mental stress may include:

• unusual weight gain or loss
• crying
• trouble sleeping
• tearfulness
• nervousness
• uneasiness or fear around the caregiver
• agitation and difficult behaviors, such as refusing to do what the caregiver asks.

Neighbors may hear screaming, crying, or fighting in the older adult's home.

Friends and family members may notice:

• dental neglect, such as dentures that no longer fit or complaints of tooth pain
• poor hygiene
• bald spots from pulling out hair
• the signs of abuse noted above.

If you think someone is being abused, get help right away. The situation for the older adult could get a lot worse if the abuse is not reported. It is better to be wrong than to have someone continue to suffer. If you are being abused or think that maybe someone else is being abused, call 1-800-677-1116 right away. The National Eldercare Locator hotline can help you find the right agency to report the situation.

You can also make a report to Adult Protective Services. Look in the community services pages of your telephone book for a number. You may also be able to get the number from the United Way, from Child Protective Services, or from a hospital or police department. You can make a difference and help stop the suffering of a neglected or abused older adult.