Elder Abuse - How to Define It, Recognize It, and Report It

Dorian Martin Health Guide

    Here are some of the multiple headlines over a one week span  that I found  when I “Googled” the following terms – “Alzheimer’s disease” and “elder abuse”:

    - The Minneapolis-St. Paul Star Tribune from Feb. 16, 2009: “Her family's legacy is gone, and she will never know it.” (The article describes how the Alzheimer’s patient’s son allegedly sold the family farm and also forged more than $100,000 from her account.)

    - CNN on Feb. 18, 2009: “Brooke Astor would have been 'mortified' by son's trial”

    - The Los Angeles Times from Feb. 20, 2009: “3 arrested in nursing home deaths in Lake Isabella”

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    So what is elder abuse? How often does it happen? And what should you do if you suspect that elder abuse is happening? I hope this sharepost will help start a conversation about identifying and preventing elder abuse. Often we read about this abuse as a financial situation (such as identity theft), but elder abuse also can be mental or physical in nature. And we often think of it happening by someone who is employed as a hired hand, whether a nursing home staff member or a home health care aide; however, family members are often the abusers of  elders who have dementia. So the first step in let’s define what we’re talking about.


    What is Elder Abuse?

                The National Ceenter for Elder Abuse defines elder abuse as “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. The specificity of laws varies from state to state, but broadly defined, abuse may be:

        * Physical Abuse - Inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need.
        * Emotional Abuse - Inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts.
        * Sexual Abuse - Non-consensual sexual contact of any kind.
        * Exploitation - Illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder.
        * Neglect - Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable elder.
        * Abandonment - The desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.”

    NCEA reports that while one sign does not necessarily indicate abuse, there are tell- signs that indicate that abuse may be happening. These include:

        * Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.
        * Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
        * Bruises around the breasts or genital area can occur from sexual abuse.
        * Sudden changes in financial situations may be the result of exploitation.
        * Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.

  •     * Behavior such as belittling, threats, and other uses of power and control by spouses are indicators of verbal or emotional abuse.

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        * Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.

    Who are the Abusers?

    NCEA reports that gender does not determine who will be abusers of older adults. However, NCEA noted that family members- including spouses as well as  adult children --  are more often the abusers than any other group.


    How Often Does Elder Abuse Happen?

    The National Center for Victims of Crime shared the following statistics:

        * There are presently about 39 million individuals over the age of 65; the U.S. Census Bureau projects that more than 62 million Americans will be 65 or older in 2025 (McCoy and Hansen, 2004).
        * Older women (67%) are far more likely than men (32%) to suffer from abuse and slightly more than half of the alleged perpetrators of elder abuse were female (53%). (National Center on Elder Abuse Study, 2004).
        * Twenty percent of elder abuse involved caregiver neglect; 15% centered on emotional, psychological, or verbal abuse; 15% involved financial exploitation; 11% was physical abuse, and 1% was sexual abuse (Teaster, National Center on Elder Abuse, 2006).
        * In 2004, Adult Protective Services received a total of 565,747 reports of elder abuse for persons of all ages from 50 states, plus Guam and the District of Columbia, and investigated 461,135 reports. Of that number, APS substantiated 191,908 reports of elder abuse for victims of all ages, representing a 16% increase from the 2000 survey. (National Center on Elder Abuse Study, 2004).
        * Because older victims usually have fewer support systems and reserves – physical, psychological, and economic – the impact of abuse and neglect is magnified, and a single incident of mistreatment is more likely to trigger a downward spiral leading to loss of independence, a serious complicating illness, and even death. (Burgess and Hanrahan, 2006).
        * Of alleged perpetrators of elder abuse, 33% were adult children, 22% were other other family members; 16% were strangers, and 11% were spouses/intimate partners (Teaster, National Center on Elder Abuse, 2006).

    If You Suspet Elder Abuse:

    Call the police or 911 if you believe someone is in immediate, life-threatening danger. In addition, many states require that professionals such as doctors and home health professionals report suspected abuse or neglect. If you suspect abuse has occurred or is occuring, you should call the local adult protective services, long-term care ombudsman, or police.

    Each of us needs to be advocates for loved ones who have Alzheimer’s. We need to be alert to the fact that elder abuse can happen in many ways. And we need to be aware that people we don’t want to suspect – including family members – may actually be culprits. And most importantly, we need to have the fortitude to do something if we suspect that a loved one with Alzheimer’s is a victim of elder abuse.

Published On: March 12, 2009