Elder abuse: Signs to look for, action to take

Knowing more about elder abuse and when to call for assistance can help you protect your loved one.

Perhaps you suspect your elderly neighbor isn't caring for herself the way she needs to, but you aren't certain. Or maybe you wonder about some bruises you've seen on your aging uncle. You can't get rid of the nagging feeling that something's not right. But is it elder abuse?

What actions can be considered elder abuse?

Elder abuse occurs when someone knowingly or unknowingly causes harm or a risk of harm to an older adult. Elder abuse can take several forms, including:

• Physical abuse. Physical abuse is the use of physical force, such as hitting, pushing, shaking or burning, with the intention of causing pain or injury.
• Sexual abuse. Sexual abuse involves any nonconsensual sexual contact, such as inappropriate touching, rape or pornographic photography.
• Emotional abuse. Psychological or emotional abuse is the use of tactics, such as harassment, insults, intimidation or threats, that cause mental or emotional anguish or isolation.
• Financial abuse. Financial or material exploitation involves improperly using an older person's resources for the benefit of another person, for example, by stealing, trickery or inappropriate use of government checks. Inappropriate use of financial power of attorney is another common example.
• Neglect. Neglect occurs when a caregiver refuses or fails to provide the level of care necessary to avoid physical or mental harm. Examples include inadequate attention to food, water, shelter and personal hygiene.

The abuser is typically a family member — an adult child or a spouse. In institutions, such as nursing homes or group homes, professional caregivers may be abusers.

People age 80 and older, especially women, are at a greater risk of experiencing elder abuse. Older adults who are dependent on others for basic care are particularly vulnerable to elder abuse.

What should you look for if you suspect elder abuse?

If you're concerned an older adult might be abused, knowing the signs and symptoms of abuse can help you determine if a problem exists. These signs and symptoms may include:

• Physical injury. Examples of questionable injuries include bruises, cuts, burn or rope marks, and broken bones or sprains that can't be explained. Other signs of potential problems include sudden changes in behavior, comments about being battered or the refusal of the caregiver to allow you to visit the older person alone.
• Lack of physical care. Indications of substandard physical care include dehydration, malnourishment, weight loss and poor hygiene. Bed sores, soiled bedding, unmet medical needs and comments about being mistreated also may indicate a problem. Lack of physical care can happen to older adults living in their homes, as well as in institutional care settings, such as a nursing home.
• Unusual behaviors. Changes in an older person's behavior or emotional state may suggest a problem. Examples include agitation, withdrawal, fear or anxiety, apathy, or reports of being treated improperly.
• Unaccounted for financial changes. Financial problems may include missing money or valuables, unexplained financial transactions, unpaid bills despite available funds and sudden transfer of assets, as well as comments about being exploited. Another sign may be older adults who are controlling their finances but don't allow relatives to see their records.

What should you do about elder abuse?

Talking with the suspected abuser about the problem isn't likely to help. Though you might be afraid to get involved or be unsure of whom to contact, it's important for you to speak up about suspected elder abuse. There are agencies that can help. A problem can't be remedied until it's reported.

Elder abuse at home: Actions to take
Call the police if you suspect an older adult is in imminent danger. If you're not aware of immediate danger, but you suspect an older adult is being abused, check with welfare and social service agencies. Most cities and counties, according to state law, will investigate and protect vulnerable adults from elder abuse.

The Adult Protective Services agency — a component of human service agencies in most states — is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors, nurses, police officers, lawyers and social workers.

Elder abuse in a nursing home: Actions to take
If you suspect elder abuse in an institutional setting, such as a nursing home, report concerns to your state long term care ombudsman. Each state has a long term care ombudsman to investigate and address nursing home complaints.

The Web site for the National Center on Elder Abuse maintains a list of phone numbers, by state, that you can call for assistance if you suspect domestic or institutional elder abuse.

What if an older adult is hurting himself or herself?

One of the most common types of elder abuse occurs when older adults unintentionally jeopardize their own safety. Self-neglect can happen if an older adult deprives himself or herself of necessities such as food, water or medication. If the older adult is mentally competent, yet consciously makes decisions that put himself or herself in harm's way, it may be a case of self-neglect. Self-neglect often occurs in older adults who have declining health, who are isolated or depressed, or who abuse drugs or alcohol.

Signs that an older adult is neglecting himself or herself include:

• Neglecting personal hygiene
• Wearing soiled or ragged clothes
• Lacking food or basic utilities
• Refusing to take medications

Contact resources in your area if you know older adults who may be neglecting their own needs and putting themselves in danger. Contact your loved one's doctor to report your concerns. Often, helping older adults who neglect themselves involves treating underlying conditions, such as depression, or putting older adults in touch with resources designed to help them get groceries and other necessities or help them with housework. It's usually possible for the older adult to remain at home, while at the same time improving his or her safety. In some cases, a guardian might be appointed to care for the older person.

RELATED

MayoClinic.com Bookstore

• 'The Mayo Clinic Plan for Healthy Aging' (Hardcover)

Web Resources

• National Center on Elder Abuse