Elder Abuse and Neglect
Elder abuse awareness day takes place of the 15th June every year. The day aims to focus global attention on the problem of physical, emotional, and financial abuse of elders.
Unfortunately, due to COVID-19 we are unable to hold any group session but would hope that by joining our partner agencies we are able to promote Elder Abuse day via our social media platforms.
What is elder abuse and neglect?
Elder abuse includes physical, emotional, or sexual harm inflicted upon an older adult, their financial exploitation, or neglect of their welfare by people who are directly responsible for their care. Research indicates that almost half a million people aged over 65 will experience some form of abuse or neglect.
As older adults become more physically frail, they’re less able to take care of themselves or stand up to bullying. Older adults who have mental or physical ailments and may not see or hear as well or think as clearly as they used to, are more vulnerable to unscrupulous people taking advantage of them.
Elder abuse tends to take place where they live: where their abusers are often adult children, other family members or in long-term care facilities.
If you suspect that an elderly person is at risk from a neglectful or overwhelmed caregiver, or being preyed upon financially, it’s important to speak up. Everyone deserves to live in safety, with dignity and respect and free from abuse and neglect.
Types of elder abuse
Abuse of elders takes many different forms, some involving intimidation or threats against the elderly, some involving neglect, and others involving financial trickery. The most common are:
Physical abuse – The non-accidental use of force against an elderly person that results in physical pain, injury, or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints, or confinement.
Emotional abuse – The treatment of an older adult in ways that cause emotional or psychological pain or distress, including:
- Intimidation through yelling or threats
- Humiliation and ridicule
- Habitual blaming or scapegoating
- Ignoring the elderly person
- Isolating an elder from friends or activities
- Terrorizing or menacing the elderly person
Sexual abuse – Contact with an elderly person without their consent. Such contact can involve physical sex acts, but activities such as showing an elderly person pornographic material, forcing the person to watch sex acts, or forcing the elder to undress are also considered sexual elder abuse.
Elder neglect – Failure to fulfil a caretaking obligation. This constitutes more than half of all reported cases of elder abuse. It can be intentional or unintentional, based on factors such as ignorance or denial that an elderly charge needs as much care as they do.
Financial exploitation – The unauthorized use of an elderly person’s funds or property, either by a caregiver or an outside scam artist. An unscrupulous caregiver might:
- Misuse an elder’s personal checks, credit cards, or accounts
- Steal cash, income checks, or household goods
- Forge the elder’s signature
- Engage in identity theft
Typical scams that target elders include:
- Announcement of a “prize” that the elderly person has won but must pay money to claim
- Phony charities
- Investment fraud
Warning signs of elder abuse
Signs of elder abuse can be difficult to recognise or easily mistaken for symptoms of dementia or a person’s frailty.
Frequent arguments or tension between the caregiver and the elderly person or changes in the personality or behaviour in the elder can be broad signals of elder abuse. If you suspect abuse, but aren’t sure, you can look for clusters of the following warning signs.
Physical abuse warning signs:
- Unexplained signs of injury, such as bruises, welts, or scars
- Broken bones, sprains, or dislocations
- A report of drug overdose or an apparent failure to take medication regularly
- Broken eyeglasses or frames
- Signs of being restrained
Emotional abuse warning signs:
- Threatening, belittling, or controlling caregiver behaviour
- Behaviour from the elder that mimics dementia, such as rocking, sucking, or mumbling to themselves
Sexual abuse warning signs:
- Bruises around breasts or genitals
- Unexplained vaginal or anal bleeding
- Torn, stained, or bloody underclothing
Elder neglect or self-neglect warning signs:
- Unusual weight loss, malnutrition, dehydration
- Untreated physical problems, such as bed sores
- Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
- Being left dirty or unbathed
- Unsuitable clothing or covering for the weather
- Unsafe living conditions
- Desertion of the elder at a public place
Financial exploitation warning signs:
- Significant withdrawals from the elder’s accounts
- Sudden changes in the elder’s financial condition
- Items or cash missing from their household
- Suspicious changes in wills, power of attorney, titles, and policies
- Addition of names to their signature card/ missing card
- Financial activity that they couldn’t have undertaken, such as an ATM withdrawal when the account holder is bedridden
- Unnecessary services, goods, or subscriptions
Healthcare fraud or abuse warning signs
- Evidence of overmedication or under-medication
- Evidence of inadequate care when bills are paid in full
- Problems with the care facility: poorly trained, poorly paid, or insufficient staff; crowding; inadequate responses to questions about care
Risk factors for elder abuse
It’s difficult to take care of an elder who has many different needs, and it’s difficult to be elderly when age brings with it infirmities and dependence. Both the demands of caregiving and the needs of the elder can create situations in which abuse is more likely to occur.
Many nonprofessional caregivers – spouses, adult children, other relatives and friends find taking care of an elder to be satisfying and enriching. But the responsibilities and demands of caregiving, which escalate as the elder’s condition deteriorates, can also cause significant stress. The stress of elder care can lead to mental and physical health problems that leave caregivers burned out, impatient, and more susceptible to neglecting or lashing out at the elders in their care.
In addition to the caregiver’s inability to manage stress, other risk factors for elder abuse include:
- Depression in the caregiver
- Lack of support from other potential caregivers
- The caregiver’s perception that taking care of the elder is burdensome and without emotional reward
- Substance abuse by the caregiver
- The intensity of the elderly person’s illness or dementia
- Social isolation – the elder and caregiver are alone together almost all the time
- The elder’s role, at an earlier time, as an abusive parent or spouse
- A history of domestic violence in the home
- The elder’s own tendency toward verbal or physical aggression
Even caregivers in institutional settings can experience stress at levels that lead to elder abuse. Nursing home staff may be prone to elder abuse if they lack training, have too many responsibilities, are unsuited to caregiving, or work under poor conditions.
Preventing elder abuse and neglect
If you’re a caregiver to an elderly person and feel you are in danger of hurting or neglecting them, help and support are available. Perhaps you’re having trouble controlling your anger and find yourself screaming louder and louder or lashing out at the person in your care? Or other people have expressed concern with your behaviour or the tension between the two of you? Or maybe you simply feel emotionally disconnected or overwhelmed by the daily needs of the elderly person in your care? Recognizing that you have a problem is the biggest step to getting help and preventing abuse.
As a caregiver, the following steps can help you prevent elder abuse or neglect:
- Take immediate steps to relieve stress and burnout. Stress is a major contributor to elder abuse and neglect.
- Request help from friends, relatives, or local respite care agencies or find an adult day-care programme. Every caregiver needs to take regular breaks from the stress of caring for an elder and to attend to their own needs, if only for a couple of hours. Surrey County Council – Carer support
- Seek help for depression. Family caregivers are especially at risk for depression, but there are plenty of things you can do to boost your mood and outlook.
- Find a support group for caregivers of the elderly. Sharing your concerns and experiences with others facing the same challenges can help relieve the isolation you may be feeling as a caregiver. It can also be a great place to gain valuable tips and insight into caring for an elder. Action for Carers – Surrey
- Get help for any substance abuse issues. It’s never easy, but there are plenty of actions you can take to address drug or alcohol abuse. Healthy Surrey – Drug and Alcohol information
If you’re a concerned friend or family member, the following can also help to prevent abuse of an elderly person.
- Call and visit as often as you can, helping the elder to see you as a trusted confidante.
- Offer to stay with the elder so the caregiver can have a break – on a regular basis, if possible.
- Monitor the elder’s medications to ensure the amounts being taken correspond with the prescription dates.
- Watch for financial abuse by asking the elder if you can check their bank accounts and credit card statements for unauthorised transactions.
- Identify the warning signs of abuse or neglect and report it without delay. Concerned about an adult
Reporting elder abuse
If you are an elder who is being abused, neglected, or exploited, tell at least one person. Tell your doctor, a friend, or a family member whom you trust. Or call one of the helplines listed below. If you see an older adult being abused or neglected, don’t hesitate to report the situation. And if you see future incidences of abuse, continue to call and report them. Each elder abuse report is a snapshot of what is taking place. The more information that you can provide, the better the chance the elder has of getting the quality of care they need. Older adults can become increasingly isolated from society and, with no work to attend, it can be easy for abuse cases to go unnoticed for long periods.
Many seniors don’t report the abuse they face even if they’re able. Some fear retaliation from the abuser, while others view having an abusive caretaker as better than having no caretaker and being forced to move out of their own home. When the caregivers are their children, they may feel ashamed that their children are inflicting harm or blame themselves: “If I’d been a better parent when they were younger, this wouldn’t be happening.” Or they just may not want children they love to get into trouble with the law. In any situation of elder abuse, it can be a real challenge to respect an older adult’s right to autonomy while at the same time. Concerned about an adult
Age UK – Protection from Abuse
Hourglass (Previously Action on Elder Abuse)
The Sliverline (helpline for older people)
Surrey Safeguarding Adults Board Guidance leaflets/ posters/ booklets and videos:
Keeping you safe at home and in your community
Keeping you safe at home and in your community (easy read)
Are you being provide with good care at home that keeps you safe?
Keeping you safe from Abuse (Booklet)
Keeping you safe from Abuse (A4 Poster)
Surrey Police – Little book of scams