Elder abuse

Elder abuse happens when a trusted caregiver or adult knowingly harms an older person (someone 60 and older).1 It includes many types of abuse, such as physical, sexual, emotional, verbal, and financial. Elder abuse can also mean knowingly neglecting an older person to the point that they are harmed, such as by withholding food or medical care. Elder abuse affects more women than men.2 You can help prevent or stop elder abuse of yourself or someone you love by knowing the signs to watch for.

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What is elder abuse?

Elder abuse can happen in the home, in a nursing home or assisted living facility, or in public. It can include any type of abuse, such as physical, sexual, emotional, verbal, and financial, against an older person. Elder abuse is more likely to happen when an older person is dependent on other people for daily activities of living, such as eating, bathing, using the toilet, dressing, or managing money.

Elder abuse also includes neglect and taking advantage of an older person.

What are the health effects of elder abuse in older women?

Elder abuse can be very harmful to a woman’s health, especially if it continues after a single event. Researchers have found that any type of elder abuse can shorten a person’s life, regardless of any other health problems they might have.3 Studies show that if an older person also has dementia (serious problems with thinking and remembering), the risk of early death after abuse is even higher.4

How common is elder abuse?

Experts aren’t sure how common elder abuse is, because many victims of elder abuse may not report it or may not be aware of it. Studies suggest that elder abuse may affect one in 10 older adults.5 More women than men experience elder abuse, in part because women live longer.2

Emotional and verbal abuse and financial abuse are the most common types of elder abuse.2

Who commits elder abuse?

  • Physical abuse is more likely to come from partners (spouses or romantic partners).
  • Financial abuse is most often committed by family members, friends and neighbors, and home health care aides.6 Living with an adult child who is unemployed or has a history of substance abuse raises a person’s risk for financial abuse.7
  • Emotional or verbal abuse or neglect is more likely to come from caregivers of the person being abused.

Someone who abuses an older adult is more likely to have mental or physical health problems, financial problems, a history of substance abuse, or to be experiencing major stress.5

What are the signs of elder abuse?

Elder abuse comes in many forms. Below are the types of elder abuse and signs to watch for.

Physical abuse

Hitting, slapping, beating, pushing, shoving, kicking, pinching, and burning

Signs:

  • Bruises and black eyes
  • Marks on the body, like welts, cuts, and open wounds
  • Sprains, dislocated joints (like a shoulder), and broken bones
  • Injuries that are healing but were never treated by a doctor or nurse
  • Rope marks or burns on hands and feet (could mean an older person has been tied up or restrained)
  • Broken eyeglasses or frames
  • Sudden change in behavior
  • Not wanting to be alone with the caregiver
  • Not being allowed to have visitors when the caregiver is not present
  • Running out of prescription medicine too quickly or having prescription medicine that looks like it is not being taken as it should be (the bottle being too full)
  • Telling you they are being physically hurt

Emotional and verbal abuse

Verbal assaults, threats, intimidation, harassment, and isolating the person from regular activities, family, and friends

Signs:

  • Being in an upset or agitated state
  • Becoming withdrawn and not wanting to talk or interact with anyone
  • Unusual behavior, like rocking, biting, or sucking (usually thought to be symptoms of dementia)
  • Telling you they are being mistreated

Sexual assault and abuse

Any sexual contact that is not agreed to, such as unwanted touching

Signs:

  • Bruises on or around the breasts or genitals
  • Unexplained sexually transmitted infections (STIs) or vaginal or anal bleeding
  • Repeated urinary tract infections (UTIs) because they do not want to have a catheter changed
  • Torn, stained, or bloody underwear
  • Telling you they were sexually assaulted or raped

Neglect

Knowingly not taking proper care of an older person, including physical care (food, clothing, shelter, medicine, personal hygiene) and financial care (not paying for living arrangements, care, and other bills)

Signs:

  • Poor hygiene, dehydration, malnutrition, and, for a bedridden person, bed sores that aren’t being treated
  • Health problems that aren’t being treated
  • Unsafe living conditions (no heat, electricity, or water and faulty wiring)
  • Poor living conditions (dirt, fleas, soiled bedding, clothes and bedding smelling like urine or feces, improper clothing, lice)
  • Telling you they are being neglected

How can I help prevent elder abuse?

If you are an elderly or older person:

  • Keep in touch. Be socially active and don’t spend too much time alone. Being cut off from other people can increase the risk of abuse. Keep in touch with family and friends.
  • Speak up. If abuse is happening in the home, try to find the courage to speak up. We all have a right to a safe environment. If a family member is abusive, consider speaking with other family members or friends who you think can help you.
  • Call police. Call the police if you are in immediate danger. The police can help stop violence and connect you with other community services.
  • Report. If abuse is happening in a long-term care facility, report it to facility management as well as family members. If no family members can help, contact the state’s long-term care ombudsman. The ombudsman’s purpose is to be an advocate and help.
  • Plan for the future. Plan for your financial future with a trusted person or persons. Make sure that your finances are in order. Tell family, caregivers, and doctors your health care wishes.

If you or someone you know has been the victim of elder abuse, seek help from family, friends, or community organizations. Talk to a doctor or other health care professional.

Many states have 24-hour toll-free numbers for confidential reports of abuse. The National Center on Elder Abuse can help you find services in your community.

How can family members and friends help prevent elder abuse?

Elder abuse may be more likely to happen if the older person has dementia or any other type of serious problem with thinking or remembering. Family members and friends of an older adult can help to prevent abuse by:

  • Calling and visiting as often as you can. Keep in contact with the person. If the person is in a facility, keep in touch with staff there. You may also want to make surprise visits.
  • Watching for warning signs that might signal abuse.
  • Making sure that the older adult is eating properly and taking required medicines. A weakened older person may not be able to think clearly about their care or to communicate any abuse experienced.
  • Looking at the person’s bank accounts and credit card statements, with their permission, for unauthorized transactions

Many states have 24-hour toll-free numbers for confidential reports of abuse. The National Center on Elder Abuse can help you find services in your community.

What should I do if I suspect elder abuse?

Call 911 if the older person is in immediate danger.

If the older person can speak, ask about any signs of abuse you see such as bruises, unusual financial activity, or fear of caregivers. If possible, document any signs of abuse with photos, videos, or written statements. Contact the local police.

You can also report elder abuse to the local adult protective services agency, similar to child protective services. Each state has an adult protective services agency. Use this online map to find help in your area. If the older person is in a facility like a nursing home, you can report abuse to an ombudsman, whose job is to resolve disputes.

Did we answer your question about elder abuse?

For more information about elder abuse, call the OWH Helpline at 1-800-994-9662 or check out the following resources from other organizations:

Sources

  1. Hall, J.E., Karch, D.L., Crosby, A.E. (2016). Elder Abuse Surveillance: Uniform Definitions and Recommended Core Data Elements, Version 1.0. Atlanta (GA): National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
  2. Laumann, E.O., Leitsch, S.A., Waite, L.J. (2008). Elder Mistreatment in the United States: Prevalence Estimates From a Nationally Representative StudyJournals of Gerontology, Series B: Psychological Sciences and Social Sciences; 63(4): S248-S254.
  3. Burnett, J., Achenbaum, W.A., Murphy, K.P. (2014). Prevention and Early Identification of Elder Abuse. Clinics in Geriatric Medicine; 30(4): 743-759.
  4. Dong, X., Simon, M., Mendes de Leon, C., Fulmer, T., Beck, T., Hebert, L., et al. (2009). Elder Self-neglect and Abuse and Mortality Risk in a Community-Dwelling Population. Journal of the American Medical Association; 302(5): 517-526.
  5. Lachs, M., Pillemer, K. (2015). Elder AbuseNew England Journal of Medicine; 373: 1947-1956. doi: 10.1056/NEJMra1404688.
  6. Peterson, J.C., Burnes, D.P., Caccamise, P.L., Mason, A., Henderson, C.R., Jr., Wells, M.T., Lachs, M. (2014). Financial Exploitation of Older Adults: A Population-Based Prevalence Study. Journal of General Internal Medicine; 29(12): 1615-1623. doi: 10.1007/s11606-014-2946-2.
  7. National Research Council (US) Panel to Review Risk and Prevalence of Elder Abuse and Neglect; Bonnie, R.J., Wallace, R.B., editors. (2003). Chapter 13: Financial Abuse of the Elderly in Domestic Setting. Washington, DC: National Academies Press (US).