Elder Abuse Abuse, Elder

Overview, Causes, & Risk Factors

Elder abuse is the mistreatment of an older person. It mayoccur while the person is living alone, with others, or in an institution.

  • Domestic elder abuse refers to mistreatment by someone who has a specialrelationship with the elder. This person could be a spouse, sibling, child,friend, or other caregiver.
  • Institutional abuse refers to mistreatment of someone living in a facility forolder persons. This includes nursing homes, foster homes, group homes, or boardand care facilities where staff is paid to provide care.
  • Self-neglect occurs when the behavior of an older person living alonethreatens his or her own health or safety.
  • There are four common types of elder abuse.

  • Physical abuse is pain or injury inflicted on purpose by a caregiver. Itmay include slapping, pushing, pinching, beating, physical restraint, or sexual assault.
  • Psychological or emotional abuse is mental suffering inflictedintentionally by a caregiver. It may include humiliation, intimidation,threats, and destruction of belongings.
  • Financial abuse is improper or illegal use of the resources of an olderperson without consent. It may include the sale of a home or belongings.
  • Neglect is failing to provide reasonable care. For example, aperson may be abandoned or denied food or healthcare.
  • What are the causes and risks of the injury?

    A study by the National Center for Elder Abuse found there werenearly 300,000 reports of domestic elder abuse in 1996. This was a 150% increaseover the previous 10 years! Plus, the study noted that for each incident reported,as many as another 13 may have gone unreported.

    Psychological, social, and economic factors all contribute toelder abuse. One or more of these issues may trigger it:

  • Caregiver stress. Caring for older, frail people can be time-consuming andvery stressful. The stress is greater when the older person is mentally orphysically impaired.
  • Cycle of violence. Some families act more violent than others. Violence isa learned behavior passed down from parents to children. In thesefamilies, abusive behavior is the normal response to tension or conflict. Spouses arealso one of the most common elder abusers. In these cases, the elderabuse is often a continuation of a pattern of spousal abuse started years earlier.
  • Impaired mental or physical health. Elders in poor health are more likely to beabused than those in good health. Abuse tends to occur when an older person’smental or physical health worsens and stress rises.
  • Personal problems of the abuser. Adult children whoabuse their parents may suffer from mental disorders,alcoholdependence, drug abuse oraddiction, and financial problems. They may have just finished raisingtheir children and now find themselves tied down again taking care of aparent.
  • The typical victim of elder abuse is a widowed, white woman.In her mid-70s or older, she lives on a fixed income. However, it’s vital tonote that victims do not have to fit the typical picture. Elder abusehappens in all ethnic groups, races, and economic groups.

    The abuser is often a spouse or adult child. Two-thirds ofabusers are family members, most of them serving in the caregivingrole. Often, the victim does not report the abuse. He or she may:

  • fear revenge by the abuser
  • feel embarrassed
  • worry about being put into an institution
  • Symptoms & Signs

    What are the signs and symptoms of the injury?

    Elder abuse takes many forms. It may leave visible injuries,such as cuts and bruises, or less visible emotional scars. Signs andsymptoms of mistreatment vary with the type of abuse.

    With physical abuse, a person may have:

  • broken bones, sprains, or dislocations
  • broken eyeglasses
  • bruises, black eyes, cuts, and rope marks
  • open wounds, cuts, punctures, or untreated injuries in various stagesof healing
  • internal injuries
  • sudden changes in behavior
  • Other changes one might see with physical abuse include:

  • lab findings of a medicine overdose
  • a caregiver who refuses to let visitors see an elder alone
  • reports from the elder of being hit, slapped, kicked, or mistreated
  • With emotional abuse, a person may:

  • be emotionally upset or agitated
  • be very withdrawn, not talkative, or not responsive
  • behave in unusual ways, such as by sucking, biting, and rocking
  • report being verbally or emotionally mistreated
  • With financial abuse, there may be:

  • a sudden change in a bank account
  • cashing an elder’s checks without permission
  • new names added to the elder’s bank signature card
  • unauthorized withdrawal of the elder’s funds using an ATM card
  • changes in a will or other financial document
  • unexplained disappearance of funds or valuable possessions
  • unpaid bills despite available funds
  • the elder’s report of financial exploitation
  • With neglect, a person may:

  • have signs of dehydration, malnutrition, or untreated healthproblems
  • have bedsores
  • have poor personal hygiene
  • be living in conditions that are not safe, sanitary, or clean
  • wear inappropriate or inadequate clothing
  • lose weight
  • Diagnosis & Tests

    How is the injury recognized?

    The signs listed above often point to elder abuse.

    Prevention & Expectations

    What can be done to prevent the injury?

    Campaigns and education to raise awareness of the problemand its warning signs may help prevent elder abuse. Most states havea confidential hot line open 24 hours a day to report suspected abuse.

    People can help by:

  • asking directly about signs of possible abuse
  • supporting the victim and talking to help him or her feelless alone
  • showing concern, so that the person knows there is someone to turn to if heor she wants help
  • Treatment & Monitoring

    What are the treatments for the injury?

    Treatment depends on the type of abuse. Any physical injuriesshould be treated. If possible, the victim needs to be separated from the abuser.Emergency care is provided when physical injuries have occurred.

    When suspected abuse is reported to the propergovernment agency for adult protective services, it will arrangeto help protect the victim.Many different programs and services may be offered, such as:

  • respite carefor the caregiver
  • adult day care
  • housing assistance
  • meal programs
  • Untreated elder abuse may continue to grow worse. If theabuse is severe, it can lead to death.

    What are the side effects of the treatments?

    In cases of domestic abuse, an elder may need to leave thehome. He or she may have to live with someone else or in a nursinghome to be safe.

    What happens after treatment for the injury?

    Once the abuse has been stopped, ongoing care of theelderly person continues in a safe place. Ongoing monitoring by theelderly person’s doctor and the correct government agency should continue.

    Article type: xmedgeneral