About Abuse

Elder Abuse

Elder Abuse

August 15, 2019

This page is about older adults who are being abused by a caregiver. Sometimes a family member or an intimate partner can also be a caregiver. This means that if you are being abused by a caregiver, you may also qualify for a domestic violence restraining order in your state. You can see more about this in Can I get a restraining order for elder abuse? If you are an older adult in an abusive relationship with an intimate partner, you can read more about domestic violence on our Forms of Abuse page. You can also read about domestic violence restraining orders in your state on our Know the Laws - By State pages.

Basic info and definitions

Who is considered “elderly” or an “older adult?”

There are many definitions for “senior citizen,” “older adult,” or someone who is “elderly” in the United States. For instance, the original age set by the Social Security Administration (SSA) to collect retirement benefits in 1935 was 65 years old. Currently, it is 66 years old, with plans to increase it to 67 years old in the future. However, at 62 years old, the SSA allows a person to collect partial retirement benefits.1 The Older Americans Act provides services to people as young as 55 years old.2 The Centers for Disease Control and Prevention defines an “older adult” as someone who is at least 60 years old. Many states may also have different definitions of “elderly” when determining what resources are available in cases of elder abuse, although most states commonly use 65 years of age as the cut-off.3

1Benefits Planner: Retirement,” Social Security Administration
2Older Americans Act,” National Committee to Preserve Social Security & Medicare
3State Specific Laws,” Elder Abuse Guide for Law Enforcement

What types of “caregivers” are there?

There are many people who may be involved in an older adult’s care. Especially in cases where an older adult is mentally not able to make decisions for him/herself, the law often refers to a caregiver as a “responsible adult.” The types of caregivers include:

  • Family members or informal caregivers, who could be a relative, partner, friend, or neighbor with a significant personal relationship with the older adult. They may provide many different kinds of assistance for an older adult, and may be the main person responsible for an older adult’s care.
  • Formal caregivers, who are paid workers or volunteers that assist and care for an older adult through an organization or other formal service. They may provide a variety of supportive services, both in an older adult’s home or through local, community services. These services can include assistance with bathing, chores, adult day services, transportation, and meals.1

1 This information is adapted from the Family Caregiver Alliance.

What is elder abuse?

The Centers for Disease Control (CDC) defines elder abuse as “an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult.”1 The World Health Organization (WHO) defines elder abuse as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an adult 60 years and older.“2 In other words, elder abuse is when a person who an older adult should be able to trust harms or risks harm to the older adult, by either purposely hurting him/her or failing to stop him/her from being hurt. An older adult is defined by the CDC as someone age 60 or older.1 However, there isn’t one universally-recognized age for “older adults” as explained in Who is considered “elderly” or an “older adult?

1Elder Abuse: Definitions,” Centers for Disease Control
2Abuse of Older People,” World Health Organization

Signs of elder abuse and risk factors

How can I recognize signs of elder abuse?

Here are some common signs of abuse that an older adult may show. Please note that some of the symptoms listed below contain graphic descriptions of injuries related to sexual abuse. However, because the older adult might not be able to report the abuse, it’s important to watch out for these signs that may indicate sexually abusive behavior. 

  • Physical abuse:
    • bruises, especially when bruises are grouped in one area or in regular patterns; black eyes; welts;
    • lacerations;
    • open wounds, cuts, punctures, or other untreated injuries at different stages of healing;
    • sprains, dislocations, or internal injuries/bleeding;
    • broken eyeglasses/frames;
    • signs of being restrained, like rope marks; 
    • laboratory findings of medication overdose or under-utilization of prescribed drugs;
    • sudden changes in behavior;
    • partner’s/caregiver’s refusal to allow visitors to be alone with the older adult; or
    • the older adult’s report of being physically abused or mistreated.
  • Sexual abuse:
    • bruises around the breasts or genital area;
    • unexplained venereal disease or genital infections;
    • unexplained vaginal or anal bleeding;
    • changes in behavior, such as showing fear or becoming withdrawn when a specific person is around;
    • evidence of pornographic material being shown to an older adult with diminished capacity;
    • blood found on sheets, linens, or clothing; or
    • an older adult’s report of being sexually abused or assaulted.
  • Emotional/psychological abuse:
    • being emotionally upset, agitated, or in fear of a specific person, usually the abuser;
    • being extremely withdrawn, non-communicative, or non-responsive;
    • unusual behavior, such as sucking, biting, rocking;
    • witnessing a caregiver controlling or isolating an older adult;
    • exhibiting a change in sleeping patterns or eating habits;
    • personality changes, such as apologizing excessively;
    • depression or anxiety; or
    • the older adult’s report of being verbally, emotionally, or psychologically mistreated.
  • Financial abuse/exploitation:
    • sudden changes in bank accounts or banking practices, including unexplained withdrawals of large sums of money by a person accompanying the older adult;
    • unexpectedly including other people on an older adult’s bank account;
    • unauthorized withdrawals of the older adult’s funds using his/her ATM card;
    • abrupt changes in a will or other financial documents;
    • unexplained disappearance of funds or valuable possessions;
    • bills left unpaid despite the availability of adequate financial resources;
    • forged signatures on financial transactions or on the title of the older adult’s car, home, etc.;
    • relatives claiming the rights to an older adult’s property or possessions;
    • unexplained sudden transfer of assets to a family member or someone outside the family;
    • misuse of the older adult’s money for services that are not needed; or
    • an older adult’s report of financial abuse or exploitation.
  • Neglect and abandonment:
    • dehydration, malnutrition, untreated bed sores, or poor personal hygiene;
    • unattended or untreated health problems;
    • hazardous or unsafe living conditions/arrangements, for example having improper wiring, no heat, or no running water in the residence;
    • unsanitary and unclean living conditions, like dirt, fleas, lice, soiled bedding, fecal/urine smell, inadequate clothing, etc.;
    • abandoning the older adult at a hospital, nursing facility, or other similar institution, or at a shopping center or other public location; or
    • an older adult’s report of being neglected or abandoned.1

Signs of elder abuse could be mistaken for normal issues with aging. For instance, a person may think an older adult has simply changed with age if s/he used to be outgoing and talkative, but now startles easily or avoids eye contact. However, since many symptoms of elder abuse may, in fact, overlap with symptoms of aging or medical issues, such as dementia, frailty, or other problems related to age, signs of abuse may need to be compared to the older adult’s typical behavior, and considered in light of his/her mental and physical health.

If you are concerned that an older adult is being abused, or if you are an older adult who is being abused/neglected, there are organizations and people who care and can help. Please consider the following options:

  • tell your doctor, a friend, or a family member you trust;
  • locate help near you through this Eldercare Locator from the US Administration on Aging; or
  • contact the local Adult Protective Services office.

Red Flags of Elder Abuse,” US Department of Justice

How common is elder abuse among older adults?

The National Counsel on Aging reports that one in ten Americans aged 60+ have experienced some form of elder abuse. However, only one in fourteen cases of elder abuse are reported to the authorities. In almost 60% of elder abuse and neglect incidents, the perpetrator is a family member and most likely an adult child or spouse. Other times, abuse happens in institutions, such as residential care, hospitals, and day care facilities.1

However, there are several reasons that it may be hard for researchers to get completely accurate elder abuse statistics. For instance, like many victims of abuse, older adults may be unwilling to report their abuse because they are scared the abuse will get worse. Some victims of elder abuse are unable to report their abuse or are not believed when they do report it because of their physical or mental condition.2

1 Elder Abuse Facts,” National Counsel on Aging
2Elder Abuse,” Rape, Abuse & Incest National Network (RAINN)

What are the risk factors for elder abuse?

There may be certain risk factors that make a caregiver more likely to commit elder abuse in both the home and in professional care environments, such as:

  • current and untreated mental illness;
  • current abuse of alcohol;
  • lack of patience;
  • having a “short temper;”
  • lack of preparation and training for caregiving responsibilities;
  • caregiving from an early age;
  • lack of coping skills;
  • exposure to abuse as a child;
  • financial or emotional dependence on a vulnerable older adult;
  • a history of disruptive behavior;
  • lack of social and institutional support;
  • lack of formal services in the community for caregivers, like respite care or frequent breaks or shift changes at a nursing home;
  • an environment that tolerates or accepts aggressive behavior;
  • lack of administrative or community oversight for healthcare personnel, guardians, or other people responsible for an older adult’s care;
  • isolation from friends, family, or a support network;
  • negative or unsympathetic beliefs about older adults and aging; or
  • under-staffing, staff burnout, and stressful working conditions.1

1 This information was adapted from the Centers for Disease Control and Prevention.

Additional info and where to get help

I am an older adult experiencing elder abuse. How could abuse affect my health and wellbeing?

Unfortunately, there have not been many studies about the long-term effects of elder abuse on older adults. The studies that have been done, however, show that many of the immediate effects of elder abuse are similar to the signs of elder abuse, including physical damage, like welts, bruises, and other injuries, and emotional damage, such as agitation, shame, and regression. Other effects of elder abuse include:

  • problems with eating and drinking;
  • difficulty sleeping;
  • increased vulnerability to new illnesses, including sexually-transmitted infections;
  • increased damage from existing health conditions;
  • greater risks of fear and anxiety;
  • inability to care for oneself;
  • post-traumatic stress disorder (PTSD); and
  • greater risks of early death.1

1 This information was adapted from the Centers for Disease Control and Prevention.

Can I get a restraining order for elder abuse?

If you are being abused by a caregiver, or if an older adult you know is being abused by a caregiver, you or the older adult you know may qualify for a restraining order. This could be a restraining order for domestic violence or a restraining order specifically for “elder abuse” or for “vulnerable adults,” depending on your state.

The following states and territories have legal orders that specifically protect older or vulnerable adults from abuse by someone who is supposed to be responsible for their care:

Florida (coming soon on WomensLaw.org!)
Puerto Rico
South Dakota
Tennessee (coming soon on WomensLaw.org!)
Virgin Islands (coming soon on WomensLaw.org!)

In states without a specific order protecting older or vulnerable adults, you may still be able to get legal protection from another kind of order. For instance, an older adult who is being abused by a family member may be able to get an order protecting victims of domestic violence. Check your state’s available restraining orders by selecting your state in our Know the Laws – By State section.

Where can I find additional resources and help for elder abuse?

If you want to learn more about how elder abuse can affect older adults and how to get help, here are some additional websites that may be helpful:

You can also find organizations that help victims of elder abuse on our National Organizations – Elder Abuse page.

WomensLaw serves and supports all survivors, no matter their sex or gender.