Elder Abuse

Updated:

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 an “older adult?”

There are many definitions of an “older adult”¹ in the United States. The definition may vary by state and depending on the purpose for which it is used.

The Centers for Disease Control and Prevention defines an “older adult” as someone at least 60 years of age,² while the National Institute on Aging uses 65 years of age.¹However, many states define “older adult” or “elderly” differently when determining what resources are available in elder abuse cases.³ For example, a state may provide supportive services to people over 60 while only prosecuting “elder abuse” if the older adult is over 65. For this reason, the definition needs to be researched on a case-by-case basis when determining what protections your specific state may offer. If you or a loved one are survivors of elder abuse and you would like legal information for your specific situation, please send us a message on our Email Hotline.

Note: As recommended by the National Institute of Aging, WomensLaw uses the term “older adult” instead of “elderly” because it affirms agency and personhood.

¹ National Institutes of Health, Older adults vs. the elderly
² “Elder Abuse: Definitions,” Centers for Disease Control
³ “State Specific Laws,” Elder Abuse Guide for Law Enforcement

What types of “caregivers” are there?

Many people may be involved in an older adult’s care. Especially in cases where an older adult is mentally unable 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 could be relatives, partners, friends, or neighbors with significant personal relationships with the older adult. They may provide many different kinds of assistance for the older adult and may be the main person responsible for his/her care.
Formal caregivers are paid workers or volunteers who assist and care for an older adult through an organization or other formal service. They may provide various supportive services 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 older people abuse, also known as 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 it 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, the older adult is put at risk of being harmed or is harmed by a person they should be able to trust. This can be done intentionally or by failing to keep the older adult from being hurt.

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

Signs of abuse and risk factors

How common is abuse among older adults?

The National Council on Aging reports that one in ten Americans aged 60+ have experienced some form of elder abuse. However, only one in 24 cases are reported to the authorities. In almost 60% of older person 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 daycare facilities.¹

¹“Elder Abuse Facts,” National Council on Aging

How can I recognize if an older person is being abused?

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 and might be a trigger for some readers. Because the older adult might not be able to report the abuse, it’s important that loved ones know 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;
- 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 abuse in an older adult could be mistaken for normal issues with aging or medical issues, such as dementia, frailty, or other problems related to age. Therefore, 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. A medical specialist can determine whether or not symptoms that might mirror “typical aging” are in fact caused by dementia, or a similar condition. If all medical conditions are ruled out, this may make it more likely that abuse is the cause for the older adult’s behavior.

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.

¹“Red Flags of Elder Abuse,” US Department of Justice

What factors put older adults at higher risk of being abused?

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

current and untreated mental illness;
current alcohol abuse;
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, 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; and
under-staffing, staff burnout, and stressful working conditions.¹

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

Preventing the abuse of older people and finding help

What can I do to protect myself against older adult abuse?

Even though abuse can still happen to anyone, these are some things you can do to try to protect yourself:

make sure to seek and maintain social and community support to avoid isolation;
have your own phone;
take care of your health;
seek professional help for drug, alcohol, and depression concerns;
plan for your future with a power of attorney or a living will so that you can address health and lifestyle decisions now; (Note: If someone else prepares these documents and asks you to sign them, try to get advice from a lawyer before signing;
post and open your mail - don’t let someone else do it for you;
don’t give personal information over the phone; and
use direct deposit for all checks.¹

To learn about your legal rights or to get help preparing legal documents, such as a will, you can find attorneys in your state on our Finding a Lawyer page. For non-legal resources, go to Where can I find additional resources and help for older adult abuse?

¹ “Elder Abuse Facts,” National Council on Aging

Can I get a restraining order for elder abuse?

If you are an older adult who is being abused or you know someone who is, you or the other older adult may qualify for a restraining order. 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:

Alabama
California
Colorado
Florida (coming soon on WomensLaw.org)
Illinois
Iowa
Maine
Maryland
Oregon
Puerto Rico
South Dakota
Tennessee
Washington
Wisconsin
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 qualify for a domestic violence restraining order or if the abuser is arrested, a criminal court protection order may be issued. Check what civil restraining orders may be available by selecting your state in our Know the Laws – By State section.

Where can I find additional resources and help for older adult 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:

Elder Abuse from the Centers for Disease Control and Prevention;
Get Help in Your Area from the National Adult Protective Services Association;
Elder Abuse Facts from the National Council on Aging; and
Elder Abuse from VAWnet.

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

If you or a loved one are survivors of elder abuse and you would like legal information related to your specific situation, please send us a message on our Email Hotline.

About Abuse