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About Abuse

Elder Abuse

Updated: 
August 15, 2019

How can I recognize signs of elder abuse?

Here are some common signs of abuse that an older adult may show. However, these are not all of the possible signs of elder abuse.

  • Signs of physical abuse, sexual abuse, and neglect:
    • bruises, especially when bruises are grouped in one area or in regular patterns;
    • black eyes;
    • welts;
    • signs of medication overdose;
    • signs of medication not being taken;
    • avoiding eye contact;
    • startling easily;
    • cringing from contact;
    • unusual or inappropriate affection;
    • change in sleep patterns;
    • complaints of stomachaches or headaches; and
    • refusal to see visitors.
  • Signs of emotional or psychological abuse:
    • agitation or fear in the presence of a specific person (usually the abuser);
    • withdrawal from contact and normal activities;
    • apathy;
    • regression to childlike behaviors, such as sucking, rocking, or biting; and
    • mood swings.
  • Signs of financial abuse:
    • shame;
    • suspicion; and
    • withdrawal from contact and normal activities.1

Many signs of elder abuse are often 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. Assessing elder abuse can be complicated, 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.

Often, if the older adult does report the abuse, the abuser will deny being abusive if confronted, and may say the older adult is making the abuse up, exaggerating, or misinterpreting normal behavior. In many cases, however, older adult victims of abuse, like victims of abuse of other ages, may deny that they are being abused for a variety of reasons.

Victims of elder abuse will each show different signs of abuse and need different kinds of help, just like victims of other ages. Signs of abuse may need to be compared to the older adult’s normal behavior, and considered in light of his/her mental and physical health. If you are concerned that an older adult is being abused, you may want to speak to a trusted medical professional about assessing the symptoms of abuse or to your local Adult Protective Services office.2

1 Recognizing and Responding to Domestic Violence and Sexual Abuse in Later Life,” American Society on Aging
2Abuse of the Elderly,” World Health Organization

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.