5 Signs of Elder Abuse

5 Red Flags That Could Signal Neglect, Mistreatment, or Abuse


Have you ever worried whether an elderly person is really all right?

Sometimes it's a loved one we're worried about -- we're concerned about whether she's being treated well by her caregiver, friends, or family members. Sometimes it's just a worry about a senior we know casually -- someone we see around the neighborhood, at church or synagogue, or at local gatherings. We wonder whether we should worry; we wonder whether we should say something.

The fact is, far too many of our elders are not all right. The Senate Special Committee on Aging says there are as many as 5 million victims every year, while the National Center on Elder Abuse cites recent studies that estimate that up to 3 to 5 percent of the elderly population in the U.S. have suffered abuse.

Unfortunately, this type of appears to be on the rise, according to Elizabeth Loewy, former chief of the Elder Abuse Unit in the Manhattan District Attorney’s Office, where she oversaw thousands of elder abuse cases. Despite the prevalence of the problem, Loewy says it remains signicantly underreported.

That may be partly because neglect, mistreatment and abuse aren't always easy to spot. Some signs are obvious, some not so much. The New York City Elder Abuse Center defines elder abuse as an act that causes harm or distress to an individual 60 years or older. It happens most often in relationships based on trust. And it can be intentional or unintentional. Elders with cognitive impairment are particularly vulnerable, both because dementia behaviors can be extremely frustrating to caregivers, and because elders with dementia can lose the ability to recognize abuse and defend themselves.

Here are five signs to look for:

1. Signs of Physical Abuse

  • Bruises

  • Broken bones

  • Burns

  • Abrasions

  • Pressure marks

  • Hearing odd explanations for injuries -- "Oh, she ran into a wall."

Common signs of physical abuse against an elderly person include unexplained signs of injury such as those listed above, says Anne Sansevero, a registered nurse and member of the board of directors of the Aging Life Care Association.

“Be alert for a history of broken bones, sprains, or dislocations and sudden hair or tooth loss especially if the injuries are unexplained or explanations do not ‘fit’ with the findings,” she says.

Sansevero also advises looking out for behavioral indicators on the part of the elderly person’s primary caregivers. Not allowing you to visit with the elderly person alone, inconsistent explanations for injuries or taking the elder to multiple medical facilities for treatment can all be red flags that abuse is occurring.

2. Signs of Neglect

  • Dirty clothes

  • Soiled diapers

  • Bedsores

  • Unusual weight loss

  • A home that's unusually messy -- especially if it wasn't before

  • Lack of needed medical aids, such as hearing aid, cane, glasses

If the elder is disabled, especially cognitively disabled, and needs help taking medication or getting dressed, it can be considered neglect if their caregiver is not providing assistance. Alternatively, passive neglect occurs when the abuse is unintentional, often as the result of an overburdened or untrained caregiver.

3. Signs of Verbal or Emotional Abuse

  • Withdrawal and apathy

  • Unusual behavior, such as biting or rocking

  • Nervous or fearful behavior, especially around the caregiver

  • Strained or tense relationship between caregiver and elder

  • Caregiver who is snapping or yelling at the elder

  • Forced isolation by the family member/caregiver

Emotional abuse is one of the most difficult problems to spot, since the victim may be unable to convey what's happening because of illness, dementia, or fear of being neglected. "The elderly person is unable to fight back," says Dr. Irene Deitch, professor emeritus of psychology at the College of Staten Island, part of the City University of New York.

Emotional abuse can range from a simple verbal insult to an aggressive verbal attack. It can also include threats of physical harm or isolation.

Deitch says verbal attacks include a caregiver or family member yelling or cursing at the person, or using phrases such as, "I can't wait till you die and I have my life back again."

Often in cases of emotional abuse, Deitch adds, a spouse or adult child will isolate the senior, not allowing calls or visitors, so no one else gets a sense of what's happening in the house.

4. Signs of Sexual Abuse

  • Bruises around the breasts

  • Bruises around the genital area

  • Evidence of venereal disease

  • Vaginal or rectal bleeding

  • Difficulty walking or standing

  • Depressed or withdrawn behavior

  • Flirtation or touchiness by the caregiver

We don't even want to think about it, but it happens. Attackers look for vulnerable people to victimize. Seniors can be perceived as easy to overpower. They may also be less likely to report abuse because of their dependency on others for care.

5. Signs of Financial Exploitation

  • Bills not being paid

  • Money disappearing and unaccounted for

  • Caregiver taking money for a purchase that doesn't arrive

  • Unusual purchases that your loved one didn't used to make

  • Increased use of credit cards

  • More frequent withdrawls of cash

  • Adding someone new to bank accounts or credit cards

Financial exploitation of elders is all too common. Older adults may be particularly vulnerable to this type of abuse for a number of reasons, says Loewy, who now serves as general counsel and senior vice president for industry relations at EverSafe, a financial monitoring service for older adults.

Loewy says it may be that financial exploiters are simply following the money, and seniors tend to have a higher net worth than younger adults. And some older adults are at greater risk of exploitation due to cognitive impairment.

Financial exploitation can also happen when a professional caregiver takes advantage of the elder. Both family caregivers and paid caregivers are in a unique position to perpetrate this crime, Loewy notes. This is why background checks are especially important when hiring a professional caregiver.

What to Do if You Suspect Elder Abuse

The National Center on Elder Abuse (NCEA) recommends calling 911 immediately if you believe an elderly friend, relative, or neighbor is in immediate, life-threatening danger.

If the danger is not immediate but you suspect that abuse has occurred or is occurring, relay your concerns to the local adult protective services agency, long-term care ombudsman, or police.

To find the right helpline, hotline, or elder abuse resources in your local area, visit the NCEA webite.


about 2 years ago, said...

I have an aunt who is sharing all of her financial and other information with a caregiver. We live an hour away and still have kids at home. I am power of attorney, and my aunt and her caregiver are having a lot of fun going on trips, eating out, etc. The caregiver is telling the other part-time caregiver that she is my aunts only family and that her family doesn't care about her, which couldn't be further from the truth, but we can't be there as often as we would like due to other family obligations. I am getting very concerned. What do I do? I believe the caregiver is trying to turn my aunt against me.


over 3 years ago, said...

Three years ago, I moved in with a man with whom I was "romantically " involved. He is now 81 and I am 78. Shortly after I moved in, I realized that all he wanted was for someone to wait on him hand and foot. He neglected his health until about 9 months ago, when a large tumor was discovered, then removed, on his bladder. He refused post-op treatment. Now he has 6 more tumors on his bladder; he underwent emergency surgery for a hernia repair; and he is now in a nursing home for physical therapy. He has refused to eat, then told the neighbor that I don't feed him. He has so little strength left that he could barely stand,and fell repeatedly. He said that every night he prays that he will not wake up in the morning.He refuses to take his meds for diabetes and blood pressure. He is now in a nursing home for physical therapy to regain some of his strength before returning home. After several attempts at trying to get his Godson to be more active in his care, I finally shamed him by telling him I was going to move out. He is now indignant, and has painted me as the bad guy in this situation. His Dr. doesn't seem to take this seriously. Although I have health care professionals as witnesses that I have been verbally and emotionally abused by him, I fear that the Godson is going to try to accuse me of neglecting or abusing his Godfather.


over 3 years ago, said...

SOOOO much of this goes on, and even when it is reported, it gets looked over, not believed, hidden. This can be an unhealthy, actually another elderly abuse situation, when a daughter 60+ is blocked from talking to her mother and care giver refuses to talk to her. Sooooo Sad.


over 3 years ago, said...

nursing homes are the worst places for some type of abuse and everyone really know's this,they don't care enough to walk along side a CNA and have her do her job as she does every day , don't candy coat it , Per CNA they will have 8 to 12 or more pt's, 6am to 730 they are to have the pts up dressed and in the breakfast area, Do you think these little old pts are awake and ready...NO... knowing they have 11 more to go, so they pull back blankets and start dressing and put in wheelchair as is , after breakfast ,then off to the showers , all in a rush, then back to lunch, no time to slow down , they need to be checked every 2 hrs, turned if in bed , taken to the restroom if able , vital's need to be done twice during shift weights,keep your eye's on the one's that wonder around,i ask why if these people are paying so much money to be taken care of why are they treated like a slab of meat with clothe's on ,made to sit and look pretty for the place.....when inside its sad to know that its all for the money and the saving of money,I ask questions and the answers are alway's its the state....WHO IS THE STATE IN THIS MATTER,WHO HAS GONE ON THE FLOOR WITH A CNA AND SEEN HOW ITS DONE,AND IM NOT TALKING AFTER THEY KNOW STATE IS ON THE WAY SO BRING OUT ALL THE GOOD STUFF, PLAY GAMES THE PTS NEVER PLAYED BEFORE THAT DAY,PUT THE FIRE FEAR IN THE WORKERS IF ANYTHING IS DONE WRONG.....PLEASE STOP WITH THE BLINDERS FOR MONEY , RN's and LVN's DO NOT HELP WITH PT FLOOR WORK, ITS RARE ,SO who is the man to set 1 cna to 9 to 12 pt's, and pretend its good pt care and that the pt is happy....nursing home's are sweat shop's to the cna's.. the one's i talked to hate their job because of the DON's and asst DON's that come out of their office just long enough to put fear into the worker......I love my job as a care giver ,My heart goes out to my pt's to have to be handled like a piece of meat with no right's, when all we hear is pt's right's....I often wonder what would happen if every cna around the world would just walk out ,and leave the DON'S , RN'S ,LVN'S to care for the pt's.....then maybe someone will stop saying it's the law to have up to 12 pt's to 1 cna. if you go to a nursing home and ask a cna if she likes her job she will answer I love my pt's.CNA'S are not in it for the money because wal mart pays more, we have a love for caring for people, So all the bumps , bruises, skin tears, falls , should be blamed on this place called the state for the overload of pts......and state if you really wanted to see and know what happens , you wouldn't let them know when you'll be there .............


over 3 years ago, said...

i called the adult abuse hot line I will never both to do it again as nothing as far as I was concerned was done I knew a couple and she was the abuser and had been for yrs but she had cancer and alzheimers and it was getting much worse so I called one day and reported it they went out to investagate her son retired cop was there said oh everything is ok another day she was beating on him I called again and to my knowledge nothing was done I called the police dept and I didn;t have their exact add just their names they told me they couldn't find them I finally got the address and it was called in again, they had homehealth in by this time and she attacked the aid still nothing was done then she attacked her son yep FINALLY something got done....but her husband who is 92 had been the punching bag for yrs without anyone saying a thing not even his family cares..it is just NOT RIGHT>>>>


over 3 years ago, said...

This should be repeated at least 3/4 times a year as a reminder.


over 3 years ago, said...

This happened to my mother by own own grown children who told her to go stand by the dryer to get warm so they could use her S.S. check to go play golf and by lunches at 65.00! It happens. When it does and you have to be the bad guy or bad daughter to come in and clean house, be prepared! you will need a lawyer from the get go.Do not put your things inside your parents home thinking they are safe because like mine, they will be gone through and stoilen by your siblings as they want you out of the way to continue their evil ways.


over 3 years ago, said...

It is extremely helpful and concise. May I have the author's permission to reprint all or part of the article in a newsletter for Andelcare in Bellevue, WA? Thanks, Leslee Jaquette


over 3 years ago, said...

The info on Signs of Verbal and Emotional Abuse. My 82 yr old father is totally dependent upon my 'mother'. She has always been hot headed and she never told my father about her abuse (physically, emotionally, and verbally) to me throughout my childhood and some since adulthood. After recently helping them out, leaving my family one week each month, to assist them, as my dad has congestive heart failure, osteoarthritis, and extreme tremors, I wanted to spend his last few months with him. During a visit, my mother became rude to me and has made my dying father call me and leave a message that I know he would never do on his own! I'm a daddy's girl! I'm his little girl still at my age of 45. I have called their home and mother picks the phone up and in a very rude voice ask my daddy, "Do ya wanna talk to her?" He knows he depends on her for everything and if you don't agree with her she will make you live to regret it. So he says no and she hangs up the phone. Now she won't answer the phone when I call. I'm so scared for my father that he is going thru that sort of wrath. I am not allowed to go to their home and I'm scared I have seen him for the last time. She is so vindictive that she would keep me from his Funeral. I love my dad but I'm scared if I try to get help in their situation that he will be verbally and emotionally abused even more. So confused! So sad! But now I know it truly exist as I was wondering if this is what my mom is doing with my dad. Using him to hurt me for her actions she is being held accountable for when I was growing up! She is keeping him and I apart at the end of his life.


almost 4 years ago, said...

Very well written, easy to read and informative. Thank you.


almost 4 years ago, said...

I think Ombudsman does a lousy job investigating elder abuse!!!! If I'm in the medial field and I report neglect or some other violation, you better believe my accusations are warranted!!! Ombudsman sends a letter and says your accusations were unfounded!!! What a bunch of bull!!!! Are they getting paid off or do they simply not care?


almost 4 years ago, said...

I have had the same experience as annonymous below....who do you go to for help? Reporting to the elder care social services is pointless ~ unless you want your family to disown you ~ they say everything is fine but now I have been banned from visiting and so have no ability to pick up on red flags or signs any more!


almost 4 years ago, said...

Thanks for this info. Bev


almost 4 years ago, said...

Thank you for the good article. My Dad has bruises, but they come from him falling and not telling the employees of the AL facility.


almost 4 years ago, said...

Excellent article. I work in the medical field.


almost 4 years ago, said...

many are sexualy abused ? we must vet the staff in all dept , for sex crime and that they are drug free from all encluding smoking , and alcohol , christians values are most wanted ?


almost 4 years ago, said...

It's unfortunate, but even reporting the abuse to local agencies does not seem to help. For years, I was alerting local authorities of the neglect, emotional abuse and financial exploitation that my aunt Frieda suffered while under the supposed care of her daughter and granddaughter. I even alerted investigators and case workers of the obvious fear my aunt had to speak truthfully to them about her living conditions, all the while in the presence of the daughter. Literally years of witnessing her eventual demise and notifying the authorities - all to no avail. Last week my dear aunt died, without a penny to her name and not even plans for a dignified funeral, as the daughter merely signed the hospital papers and released the corpse. If there is any poetic justice to any of this, it will be that the daughter and granddaughter (and the six dogs and numerous cats) will no longer be able to remain in the subsidized apartment that was in my aunt's name, and without a single job between the both of them, the two freeloaders will ultimately end up on the street.


almost 4 years ago, said...

I take care of my mother, who has dementia. Sometimes I do get frustrated and yell. I realize it is wrong and work very hard at not doing it. So I wanted to check myself in area of "Verbal and Emotional Abuse" to see if I am guilty. I'm glad to say I am not but am border line on the yelling. I am glad to say I have not, nor have even thought of telling or yelling at her, "I want her to die and get my life back." I want her around for as long as possible.