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
Common signs that an elderly person is being physically abused include the following.
- Broken bones
- Pressure marks
- Hearing odd explanations for injuries -- "Oh, she ran into a wall."
Signs of physical abuse against an elderly person tend to 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
Potenial signs that your loved one is being neglected include:
- Wearing Dirty clothes
- Soiled diapers
- 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
The following are signs that your elderly loved one may be experiencing 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
Signs that your loved one may be a victim of sexual abuse include:
- 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
Signs that an elderly loved one is the victim of financial exploitation include the following.
- 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 website.