5 Signs of Elder Abuse


An elder being abused by her caregiver may become withdrawn and depressed.
An elder being abused by her caregiver may become withdrawn and depressed.
©iStockphoto/video1

The older population of the United States is growing fast, to put it mildly. According to the U.S. Census Bureau, there were about 35 million people over the age of 65 in 2000 [source: U.S. Census Bureau]. This number will soon rise dramatically as the oldest of the 76 million baby boomers reach retirement age [source: PRB]. This rise in the elder population unfortunately has also come with a rise in elder abuse. There are more than 2 million cases of elder abuse reported each year, and as many as five cases that go unreported for each reported case [source: APA]. And while it's easy to assume that elder abuse occurs only in institutional settings, it might surprise you to know that it's actually more likely to involve a family member such as a spouse or child.

Elder abuse can mean that an elderly person is being intentionally harmed, put in harm's way or neglected. In some cases, the vulnerable physical and mental state of some elders makes them more susceptible to unscrupulous people. In others, the abuse is unintentional -- the caregiver simply isn't equipped to deal with the demands of caregiving.

Spotting elder abuse can be difficult, but we've got five basic signs of elder abuse to look for. First up: financial changes.

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Changes in Finances

A drastic change in financial situation that can't be explained is a sign of potential elder abuse. In some situations, caregivers simply steal money outright, believing that the elder won't notice or report it. Or, the elder may be bullied or manipulated into giving away large sums of money or rewriting a will. The most devious way that this exploitative abuse occurs, however, is when a person takes over the elder's finances completely.

While not every elderly person is unable to handle the demands of keeping up with finances, some are. When that's the case, the elder might place the caregiver on his or her bank account. This means that the caregiver can write checks and withdraw money to act on the elder's behalf, which can provide peace of mind for the elder and his or her family. But it also leaves the account holder vulnerable, because the other person can do whatever he or she wishes with that money.

Ask yourself these questions if you're worried: Does the elder have unpaid bills laying around? Does he or she suddenly seem unable to afford things that shouldn't be a big stretch? Does he or she dodge financial questions? What about the caregiver -- have you noticed any big purchase? If you suspect something is going on, it may be best to discuss it with other concerned people before initiating a confrontation -- finances can be a tricky subject to bring up.

Next, we'll look at another sign of elder abuse: conflicts between elder and caregiver.

4
Caregiver Conflicts

When you've spent your whole life used to independence, it's reasonable to expect that you might become resentful when you suddenly have to rely on other people for daily activities like bathing. Such is often the case with caregiver and their elderly charges. This can manifest in the form of arguments as the elder struggles to adapt to the new situation and the caregiver struggles to balance understanding with necessity. In addition, some conditions common in the elderly, such as dementia, may cause them to be angry because they're confused about what's going on.

In some cases, these conflicts may be the result of a new friend or newly emerged relative showing up to "help" the elderly person. Although initially their intentions seem good, they may also have taken charge simply because they see an opportunity to exploit or abuse the elder. If the elder or family or friends feels like the new arrival is taking advantage, conflicts can quickly balloon.

If there's more than one person involved in the elder's care, you may be given contradictory stories as to what's going on. A common sign that there's something fishy is going on is if you notice the caregiver issuing threats (such as taking away much-loved privileges) or humiliating his or her charge (by making fun of the elder's incontinence in public, for example).

If you feel tension with the caregiver when you try to discuss incidents that worry you, or if an elder is in constant conflict with his or her caregiver, it's time to evaluate the situation and make sure it's a healthy one.

3
Changes in Behavior

As we mentioned with the last sign, it's pretty typical for an elder with a caregiver to get angry and upset over losing independence. If your formerly cheerful and upbeat grandmother suddenly becomes negative and moody, though, it may signify more than sadness over her declining health.

Many elders in abusive situations are ashamed and don't want anyone to know what's going on. An abusive caregiver may make his or her charge feel stupid and worthless, convincing the person that he or she is somehow to blame for the abuse. Especially if the caregiver is a friend or child, the abused elder may not want to "tell" on him or her -- it's hard to admit that a loved one is capable of treating you so badly. If the elder is mentally incapacitated in some way, the situation is even more complicated.

So, how can you tell when this kind of abuse is going on? To avoid discussing the problem, the elderly person may stop talking to you or change the subject when you do talk. He or she may also stop participating in favorite activities and become withdrawn. Some elders who are emotionally or physically abused start to exhibit behaviors that at first appear to be symptoms of dementia, such as talking to themselves, rocking, or exhibiting a new physical tic, such as sucking their teeth.

So far, the signs of elder abuse mentioned are more difficult to spot and can sometimes be easily missed or explained away. We'll now look at some more obvious signs, starting with a lack of basic care, like a clean environment and cleanliness.

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Lack of Basic Care

The role of caregiver typically includes providing for someone's basic needs when he or she is no longer able to: adequate nutrition and water, physical cleanliness and comfort and a safe environment. Depending on the older person's health, caregiving duties may also involve doling out medication, driving the person to doctor's appointments, bathing and feeding by hand. It's a highly demanding job.

Failure to provide for these basic needs constitutes neglect on the part of the caregiver, the most common form of elder abuse. Sometimes caregivers intentionally neglect their charges. Other times, they're simply ignorant of what needs to be done or are in denial of the amount of care the elder requires. In an institutional setting, a lack of basic care may mean that the staff hasn't been properly trained. If the person charged with caring for the elder doesn't even make an attempt to care for him or her, it's considered abandonment.

Neglected or abandoned elders may appear dirty or wear dirty clothing. Some live without essentials like electricity or adequate heat in the winter, while others wander the streets. They may appear malnourished or dehydrated. Neglected elders may have untreated medical conditions such as bedsores.

Elders can also neglect their own basic self-care. While it can be a conscious choice in the part of the elder, it can also result from Alzheimer's disease, dementia or addiction. Many cases reported to elder care services are due to self-neglect.

Finally, we'll examine the most obvious sign of elder abuse: unexplained injuries.

1
Unexplained Injuries
Are those bruises from accidents or abuse?
Are those bruises from accidents or abuse?
©iStockphoto/cobalt

For violent and aggressive people, seniors are an ideal target -- they're often weak, fragile and unable to fight back. They may feel ashamed (and therefore reluctant to tell) that they've found themselves in that particular situation, or they may not be completely aware of what's going on due to diminished mental capacity.

Because many seniors have medical conditions that can lead to injuries, they or their caregivers may try to explain away cuts, burns, bruises and broken bones as accidents. But if these injuries occur repeatedly, are localized to one part of the body, or are accompanied by odd behavior on the part of the elder or caregiver, they may be the result of physical abuse. Physical abuse may be more subtle than giant bruises -- the caregiver may administer an overdose of medication, for example, or put the senior in restraints.

Sexual abuse also occurs in caregiver situations. Forcing sexual encounters on an elder without his or her consent is part of it, but sexual abuse may also mean involving him or her in sexual conversations or unwanted viewing of sexually oriented material. What to look for: unexplained bruises around the genitals or breasts, unexplained genital or anal bleeding, or bloody or torn underpants. Elders who have been sexually abused may also contract sexually transmitted infections or other genital infections as a result.

If you suspect that someone is being physically or otherwise abused, err on the side of caution and start asking questions.

For more articles focusing on the older part of the population, see the next page.

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