Worldwide, one in six people over the age of 60 will experience elder abuse (World Health Organization). Although people may be unaware, elder abuse is common; and its five types are physical, sexual, emotional, neglect, and financial. Although they look extremely different, they can all have similar effects on the victim. Elder abuse, often an unnoticed issue, demands attention; and people should know what it is, the consequences, prevention, and what to do when they see the signs so that it does not result in the death or harm of a loved one. It is incredibly important to know what the types of abuse are and their characteristics. 

Abuse is defined by the National Center for Injury Prevention and Control as “...an intentional act, or failure to act, that causes or creates a risk of harm to an older adult.” There are five main types of elder abuse: physical, sexual, emotional, neglect, and financial abuse (National Center for Injury Prevention and Control). Almost anyone can be an abuser and the abuse can be intentional or unintentional (Holm Law Group). Physical abuse is physical force, intentionally used, that causes harm to an elderly person. Sexual abuse is forcing an elderly person to watch or participate in sexual interaction. Emotional abuse is the use of behaviors by the caretaker to scare or hurt the elderly mentally these can be either verbal or nonverbal. Neglect is failure to care for the elderly which may be failure by the caregiver, or self-neglect when the elder can not care for him or herself any longer, but does not reach out for assistance. People are considered cared for when their basic needs have been adequately met (National Center for Injury Prevention and Control). "Neglect is one of the most common forms of elder abuse and presents with clear warning signs, such as soiled or dirty clothing, living in unsanitary conditions, abandonment of the elder, the appearance of having had too much medication or not enough, and unexplained weight loss or dehydration” (Viles and Beckman, LLC). Because of the lack of proper living conditions, neglect can cause a loved one to pass before their time. Not all types of abuse are so straightforward; financial abuse is the use of an elder’s money or belongings without their consent. Financial abuse can be tricky, but that is the definition on a basic level (National Center for Injury Prevention and Control). When people commit financial abuse, they might try to hide it, but sometimes they do not. Some financial abusers steal possessions or make withdrawals from bank accounts. More dangerous signs of financial abuse are when doctor appointments are canceled repeatedly or the elderly person begins to refuse care.  This is the leading type of abuse (Schmidt). There are many signs of abuse as well as many risk factors. 

Signs of elder abuse can easily blend in with an elder’s everyday life when a person is not aware of the signs. For example, is there constant bruising from medication or is it from rough handling when being cared for? Withdrawal from social interactions and change in attitude can be signs as well, but these can all be reactions to impending death or abuse. Lack of hygiene products or medical aids can be another sign. In order to be cared for properly, people need certain resources like food and clothes (American Psychological Association). If caregivers do not report an injury right away, visit different emergency rooms, have poor explanations of the elder’s injury, or take the elderly person to the hospital on a regular basis for similar injuries, then the elderly person may be suffering abuse (The Nursing Home Abuse Center Team). Having a caregiver with substance abuse issues, either in the past or present, can increase the risk of abuse as well because the elder and his or her caregiver may be living in social isolation. When this happens, no one is assisting the caregiver in providing good quality care. The additional social stigma that elders are weak and too reliant on others does not help this issue. Understaffed nursing homes and assisted living facilities can also lead to unintentional abuse (Viles and Beckman, LLC). Additionally, the elderly are sometimes abandoned. They might be left alone in their home, with another family member incapable of caring for them, or at a healthcare facility without warning (The Nursing Home Abuse Center Team). Although it is difficult to prevent geriatric abuse, there are actions to be taken. Giving caregivers breaks and assisting them can reduce stress; and therefore, make them less likely to commit abuse. It is important to remember abuse can be committed voluntarily and involuntarily. Caregivers can also be connected with services that help to make caregiving easier (World Health Organization). 

North Dakota has the 12th highest proportional number of elderly people in the US. The mixture of their age and the wealth that they have accumulated makes them ideal candidates for financial abuse. However, abuse doesn't just affect the victim, it also affects the community. Many elders donate money, either before or after their death because they wish to give back to the community they've lived in for a large portion of their lives. In many small towns, that money can go a long way. If an elderly person is left with no money, the community cares for them which takes a toll on community members and their resources (Schmidt). 

Elder abuse can result in death. Between 2002 and 2016, over 19,000 elderly abuse victims died as a result of their abuse (National Center for Injury Prevention and Control). Unfortunately many people are uninformed, which leads to numbers that do not accurately represent the issue. Having to decide how much information to gather on the victim leads to missing information and fewer statistics to show the public because the victim’s privacy must be protected, but people need to be aware of the issue. Few federal rules and research on elderly people exist. In addition to these issues, elder abuse has few researchers in this field of study (Viles and Beckman, LLC). Legal consequences of elder abuse can be as little as a fine of various amounts or as large as incarceration in a state prison. 

It is important to understand the legal consequences for abusers as well as be informed on the basics of elder abuse. Medical professionals who abuse are susceptible to losing their license to practice. If a facility as a whole is convicted, it will be shut down as a result. Elder abuse can be a misdemeanor or a felony depending on the charges and conviction (Holm Law Group). Financial abuse has a major impact on the government because, with roughly $2.9 billion being stolen annually, more citizens must turn to Medicaid (Schmidt). Abuse can cause premature death whether life-threatening conditions are present or not (American Psychological Association). 

Furthermore, people may be reluctant to tell anyone, even their doctor, about the abuse because they do not want to ruin the doctor's relationship with the facility. At times physicians may not notice signs of abuse if they are not trained to look for them. Often, people refrain from reporting if they are unsure about their suspicion (Viles and Beckman).When emotional or financial abuse occurs, the victim may be unaware as they don’t recognize the signs (Morgan). Due to a decline in their health, some elderly people may not be able to talk about their situation, and so, dependence on the abuser causes elderly people to stay quiet. They fear abandonment and what will happen after that, especially if they can't take care of themselves. They also fear further abuse in retaliation for speaking up. When family is involved, sometimes they don’t speak up because they do not want the family member abusing them to suffer consequences. There is a lot of shame that is experienced by abuse victims which does not encourage them to share in any way. The huge lack of understanding of how to identify and report abuse leads to both the elderly and people in their lives missing or not reporting the abuse (Viles and Beckman). Some elderly people don't have the ability to say anything (Holm Law Group). If a victim is isolated, he or she might not know what the options of escape are, and it is usually too dangerous for them to leave on their own (Morgan). 

Because elder abuse has such vast consequences, but is not reported as often as it should be, we need to make people aware of the signs, prevention, consequences, and protocol for reporting it. People need to know what it is and what to do when they see it. We need to create a voice for those who can’t or won’t speak up. This problem will only increase around the world with the aging population, unless we start doing something about it. In the end, everyone deserves love and proper care (World Health Organization).