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Module 1:

Types of Elder Abuse

What Are the Types of Elder Abuse?

The Department of Justice's Elder Justice Initiative identifies five types of Elder Abuse, which are described below.

Emotional and Psychological Abuse

Emotional or psychological abuse is defined as infliction of emotional pain, anguish, or distress on an older person through verbal or nonverbal acts. This can include shouting, bullying, name-calling, threatening violence or abandonment, intimidating, belittling or humiliating, harassing, infantilizing, or isolating an older person from their family, friends, or community. According to the National Center on Elder Abuse, this is the most common form of EA.

How Do You Spot Signs of Emotional or Psychological Abuse?

Because these types of abuse don't cause any visible physical injuries - and because some of the signs can indicate cognitive changes experienced by older adults - they they can be hard for many people to recognize. Older people being harmed in this way may demonstrate fear of their caregiver; depression, agitation, or withdrawal from usual activities; avoidance of eye contact; changes in eating or sleeping patterns; unusual behaviors, such as rocking or biting; and excessive apologizing. In addition, a caregiver causing harm may prevent you from speaking to or visiting with an older adult in these situations.

I Must See My Dad Now Vignette.mp4

Let's Look...

This video vignette illustrates a situation in which a family friend who is providing care to an older man with dementia attempts to prevent a daughter from seeing him.

If you were the daughter in this case, what might you do to make sure that your father was OK?

Financial Abuse and Exploitation

Financial abuse or exploitation refers to the illegal or improper use of an older person’s money, property, or other resources for monetary or personal benefit, profit, or gain. This form of abuse includes theft, misappropriation, misuse, or fraudulent deprivation of money belonging to an older adult.

How Do You Spot Signs of Financial Abuse or Exploitation?

As with emotional abuse, the signs of financial abuse or exploitation can be hard to identify at first - money can quietly disappear from an older adult's bank account without anyone being the wiser. Staff members at financial institutions in Maine often receive training in spotting issues of concern, but you can also keep an eye out for sudden changes in a loved one's bank accounts or banking practices; debit and signature cards being issued to people other than the account holder; abrupt changes in a will or a financial document; unexplained disappearance or transfer of valuable possessions and assets; and bills that are left unpaid despite the availability of funds.

In addition, keep an eye out for financial scams - the grandparent scam; the romance scam; the Social Security or Medicare scam; and more. Scammers are incredibly clever and are always evolving their fraudulent practices, but you can keep up to date on their latest activities on the AARP's Scam Alert website.

Physical Abuse

Physical abuse occurs when someone causes an intentional bodily injury to an older adult. Examples of these harms include slapping, pinching, choking, kicking, shoving, or inappropriately using drugs or physical restraints.

How Do You Spot Signs of Physical Abuse?

Very often, the signs of physical abuse in older adults are evident: bruises, lacerations, fractures, and untreated injuries in various stages of healing. Other less obvious signals include broken eyeglasses, signs of restraint (e.g., chafing of the skin at the wrists); lab test results that indicate over- or under-utilization of prescription medications, or sudden changes in behavior. And when a caregiver refuses to allow visitors to see an older adult alone, that's a big red flag.

Sexual Abuse

Sexual abuse comprises any non-consensual sexual contact by one person upon another. It may happen as the result of deceiving, manipulating, or forcing the older adult into sexual activity. In addition to sexual assault, sexual abuse includes unwanted touching, coerced nudity, sexually-explicit photography, and being forcibly exposed to pornographic material.

Among older adults with dementia, this form of abuse may occur if the older person lacks the cognitive capacity to consent to sexual engagement.

How Do You Spot Signs of Sexual Abuse?

Many of the signs of sexual abuse in older adults can be difficult to spot. These include bruising, bleeding, and other evidence of injuries around the breasts, genital, or anal area; unexplained sexually-transmitted diseases, and blood on sheets or clothing. In addition, sexual abuse often leads to changes in the older person's behavior, including showing fear and withdrawing when in the company of a specific person.

Most importantly, if an older adult tells you that they are being sexually abused, believe them. Ageism and perceptions about an individual's cognitive status create enormous barriers to hearing the voices of older people who are harmed in this way.

Residing in a nursing home or other care facility significantly increases the risk of sexual abuse - 70% of cases occur in these settings and may involve staff members, other residents, or visitors to the facility.

Neglect and Abandonment

Neglect or abandonment happens when a caregiver(paid or unpaid) does not fulfill their commitment to providing for the physical, emotional, and social needs of an older person to whom they are providing care. This includes failure to provide adequate food and water, sufficient care (e.g., medications, assistance with bathing, toileting, or dressing, etc.), supervision to ensure safety, and safe and sanitary living conditions. Neglect also occurs when a caregiver disregards an older adult’s financial obligations (e.g., rent or mortgage, property tax, bills, etc.) or fails to provide appropriate care when away from the person.

How Do You Spot Signs of Neglect and Abandonment?

Older individuals who are experiencing neglect or abandonment may present with dehydration, malnutrition, and unattended or untreated health problems. Often, their personal hygiene and living conditions will be affected, and you may notice poor housekeeping, a disheveled personal appearance, soiled clothes or bedding, fecal or urine odors, or a lack of heat or running water.

Abandonment occurs when a caregiver deserts an older adult at a hospital, care facility, or other public location.

Systems and Self-Neglect

Systems or self-neglect occurs when an older adult is unable to meet their basic daily needs for adequate nutrition, shelter, and personal care. Individuals in this situation may also struggle to meet their financial obligations. Often, self-neglect occurs when older adults cannot navigate complex and fragmented systems of support and care, leaving them without the benefits or assistance they need to live safely.

How Do You Spot Signs of Systems and Self-Neglect?

In most respects, the signs of systems and self-neglect are very similar to those associated with neglect by a caregiver: dehydration, malnutrition, and unattended or untreated health problems. Often, their personal hygiene and living conditions will be affected, and you may notice poor housekeeping, a disheveled personal appearance, soiled clothes or bedding, fecal or urine odors, or a lack of heat, electricity, or running water. People in these situations often struggle to attend to their health needs due to a lack of transportation and challenges in medication management, among other issues.

Different Types of EA Often Co-Occur

Older adults experiencing EA often face multiple types mistreatment at the same time. Research by Weissberger et al. (2020) found that nearly a quarter of EA reports involved more than one type of abuse or neglect, with physical abuse most often co-occuring with one of the other types of abuse.

If you believe that an older adult is in a situation of imminent, life-threatening harm,

CALL 911 NOW.

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