One in ten seniors is a victim of elder abuse every year. This abuse can be carried out by any individual close to the older adult’s health and finances, including relatives, care providers, and even professionals. Though the reality of elder abuse is sobering and uncomfortable to think about, people in this age group are vulnerable to abuse in many forms because of their increased reliance on others over time. Seniors and their loved ones need to know what elder abuse is to prevent and report it. Here, we’ll explore what constitutes elder abuse, the different types of elder abuse, and how to protect yourself or your loved one from elder abuse, including how to report it.

What is elder abuse?

The National Council on Elder Abuse (NCEA) defines elder abuse as “an intentional act or failure to act that causes or creates a risk of harm to an older adult.” Essentially, elder abuse occurs when an older adult is knowingly mistreated in such a way that their safety is at risk. 

Consider the areas of life that aging individuals often need help managing in their senior years: personal care, health and well-being, and finances. Because other individuals often become involved in these areas of a senior’s life, abuse can occur in any of them. “Elder abuse” is a broad term that covers a range of kinds of abuse, so let’s take a closer look at the different types and how they’re generally defined.

Emotional abuse

This form of psychological abuse involves demeaning or humiliating communication, threat of withholding necessary care, and other emotionally traumatizing behavior. The National Institute on Aging (NIA) states that other psychologically damaging behaviors can fall into this category, such as preventing an older adult from spending time with friends or relatives.  

Signs of emotional elder abuse can include:

• The older adult becomes unusually socially withdrawn from others or displays nervousness or fear of situations with specific individuals.
• The older adult becomes agitated or fearful before or during appointments or encounters with a specific individual.
• Depressed or anxious behaviors that may be uncharacteristic or new in the older adult.
• The older adult expresses concerning emotions or talks about situations in which another individual is being psychologically abusive.

Physical abuse

The NCEA defines physical abuse as the “intentional or reckless use of physical harm or physical coercion” that can cause or put an individual at risk of injury. Slapping, kicking, punching, and other actions are considered physically abusive. The NCEA also lists unlawful or excessive use of restraints, force-feeding, overmedication, and undermedication as examples of physical elder abuse.

Look out for these signs of physical elder abuse:

• The older adult has unexplainable bruising, cuts, or injuries.
• The older adult seems extra jumpy or agitated.
• A family member, caregiver, or other individual close to the older adult refuses to let anyone see or visit with the senior.
• The older adult states that someone is hurting them.

Exploitation or financial abuse

Elder financial exploitation occurs when someone intentionally misuses an older adult’s money or property. Because older adults may need help with finances or estate planning documents, they can be vulnerable to financial exploitation. 

There are several signs that may indicate financial abuse:

• A sudden or unusual change to a person’s estate planning documents, such as a last will, living will, health care proxy, power of attorney, or other documents.
• An unusual decrease in the senior’s bank account or retirement account balance.
• Unexplainable or unusual spending by the senior or someone close to them. 
• The older adult says someone is trying to take money from them or convince them to change their documents for the other person’s advantage.

Sexual abuse

This type of elder abuse involves unwanted sexualized behavior, according to the American Psychological Association. Such behaviors are not limited to but can include inappropriate, nonconsensual touching, forced sexual activity, or coercion to engage in other nonconsensual, suggestive acts.

Signs that an older adult may be the victim of sexual abuse can be physical or behavioral. Be on the lookout for these concerning signs:

• Bruising, cuts, or other injuries on areas of the body may indicate a physical struggle to get away from a nonconsensual sexual situation.
• External bruises or injuries on areas of the body near or on the genitals. A health care provider may be able to recognize these during an appointment.
• Internal injuries. A health care provider may be able to recognize this during an exam or procedure.
• Social withdrawal from others, even those who are not involved in the abusive behavior. A victim of sexual abuse may feel shame and want to avoid talking about it, resulting in increased withdrawal from others altogether.
• The older adult states that someone is touching them inappropriately or is making nonconsensual sexual advances.

Neglect and self-neglect

The Elder Justice Act defines neglect as “the failure of a caregiver or fiduciary to provide the goods or services necessary to maintain the health or safety of an elder.” In some instances, self-neglect is also a form of elder abuse. According to the National Adult Protective Services Association, self-neglect occurs when an older adult fails to provide adequate food, clothing, and care essential to their own health and safety.

Signs of neglect and self-neglect might include:

• A sudden, negative change in the older adult’s personal care or hygiene. When they may have typically bathed a few times a week, they now don’t bathe, for example. 
• The older adult continually wears dirty clothes that go unwashed.
• The older adult remains in soiled clothing or underwear for long stretches of time.
• The older adult no longer has the personal care services that they used to and for no explainable reason.
• The older adult expresses that they feel their needs are not being cared for and need help.
• An older adult in charge of caring for themself is not meeting their basic needs.

Abandonment

The NCEA states that abandonment occurs when a caregiver or an individual who has assumed responsibility for or has custody of an older adult stops providing care for them. This type of abuse can appear in the form of the caregiver leaving the older adult without the help they need or a plan to get care, resulting in unsanitary or unsafe living conditions.

Look out for these signs of potential elder abandonment:

• An increase in preventable conditions, such as sitting in soiled clothing for extended periods, pressure wounds (bed sores), and other unhygienic situations.
• Unclean living conditions that become unsafe.
• The older adult’s caregiver no longer provides care and does not leave the older adult with a plan to receive the services.
• The older adult states that they feel abandoned and cannot care for themself.

It’s important to take these worrying signs seriously. Individuals close to the senior should express concern if these signs appear. Loved ones of an older adult can regularly talk with the senior about their feelings and circumstances to understand the situation and notice even subtle changes. 

How to report elder abuse

Looking out for a senior loved one’s health and safety may mean having to report a case of elder abuse. Fortunately, seniors and their families have resources to help. Let’s take a look at your options for reporting elder abuse:

• 911 for emergencies: Just as in any emergency or when a senior is in imminent danger or a life-threatening situation, call emergency services. 
• National Elder Fraud Helpline for non-emergencies: Calling the National Elder Fraud Helpline allows seniors and their advocates to discuss a situation and get help handling the next step, depending on the type of fraud or abuse involved. This number shouldn’t be used for life-threatening emergencies.
• Long-term care ombudsman: Every state has a long-term care ombudsman program that staffs individuals to advocate for residents of long-term care facilities. If elder abuse is suspected in a long-term care facility, an ombudsman can help you learn your options. 
• Adult protective services: Each state has a division of adult protective services. These services help and protect older adults and adults with disabilities and can offer guidance on situations of potential abuse.
• Elder Justice Initiative resources for identifying and reporting financial abuse: The U.S. Department of Justice’s Elder Justice Initiative provides this helpful resource with details about different types of financial fraud and abuse that target seniors and how to report these situations. 

Though elder abuse seems unthinkable and stressful to consider, it is even more upsetting to experience. Understanding the many faces of elder abuse can help older adults and their advocates identify abusive or dangerous situations and not only stop them but prevent these situations altogether.