• A Cry for Help: How to Recognize Elder Abuse

    IMAGE Eighty-two year old June lost her husband a few years ago. As a result of health problems, she moved in with her 53-year-old daughter Terry. It has been difficult for the whole family. The tension mounts as Terry cares for her mother. Terry is also dealing with a teenage son who is having problems in school, and a husband who is in danger of being laid off. Several times, Terry has caught herself screaming at her mother and accusing her of ruining the family’s life. In a fit of anger, she slapped June. June feels frightened, alone, trapped, and worthless.
    Victims of elder abuse are often frail and vulnerable and cannot advocate for themselves. Many depend on others to meet their most basic needs. Research suggests that elders who have been abused tend to die earlier than those who are not abused, even in the absence of serious health problems.

    Signs of Abuse

    According to the US Department of Health and Human Services, elder abuse may involve one or more of the following:

    Physical Abuse

    Physical abuse is willful infliction of physical pain, injury, or restraint. Signs may include:
    • Bruises, marks, or welts around the arms, neck, wrist, and/or ankles
    • Burns, often to the palms, soles, and buttocks
    • Sprains and dislocations
    • Frequent unexplained injuries
    • Minimizing the importance of injuries or refusing to discuss them
    • Refusing to go to the same emergency department for repeated injuries
    It is important to note that these symptoms may also occur as a result of health conditions or medicines. If symptoms appear, they should be investigated to determine the cause.

    Psychological Abuse

    Psychological abuse is the infliction of mental or emotional anguish, such as humiliation, intimidation, or threats. Signs may include:
    • Lack of communication or responsiveness
    • Unreasonable fear or suspicion
    • Not wanting to socialize
    • Chronic physical or psychiatric health problems
    • Evasiveness

    Sexual Abuse

    Sexual abuse is the infliction of nonconsensual sexual contact of any kind. Signs may include:
    • Unexplained bleeding from the vagina or anus
    • Underwear that is torn or bloody
    • Bruised breasts
    • Sexually transmitted diseases
    • Vaginal infections

    Financial or Material Exploitation

    Financial or material exploitation involves improperly using the resources of an older person without consent for someone else's benefit. Signs may include:
    • Life circumstances that do not match the size of the elder’s estate
    • Large withdrawals from bank accounts
    • Switching bank accounts
    • Unusual ATM activity
    • Signatures on checks that do not match elder’s signature


    Neglect is the failure of a caretaker to provide goods or services necessary to avoid physical harm, mental anguish, or mental illness. Neglect may involve abandonment or denial of food or health-related services. Signs of neglect may include:
    • Sunken eyes
    • Weight loss
    • Extreme thirst
    • Bed sores
    • Excessive dirt or odor on body or clothing
    • Glasses, hearing aids, dentures, and walking devices in poor condition or missing
    • Inappropriate clothes

    Common Factors in Elder Abuse and Neglect

    According to the National Center on Elder Abuse, most cases of elder abuse and neglect occur at home. The perpetrators are often family or other household members or paid caregivers.
    Though there are extreme cases of elder abuse, most elder abuse is subtle. It is not always easy to tell the difference between normal stress and abuse. Common factors at the root of elder abuse include a stressful caregiving situation, financial problems, family problems, a caregiver’s history of family violence or personal problems, and isolation of the older person.

    What You Can Do About Elder Abuse and Neglect

    Elder abuse and neglect can be prevented. Here are some tips from the American Psychological Association:
    If you suspect that an elderly person is being abused or neglected:
    • Do not worry about meddling into someone else’s business. You could be saving a life.
    • Contact your state’s adult protective services agency or other services that investigate allegations of elder abuse and neglect.
    • Do not confront the abuser unless you have the victim’s permission and are able to move him or her to a safe place immediately.
    If you feel that you are being abused or neglected:
    • Always keep your personal safety in mind.
    • If you can find someone who can remove you from the situation (such as your doctor, a trusted friend, or member of the clergy), do so at once.
    • Let your doctor know about the abuse.
    • If you are able to get to a phone, call protective services or a friend who can help you find safety.
    If you have been abusive or are in danger of abusing an elderly person:
    • Find ways to relieve the stress of having total responsibility for the elder person’s care. Look into local respite and day care programs.
    • You can find new ways of relating that are not abusive. Talk to someone who can help you, such as your doctor, a trusted friend, family member, or therapist.
    • Find a support or self-help group, especially if you have substance abuse problems.
    • If you cannot afford private therapy, contact your city or state mental health services department.
    • Be honest about your abusive behavior.
    There are options available for Terry. She can talk to her doctor or contact the local protective service agency for help. With some of the pressure lifted, hopefully she will enjoy the wisdom and comfort that a multi-generational family can bring.


    National Center on Elder Abuse http://www.ncea.aoa.gov/

    US Administration on Aging http://www.aoa.gov/


    Canadian Network for the Prevention of Elder Abuse http://www.cnpea.ca/

    Ontario Network for the Prevention of Elder Abuse http://www.onpea.org/


    Elder abuse and neglect: in search of solutions. American Psychological Association website. Available at: http://www.apa.org/pi/aging/eldabuse.html . Accessed June 16, 2008.

    Edler abuse—work in progress. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated August 2009. Accessed April 14, 2010.

    Elder rights and resources: elder abuse. US Administration on Aging website. Available at: http://www.aoa.gov . Updated June 2008. Accessed June 16, 2008.

    Major types of elder abuse. National Center on Elder Abuse website. Available at: http://www.ncea.aoa.gov . Updated November 2007. Accessed June 16, 2008.

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