Signs of Elderly Abuse
Since elder abuse can take many forms, it can be very difficult to recognize it so we have learn to recognize the signs of abuse and the individuals involved in elder abuse being both the abused and the abusers. You may suspect that an elderly person you know is being harmed physically or emotionally by a neglectful or overwhelmed caregiver or being preyed upon financially. By learning the signs and symptoms of elder abuse and how to act on behalf of an elderly person who is being abused, you’ll not only be helping someone else but strengthening your own defenses against elder abuse in the future.
Victims of elder abuse often experience significant distress. Beyond the physical and psychological repercussions, be they temporary or permanent, they also bear a number of impacts which diminish their quality of life, such as:
- A growing sense of insecurity
- Social withdrawal
- Weight loss, illness or anxiety
- Depression and confusion
At first, you might not recognize or take seriously signs of elder abuse. They may appear to be symptoms of dementia or signs of the elderly person’s frailty — or caregivers may explain them to you that way. In fact, many of the signs and symptoms of elder abuse do overlap with symptoms of mental deterioration, but that doesn’t mean you should dismiss them on the caregiver’s say-so. There are certain risk factors that are related to elder abuse. The existence of more than one of these factors places an older person at high risk of abuse. Some of these risk factors include:
Ageism and Lack of Knowledge about the Aging Process
- · Negative attitudes and incorrect assumptions about aging and the resulting behaviours are a form of discrimination called ageism. Ageism can often be found at the root of elder abuse. It perpetuates stereotypes and leads to insensitive responses to the needs and wishes of older persons, which can in turn lead to abuse or neglect.
- Values, habits, emotional and coping skills are learned early in life, largely through family interaction. If unhealthy or violent behaviours go unchecked, abuse may continue when roles are reversed. If a child who was previously abused becomes a primary caregiver, there is a probability that the cycle of abuse will continue and be inflicted on a dependent parent.
History of Spousal Abuse
- Abuse can be a continuation of domestic violence that has occurred throughout a marriage. In these cases, older adults who have been in troubled marriages characterized by abuse will likely continue to be abused by their spouses.
Inability to Cope With Long-Term Caregiving
- Caring for an older person can cause a great deal of stress. In some cases, family members find themselves in the role of caregiver out of a sense of duty or pressure. Whatever their motives, caregivers can experience feelings of resentment, frustration or anger. In some cases, caregivers are simply not able to cope with this stress and react in inappropriate ways that may lead to abuse or neglect. This is especially true if adequate support for the caregiver is not in place.
- · Some long-term care facilities maintain a workforce that is overworked, poorly trained and undervalued. Combined with a potentially stressful and exhausting workplace, high staff turnover and insufficient resources, this may lead to neglect or abuse of residents.
- Isolation doesn’t just conceal abuse and neglect; it perpetuates the problem. An older person can become isolated because of physical or mental illness, or through the loss of friends and family members. The result of this isolation can make it easier for an abuser to exploit, neglect or abuse an older person. Without a caring support network nearby, there is a significantly higher risk for elder abuse.
Society’s Acceptance of Violence
- Violence is all around us: in the news, at sporting events, in movies and on television shows. Persistent exposure can have a desensitizing effect on a society, leading to tolerance of violence as an acceptable means of venting frustration or anger or seeking revenge. The ease with which Canadians accept violence as acceptable can contribute to abuse and neglect of older adults.
Troubled Relatives, Friends or Neighbours
- People who abuse or neglect older adults are often functioning only marginally themselves. They may suffer from psychological or physical impairments and may be ill-equipped to handle the responsibility required of their own lives.
The signs of abuse vary considerably among older people and with the type of harm being experienced. Any of the following potential signs can indicate problems other than abuse or neglect, and none of these “proves” there is harm occurring. The presence of the signs simply indicates that further inquiry may be necessary. Most importantly, be alert. The suffering is often in silence. If you notice changes in a senior’s personality or behaviour, you should start to question what is going on. While one sign does not necessarily indicate abuse, some tell-tale signs that there could be a problem are:
- Changes in personality or behaviour in the elder
- Behaviour such as belittling, threats and other uses of power and control by spouses are indicators of verbal or emotional abuse.
- Family members who provide minimal care, interpersonal conflicts with family or friends
- Feel anxious, fearful, angry, agitated
- Frequent arguments or tension between the caregiver and the elderly person
- Not accept invitations to spend time away from their family or a caregiver
- Not have any spending money
- Put off going to the doctor
- Say she or he is being harmed
- Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.
- Bruises around the breasts or genital area can occur from sexual abuse.
- Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.
- Seem afraid to make their own decisions, seems paranoid, is depressed, withdrawn
- Seem to be hiding something about a caregiver
- Seem to have too many household “accidents
- Seem depressed and withdrawn
- Signs of depression in elders are not getting dressed
- Not performing basic care of themselves that they are able to do
- Never going out even if they can
- Inability to sleep or sleeping too much
- Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.
- Sudden changes in financial situations may be the result of exploitation.
- The worker’s account does not seem credible in light of the degree of injury suffered by the resident
- Try to “run away,” leaving their place of residence and not wishing to return
- Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
If you suspect elderly abuse, but aren’t sure, look for clusters of the following physical and behavioural signs. Signs and symptoms of specific types of abuse:
- Behaviour from the elder that mimics dementia, such as rocking, sucking, or mumbling to oneself
- Constantly be disturbed or upset
- Demonstrate signs of insecurity, such as constant sucking or biting of the fingers
- Caregiver behaviour that you witness
- May display a nervous behaviour, a negative attitude
Financial Abuse or Exploitation
- Addition of names to the senior’s signature card
- Financial activity the senior couldn’t have done, such as an ATM withdrawal when the account holder is bedridden
- Items or cash missing from the senior’s household
- Significant withdrawals from the elder’s accounts
- Sudden changes in the elder’s financial condition
- Suspicious changes in wills, power of attorney, titles, and policies
- The elder does not receive his pension or Social Security check from the mail
- The elder unexplainably signs contracts that results to unwanted financial commitment
- The elder, without any valid reason, revises his will and changes his beneficiary
- Unnecessary services, goods, or subscriptions
- Unpaid bills or lack of medical care, although the elder has enough money to pay for them
Healthcare Fraud and Abuse
- Evidence of overmedication or under-medication
- Duplicate billings for the same medical service or device
- Evidence of inadequate care when bills are paid in full
- Problems with the care facility:
- Poorly trained, poorly paid, or insufficient staff
- Inadequate responses to questions about care
Neglect by caregivers or Self-neglect
- Being left dirty or unbathed
- Desertion of the elder at a public place
- May show signs of insanity
- Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards)
- Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
- Unsuitable clothing or covering for the weather
- Unusual weight loss, malnutrition, dehydration
- Untreated physical problems
- Bed sores
- Sores are untreated
- Broken eyeglasses or frames
- Burn markings from cigarette
- Caregiver’s refusal to allow you to see the elder alone
- Fingernails that are broken
- Report of drug overdose or apparent failure to take medication regularly (a prescription has more remaining than it should)
- Signs of being restrained, such as rope marks on wrists
- The elder’s skin is very poor condition
- Unexplained signs of injury such as bruises, welts, or scars, especially if they appear symmetrically on two side of the body
- Broken bones, sprains, or dislocations
- Bite marks
- Black eye, lacerations, bruises or cuts that cannot be explained
- Fractures of the bone
- Anal or vaginal bleeding that cannot be explained
- Bruises around breasts or genitals
- Genitals are bruised
- Mysterious and unexplained genital infection
- Unexplained venereal disease or genital infections
- Ripped underwear
- The elder may tell someone that she has been sexually abused
- The elder may report that her care giver is showing her pornographic materials
- The report of the elder that she is forced to touch someone’s genitals, observe sexual acts, tell dirty stories and pose nude for a picture
- Torn, stained, or bloody underclothing
- Unexplained vaginal or anal bleeding