Abuse of the Elderly

Types, Risk Factors and Prevention

Abuse of the elderly is a serious concern. It not only includes physical abuse but also emotional, sexual, neglect/abandonment and financial abuse.

It can happen anywhere - in the seniors home, senior housing communities and nursing homes. Find out more to protect yourself or your loved one.

Abuse of the elderly is also referred to as elderly or elder abuse.

It is defined as "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person."

Abuse of the elderly can happen to seniors anywhere - in their own homes, at independent living communities, at assisted living communities and at nursing homes. Elderly are being abused - harmed in some substantial way - usually by people who are directly involved in their care.

Family members are more common abusers but professional caregivers are also potential perpetrators of elderly abuse.

Although there are several types of abuse of the elderly (described in detail below), they all share the same underlying theme - the use of power and control by one individual to affect the well-being and status of another (older) individual.

Different Types of Abuse

There are a several types of abuse of the elderly:

Physical Abuse

Physical abuse accounts for 25% of all elderly abuse cases. It includes inflicting (or threatening to inflict) physical pain or injury such as punching, pushing, shaking, pinching, burning, force feeding, and any sort of physical punishment or restraint. It also includes depriving them of basic needs (such as food, medication).

Emotional/Psychological Abuse

Emotional/psychological abuse includes inflicting mental pain, anguish, or distress through verbal or nonverbal acts. It accounts for 36% of abuse cases.

It can include name-calling, ridiculing, constantly criticizing, accusations, blaming, and general disrespect. It also includes non verbal forms such as ignoring, silence or shunning.

Emotional abuse can be difficult to detect unless witnessed. Seniors being abused in this manner can show changes in behavior (such as fear when in the presence of the abuser, agitation or withdrawal).

Sexual Abuse

Sexual abuse is non-consensual sexual contact of any kind. It can be difficult to detect except for those involved in their direct personal care. It also includes forcing the senior to participate in conversations of a sexual nature against their will.

Financial Abuse

Financial abuse is the illegal taking, misuse, or concealment of funds, property, or assets. It accounts for 30% of all cases of abuse. It includes the unexplained disappearance of funds, valuable possessions, changes to wills or financial documents. It also includes fraudulently obtaining or use of a power of attorney.


Neglect includes failing or refusing to provide food, shelter, healthcare or protection. Abandonment includes deserting an elder when that person has assumed the responsibility for care of them. They account for 49% of cases of abuse.

The deprivation may be intentional (active neglect) or out of lack of knowledge/resources (passive neglect).

The physical signs of neglect are often easy to see, including: dirty surroundings, poor personal hygiene, soiled bedding, smell, untreated cuts or sores, poor dental hygiene.

Signs and Symptoms

Protect your elderly parents by being aware of the signs and symptoms of abuse of the elderly. At first, you may not recognize them as signs of abuse as they may appear to be symptoms of dementia or signs of frailty. Many of the signs and symptoms of elder abuse overlap with symptoms of mental decline so it is important to pay careful attention.

General signs include:

  • Changes in the senior's personality or behaviour
  • Arguments between the senior and caregiver

Signs of specific abuse of the elderly include:


  • Unexplained signs of injury (such as bruises, welts, or scars)
  • Broken bones, sprains, or dislocations
  • Report of mismanagement of medications (including drug overdose or apparent failure to provide medication as prescribed)
  • Broken eyeglasses
  • Signs of being restrained
  • Caregiver's refusal to see the elder alone


  • Threatening, belittling, or controlling caregiver behaviour
  • Behaviour from the elder that mimics dementia (rocking, sucking, or mumbling to oneself)
  • Uncommunicative and unresponsive
  • Unreasonably fearful or suspicious
  • Lack of interest in socializing
  • Chronic physical and/or psychiatric health issues
  • Evasiveness


  • Unexplained vaginal or anal bleeding
  • Torn or bloody undergarments
  • Bruised breasts or around genitals
  • Venereal diseases or vaginal infections


  • Unusual weight loss, malnutrition, dehydration
  • Untreated physical problems
  • Unsanitary living conditions
  • Being left dirty or unbathed
  • Unsuitable clothing or covering for the weather/temperature
  • Unsafe living conditions
  • Desertion of the elder
  • Extreme thirst
  • Bed sores


  • Life circumstances don't match with the size of the estate
  • Large withdrawals from bank accounts, switching accounts, unusual ATM activity
  • Sudden changes in the senior's financial condition
  • Items or cash missing from the senior's household
  • Suspicious changes in wills, power of attorney, titles, and policies
  • Addition of names to the senior's signature card
  • Unpaid bills or lack of medical care
  • Financial activity the senior couldn't have done (such as an ATM withdrawal when the account holder is always at home)
  • Unnecessary services, goods, or subscriptions
  • Signatures on checks don't match senior's signature
  • Duplicate billings for the same medical service or device (health care fraud)
  • Evidence of inadequate care when bills are paid in full
  • Problems with the care facility such as poorly trained, poorly paid, or insufficient staff, crowding and inadequate responses to questions about care

Risk Factors of Abuse

Risk Factors Among Caregivers

Many caregivers find taking care of the elderly to be personally satisfying and rewarding. However, some caregivers find the responsibilities and demands of elder caregiving - which escalate as the elder's condition deteriorates - to be extremely stressful.

The stress of caregiving can sometimes lead to mental and physical health problems that make caregivers impatient, burned out, and unable to restrain from lashing out against seniors in their care.

Caregivers that are especially at risk for abusing elders include:

  • Inability to cope with stress
  • Depression
  • Lack of support from other caregivers
  • Caregiver's perception that caring for an elder is burdensome and without reward
  • Substance abuse

Those that are abusing elderly may display the following behaviours:

  • Substance abuse
  • Controlling elder's actions - where they go, who they talk to
  • Isolating elder from family and friends
  • Emotional/ financial dependency on senior
  • Threatening to leave or send senior to a nursing home
  • Appearing to be indifferent to senior
  • Minimizing an elder's injuries, blaming victim or others for the abuse, neglect, or exploitation
  • Threatening to harm an elder's loved one and/or pet
  • Name calling
  • Previous criminal history
  • Mental illness

Although the majority of abusers are family members - most often an adult child or spouse - abuse can also occur at a long term care facility, such as a nursing home or assisted living residence. Employees who have direct contact with residents are the most common perpetrators.

Risk Factors Among Elders

Several factors concerning elders - while they do not excuse abuse of the elderly - increase their risk for abuse:

  • The intensity of an elderly person's illness
  • Social isolation (the senior and caregiver are alone together most of the time)
  • The elder's role, at an earlier time, as an abusive parent or spouse
  • A history of domestic violence
  • Senior's own tendency toward verbal or physical aggression

Preventing Abuse of the Elderly

For Elders:

Although victims of elderly abuse are not responsible for being abused, they can help prevent abuse by:

  • Staying busy and engaged in life. Building a strong support network of family and friends.
  • Taking care of themselves. Seniors with declining health can become more vulnerable to abuse because of their increasing dependence on others.
  • Be aware of the link to addiction issues. Individuals who abuse substances are at high risk of being abusive.
  • Refuse to allow anyone, even a close relative, to add his or her name to your bank account without your clear consent.
  • Never make financial decisions under pressure. Avoid signing over money or property to anyone without first getting legal advice.
  • Assert your right to be treated with dignity and respect. Be clear about what you will and will not tolerate, and set boundaries. You have the right to make your own decisions.
  • Trust your instincts. Listen to the voice inside you when it calls out something is not right.
  • Make sure your financial and legal affairs are in order. If they are not, enlist professional help to get them in order, with the assistance of a trusted friend or relative if necessary.
  • Keep in touch with family and friends and avoid becoming isolated.
  • If you are unhappy with the care you are receiving, whether it is in your own home or in a care facility, speak up. Tell someone you trust and ask that person to report the abuse.

For Caregivers:

If you feel you are at risk for being a potential abuser, ensure you:

  • Request help, from friends, relatives, or local respite care agencies, so you can take a break
  • Stay healthy and get medical care for yourself when necessary
  • Adopt stress coping practices
  • Seek counselling for mental health issues such as depression
  • Find a support group for caregivers of the elderly
  • If you're having problems with drug or alcohol abuse, get help.

For Friends/Family of Elders:

Don't let your fear of involving yourself in someone else's business stop you from reporting your concerns. You could be saving their life.

You can help prevent abuse of the elderly by:

  • Watch for warning signs that might indicate elderly abuse.
  • If you suspect abuse, report it.
  • Take a look at the elder's medications - are proper amounts being provided? Does the medication remaining fit with what should be remaining if provided correctly?
  • Watch for possible financial abuse. Ask the senior if you can scan their bank accounts and credit card statements for unauthorized transactions.
  • Call and visit as often as you can. Help the senior consider you a trusted confidante.
  • Offer to stay with the senior so the caregiver can have a break - on a regular basis, if you can.

The reporting agencies in each state/province are different, but every state/province has a service designated to receive and investigate allegations of elderly abuse and neglect. Even if these agencies determine that there is only potential for abuse, they will make referrals for counselling.

Reporting Elderly Abuse

You should call police or adult protective services right away if you suspect that an elder is being abused. You do not need to prove abuse in order to make a report.

Most states/provinces have a toll-free number you can call to express your concerns. You will usually be asked to give the person's name, address, contact information, and details about why you are concerned. You may also be asked for your name and phone number, or some other way of contacting you in case the investigator has any questions. Most states/provinces will also take an anonymous report if you do not wish to identify yourself. Laws usually protect the confidentiality of the individual making a report.

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