Elder abuse: Many kinds, many causes

Gerald, 73, had a stroke. Unable to care for himself, he moved in with his son’s family. His son tried to help, but it was Frances, his daughter-in-law, who usually cooked special meals and helped him bathe and dress. Frances was already busy staying ahead of two teenage boys and teaching third grade. At first everyone was glad to have Gerald living with the family. But after a few months, Frances was yelling at him often and sometimes didn’t help him get dressed until late afternoon. Gerald was upset, but he didn’t know what to do.

Many Kinds of Mistreatment

Many older people are victims of elder abuse, sometimes called elder mistreatment. It can happen to anyone no matter what their race, religion, or background. And, it can happen in many places including the older person’s home, a family member’s house, assisted living facility, or nursing home.

Caring for someone who is physically or mentally disabled can be demanding and exhausting. Some caregivers become frustrated, and some type of physical or emotional abuse may occur.

  • Physical abuse happens when the caregiver causes bodily harm by hitting, pushing, or slapping.
  • Emotional abuse can include a caregiver yelling, saying hurtful words, threatening, or repeatedly ignoring an older person. Keeping an older person from seeing close friends and relatives is another form of emotional abuse.

Sexual abuse involves a caregiver forcing an older adult to watch or be part of sexual acts.

  • Neglect by caregiver occurs when the caregiver is not responsive to the other person’s needs.
  • Abandonment is leaving an older person alone without planning for his or her care.

Money Matters and Abuse

After Victor’s mother died, he started looking after his elderly grandparents. Victor insisted they add his name to their bank account so he could pay their bills. For the last 6 months, Victor has been taking money from their account for his own use. He feels guilty, but tells himself that the money will soon be his anyway.

Financial abuse happens when money or belongings are stolen. This can include forging checks, taking retirement and Social Security benefits, or using another person’s credit cards and bank accounts. Financial abuse includes changing names on a will, bank accounts, life insurance policies, or the title to a house. Financial mistreatment is becoming widespread and is hard to detect.

Many older Americans are victims of financial abuse. It can be very upsetting. In addition to losing money, some older adults never regain their sense of trust and self-worth.

Healthcare fraud can be committed by doctors, hospital staff, and other healthcare workers. It includes overcharging, billing twice for the same service, falsifying Medicaid or Medicare claims, or charging for care that wasn’t provided.

Who Is Being Abused?

Most victims of abuse are women, but some are men. Likely targets are older people who have no family or friends nearby, and those who suffer from physical handicaps or memory problems.

Abuse can happen to any older person, but often affects those who depend on others for help with activities of everyday life including bathing, dressing, and taking medicine. The frailest people are often abused because they appear to be easy victims.

How Can You Tell If Someone Is Being Abused?

Two years ago, the doctor diagnosed Eduardo’s mother with osteoporosis. When she needed more help, he moved her into a nearby nursing home. For the last few months she’s been depressed and withdrawn. Eduardo doesn’t like the way a nurse talks to his mother.

You may see signs of abuse or neglect when you visit an older person at home or in an eldercare facility. You may notice the person:

Has trouble sleeping

Seems depressed or confused

Loses weight for no reason

Displays signs of trauma like rocking back and forth

Acts agitated or violent

Becomes withdrawn

Stops taking part in activities enjoyed in the past

Has unexplained bruises, burns, or scars on the body

Looks messy, with unwashed hair or dirty clothes

Develops bed sores or other preventable conditions

What Causes Abuse?

Nancy reassured her siblings that she would take good care of their oldest sister, Agnes. And she has, but now Agnes has been diagnosed with Alzheimer’s disease. At night she is so restless that Nancy can’t get her to bed. Nancy feels tired, lonely, and angry that her brothers and sisters don’t help. More and more she feels like shaking Agnes.

Caring for an older person can be a demanding and difficult job. It can be very stressful. The caregiver may need to be available 24 hours a day to fix meals, provide nursing care, take care of laundry and cleaning, drive to doctor’s appointments, and pay bills. Caregivers may have additional worries. Many put their own financial future on hold when they give up paying jobs to care for an older friend or relative.

Are You Thinking

About Caregiving?

If you are going to be a caregiver for someone in your family or for a friend, ask yourself these questions:

Do I have a good relationship with this person?

Is the person difficult?

Am I being pressured into this job by other family members?

Are other family members going to help me?

Will I have time to rest and take care of my needs?

Can I afford to care for this person?

Are there community resources that can help me?

What are the other options for caregiving?

Being a caregiver can be even harder when the older person has dementia or memory loss. It can be upsetting, even annoying, to be asked the same questions over and over again. You can lose sleep worrying about night wandering or being asked for help at any hour of the night or day.

Caregiving can also be rewarding, but it may be hard to keep a positive outlook when there’s little hope of the older person’s physical and mental condition improving. All of these may play a part in caregiver burnout, neglect, or abuse.

Who Can Help?

Elder mistreatment will not stop on its own. Someone else needs to step in and help. Many older people are too ashamed to report abuse. Or, they are afraid if they make a report it will get back to the caregiver, and the abuse will get worse. If you think someone you know is being abused-physically, emotionally, or financially-talk to him or her when the two of you are alone. You could say you think something is wrong and you’re worried. Offer to take him or her to get help; for instance, a local adult protective service agency.

Many local, State, and national social service agencies can help with emotional, legal, and financial problems.

If you think the older person is in urgent danger, call 911 or your local police to get help right away. Most States require that doctors and lawyers report elder mistreatment. Family and friends can also report it. Do not wait. Help is available. If a crime has been committed, the police will be called.

What Is the Long-Term Effect of Abuse?

Most physical wounds heal in time. Any type of mistreatment can leave the abused person feeling fearful and depressed. Sometimes, the victim thinks the abuse is his or her fault. Protective services agencies can suggest support groups and counseling that can help the abused person heal the emotional wounds.

Information adapted from article provided by National Institute on Aging, National Institutes of Health,

U.S. Department of Health & Human Services, 06/06/2012.

If you would like more information on “Elder Abuse” feel free to contact Gail Gilman-Waldner, Family Life Consultant, M.Ed., C.F.C.S. and Professor Emeritus University of Minnesota at waldn001@umn.edu. Be sure to watch for more Family Living Focus information in next week’s paper.