Elder abuse harms some of society’s most vulnerable individuals, robbing older adults of independence, dignity and a sense of safety. Addressing the maltreatment of older adults requires prevention and intervention.
Social workers, family members and others concerned about protecting older adults from physical harm or financial exploitation, for example, must work to educate themselves about elder abuse and its impact, elder abuse signs and risk factors, and strategies for combating elder abuse. To that end, the division of Adult Protective Services in Virginia and other resources offer support.
What Is Elder Abuse?
Elder abuse happens when a trusted individual, such as a family member or a caretaker in a nursing home, commits an act that harms, distresses or endangers an older adult. Elder abuse may also involve failing to care for an older adult.
The Virginia Center on Aging offers a host of resources and programs that aim to shed light on topics relevant to protecting and improving the lives of older adults in Virginia, including elder abuse prevention.
Forms of Elder Abuse
Elder abuse can take many forms, some of which are hard to identify. It often involves exploitation or neglect. The untrained eye may not always recognize subtle signs of elder abuse.
However, social workers, family members and other concerned individuals can more easily identify elder abuse if they understand the different forms it takes. This understanding serves as a foundation for protecting older adults.
The National Center on Elder Abuse (NCEA) identifies several types of elder abuse:
Neglect
Neglect is likely the most common form of elder abuse, according to the NCEA. It is the failure to give older adults basic necessities, such as food, health care and shelter.
Further examples of neglect include a caretaker’s failure to provide an older adult with hygiene maintenance, clothing or protection from danger.
Financial Elder Abuse
Financial elder abuse is the improper or unauthorized use of an older adult’s money, belongings or property. The abuse often involves the misappropriation of older adults’ finances or an illegal use of their resources.
Perpetrators of financial elder abuse employ many tactics, including:
- Forging checks or documents in the older adult’s name
- Forcing an older adult to sign a will that lists the abuser as an inheritor
- Using scams to trick an older adult into handing over money
Emotional Elder Abuse
Emotional elder abuse involves intentionally causing mental anguish or distress to an older adult. It can include acts meant to create fear or emotional pain in the person. It can be verbal or nonverbal. Perpetrators may ridicule the older adult, isolate them or ignore their needs.
Perpetrators also inflict emotional abuse through:
- Threats
- Denying access to medical devices
- Refusing to provide physical assistance
- Humiliation
- Name-calling
- Yelling
Physical Elder Abuse
Physical elder abuse involves inflicting pain or physical injury. This abuse can include slapping, pushing or intentionally letting objects hurt an older adult. It also includes restraining them.
Sexual Elder Abuse
The sexual abuse of older adults includes all sexual contact in which consent is not given.
After sexual abuse has occurred, some older adults can’t report it due to memory or communication issues.
Self-Neglect
In cases of self-neglect, older adults lose their ability to meet their daily needs and don’t arrange for outside help. This absence of self-care and assistance threatens older adults’ health and safety.
As a result of elder self-neglect, older adults may not:
- Get adequate food and hydration
- Be properly clothed
- Receive necessary medical care
- Keep up with financial responsibilities
Impact of Elder Abuse
Elder abuse can have a profound impact on the quality of life of older adults. Examining key facts and statistics offers insight:
- Studies suggest that nearly 1 in 10 older adults experience some form of elder abuse, by either family members or caretakers.
- Most older adults fear reporting the abuse, making it hard to measure the problem’s extent.
- Elder abuse significantly increases the mortality rates of older adults.
A recent study on the prevalence of elder abuse in institutional settings found:
- More than half of the staff members interviewed admitted to committing elder abuse.
- Of those who admitted to committing elder abuse, emotional abuse was the most frequent, followed by physical abuse as the next-most frequent.
- Of those who reported being abused, over a third described emotional abuse, with physical abuse being the next-most common.
A Consumer Financial Protection Bureau report indicates:
- Financial elder abuse costs older adults between $2.9 billion and $36.5 billion a year.
- Family members and scammers steal, on average, $34,200 from older adults.
- Older adults between the ages of 70 and 79 are the hardest hit by financial elder abuse, with average losses of $45,300.
Risk Factors for Experiencing Elder Abuse
What increases the likelihood of elder abuse? Identifying risk factors can help prevent abuse and manage the risk of it. Common risk factors include dependency, isolation and mental impairment.
Dependency
When either older adults or caretakers depend on one another financially or otherwise, the risk of elder abuse increases. The dependency can involve the caretaker or older adult relying on the other for money or housing, for example.
Depending on an older adult may lead caretakers to feel frustrated and angry, which can result in abuse. On the other hand, when older adults rely on their caretakers financially, caretakers may feel resentful and become abusive.
Isolation
Isolation of older adults or caregivers can limit their social support. When older adults live far from family members or have limited interaction with others, abuse can go unnoticed.
Many issues contribute to isolation as people get older, including dementia, loss of family or friends, and diminished physical and mental capacities.
Mental Impairment
Older adults with mental and cognitive impairments, such as Alzheimer’s, have a much higher risk of abuse. They tend to need a lot of care, which places stress on caretakers. Older adults with mental impairments or disabilities may experience abuse more than twice as much as those without such health issues.
Signs of Elder Abuse
Family members, social workers and others may see signs of elder abuse but not recognize their implication. However, with awareness, they can understand the signs and take action.
Consider the following warning signs of elder abuse:
Physical Signs of Elder Abuse
Physical abuse and sexual abuse, along with neglect, often leave physical evidence. Recurring injuries or injuries that don’t heal may indicate the presence of abuse.
Research has shown that certain injury patterns are associated with physical elder abuse. For example, injuries to the face and neck without injuries to upper and lower parts of the body often point to physical abuse.
Physical elder abuse may also show up as:
- Bruises around the wrist or arms
- Scrapes, cuts or rope marks
- Broken bones
- Untreated wounds
- Sprains
- Burn marks
- Internal injuries
- Falls
In addition, signs such as broken eyeglasses or damage to other personal items may indicate physical abuse. Inconsistent stories or hesitation to explain what caused injuries are also red flags of possible physical abuse.
Sexual abuse also leaves behind physical evidence, such as:
- Pelvic injuries
- Torn or bloody underwear
- Bruising on the genitals or inner thighs
- Genital or anal bleeding
- Difficulties walking or sitting
Signs of neglect include:
- Dirty clothing
- Dental problems
- Malnourishment
- Being left unbathed
- Weight loss
- Bed sores
Behavioral Signs of Elder Abuse
Unexpected behaviors or changes in behavior tend to accompany experiences of abuse. For example, in response to emotional, physical and sexual abuse, older adults may:
- Withdraw from daily life activities
- Become noncommunicative
- Assume uncommon behaviors attributed to dementia, such as rocking or sucking
- Avoid eye contact
- Appear fearful, anxious and hopeless
- Develop mood swings
- Change sleeping and eating patterns
- Become depressed or agitated
- Try to harm others or themselves
- Stop practicing self-care
Financial Signs of Elder Abuse
Many clues can suggest financial elder abuse. While one thing alone does not necessarily indicate a problem, unusual events or an odd pattern of financial behaviors deserves attention.
Signs of financial elder abuse include:
- Abrupt changes in bank practices (e.g., unexplained withdrawals or new signatories on an account)
- Sudden changes to a will
- Missing funds or unexpected transfers of assets
- Substandard care despite the older adult’s ability to afford good care
- Check forgeries
- Financial arrangements that lack documentation
Strategies for Addressing and Preventing Elder Abuse
Dealing with elder abuse calls for prevention and response. For older adults already in trouble, social workers and other practitioners can help with strategies to reduce risk of further harm.
Elder Abuse Prevention and Screening
Identifying at-risk older adults is a first step to protecting them. Screening tools play a critical role in prevention and early detection. The National Center on Elder Abuse’s Adult Maltreatment Screening and Assessment Tools Inventory describes screening and assessment tools for elder abuse prevention.
If preliminary screenings indicate the risk or presence of maltreatment, professionals can pursue additional screenings, make referrals or contact the division of Adult Protective Services in Virginia.
Elder Abuse Risk Management
Also key to elder abuse prevention is risk management. Once practitioners have identified risk factors, they can help protect vulnerable people by addressing issues such as:
- Isolation in older adults
- Depression, stress or substance misuse in caretakers
Research has shown that techniques such as logotherapy benefit isolated older adults. Logotherapy focuses on redirecting attitudes about suffering, overcoming fears and self-discovery through dialogue. In so doing, it targets the isolation of older adults that can give rise to their abuse.
Community support programs for older adults and caregivers can also serve as a vital part of risk management. Examples of invaluable assistance programs include:
- Information and help to caregivers about available services and how to access them
- Counseling and support groups
- Caregiver training
Additional Methods to Address Elder Abuse
Practitioners, family members and others concerned about elder abuse can take additional steps to protect older adults, including:
- Talking with older adults and caregivers about their challenges to provide better support
- Learning and educating others about how to recognize signs of elder abuse
- Reporting suspected abuse to Adult Protective Services in Virginia
- Supporting overwhelmed caregivers with services such as adult day care, counseling and relief care groups
Resources for Protecting Older Adults in Virginia
Accessing the right resources plays a vital role in protecting vulnerable older adults. The following organizations offer prevention and support, along with advice on navigating adult abuse prevention and assistance in Virginia.
Elder Abuse Prevention
Elder abuse prevention includes education, respite for caregivers and training programs. The following resources offer valuable solutions in several areas.
The Virginia Family Caregiver Solution Center provides caregivers with respite resources, educational information and search tools to locate community services.
The Central Virginia Task Force on Domestic Violence in Later Life focuses on protecting older women from abuse through awareness initiatives, forums for sharing resources and interaction between agencies and services providers.
The Virginia Coalition for the Prevention of Elder Abuse advocates for programs and services that protect older adults and adults with disabilities from abuse, neglect and exploitation.
The Greater Augusta Coalition Against Adult Abuse works to keep older adults safe through community action initiatives, advocacy and educational efforts that address the risk factors of elder abuse.
The Office for Aging Services of the Division for Community Living coordinates and delivers services that support older adults in their efforts to live as independently as possible, free from maltreatment.
The Virginia Association of Area Agencies on Aging collaborates with member agencies to help older adults, adults with disabilities and caregivers connect with resources and support.
The National Clearinghouse on Abuse in Later Life provides a wealth of information, resources and research on elder abuse topics.
Support for People Who Have Experienced Elder Abuse
Individuals who have experienced elder abuse can benefit from support, ranging from tools identifying available services to legal aid.
Adult Protective Services (APS) works to protect older adults from elder abuse by receiving and investigating reports of abuse, neglect and exploitation of older adults and adults with disabilities.
The Virginia Office of State Long-Term Care Ombudsman Program advocates for older adults in long-term care across Virginia, resolving complaints, investigating issues and defending older adults’ rights.
SeniorNavigator is a search tool that helps older adults and their families find local programs and organizations that provide services to older adults.
The disAbility Law Center of Virginia (dLCV) offers legal services to older adults and adults with disabilities living in the community and in institutions who have experienced abuse and neglect.
No Wrong Door is a network of providers across the state of Virginia that helps older adults get quickly and securely connected to more than 27,000 support services and programs.
Eldercare Locator is a locator tool that helps older adults and their families find local services for everything from transportation to elder rights.
Advice for Navigating Adult Protective Services in Virginia
To best navigate adult abuse prevention and assistance, one should understand what these agencies do and how they operate. The key services they provide include:
- Investigating reports of maltreatment
- Assessing risk and mental capacity
- Outlining services and goals
- Counseling
- Connecting older adults with services
- Monitoring the services delivered
While APS accepts anonymous reports, anyone making a report should try to provide as much information about the suspected abuse as they can.
Some important things to keep in mind when navigating adult protective services and resources in Virginia and elsewhere are:
- Older adults do not lose their rights to self-determination.
- Trained professionals screen reports to determine APS’ role moving forward.
- Caseworkers investigate the facts and report criminal actions to the police.
- APS services should aim for solutions that cause the fewest disruptions to a person’s life.
APS investigations differ from law enforcement investigations in that APS caseworkers strive to build trusting relationships with the older adults potentially experiencing abuse.
To report abuse, either call the APS hotline at 1-888-832-3858 or contact the Virginia Department of Social Services.
Take Action to End Elder Abuse and Protect Older Adults
Elder abuse presents complex challenges for all concerned. Finding ways to ensure older adults are safeguarded from exploitation and maltreatment while keeping their autonomy calls for thoughtful strategies and conversations. By exploring resources and seeking support from the division of Adult Protective Services in Virginia, older adults in need of help can find it and act on it.