Having the elder abuse talk
Although millions of older adults in America get abused each year, many of them are reluctant to talk about it. This article offers some tips for discussing elder abuse with an older adult, and gives information about what actions a caregiver can take if they suspect elder abuse.
Reasons why elder abuse is under-reported
Although millions of older adults in America get abused each year, many of them are reluctant to talk about it. Only an estimated 1 in 24 cases of elder abuse end up being reported to authorities.1 Reasons for an older adult’s reluctance might be:
- Shame and embarrassment: They may feel that they must have been stupid, weak, or gullible to let themselves be abused.
- Guilt and self-blame: Like victims of every kind, the older adult may blame themselves for what happened in an attempt to feel like they had more control over the situation than they actually did.
- Fear of retaliation: They may fear that their abuser will punish them for disclosing the abuse.
- Fear of getting the abuser in trouble: With 60% of abuse coming from family caregivers,2 there’s a good chance that the abuser is someone the older adult loves and may want to protect.
Anyone who suspects that an older adult is being abused may need to draw the information out through conversation. Caregivers need to handle this difficult topic with great sensitivity.
Whether the abuse was/is physical, psychological, sexual, or financial, the person has been victimized and is in a highly vulnerable state. Any conversation about abuse needs to be approached in the gentlest way possible. Speak calmly and kindly. Although you may be distressed, try not to add to the person’s stress levels by appearing agitated.
To lower the person’s defenses, use “I” statements. For example, instead of saying, “You look like you’re being neglected,” you might say, “I get worried when I come in and see that your hair and teeth look like they haven’t been brushed.”
Make any questions indirect until the person has relaxed. For instance, you could say, “Are you feeling safe in your home these days?” or “Are you still looking after your own money matters, or have you handed that over to someone else?”3 Hold off on more direct questions until the person has begun to volunteer information.
If their answers remain short and uninformative, try open-ended questions instead of yes/no ones. For example, you could ask, “How are you feeling about your care right now?” or “What kinds of things would you like to see changed about your care?”
Remember that the abused older adult’s trust, and possibly their physical person, has been violated. This will probably make it even harder than usual for them to confide in someone else. It could take multiple conversations for them to start telling you about the abuse.
As worried as you may be, try not to press the person to divulge information or come across like you are interrogating them. Stay calm and caring, and make it abundantly clear that your only interest is protecting them from harm.
When the person does start talking to you, listen with respect and without judgment, blame, overreaction, or interruption. Keep an open mind as you listen, rather than thinking about all the things you want to say or actions you want to take.
When the person tells you something about the abuse, reflect what they have said back to them, to confirm that you have heard and correctly understood. Ask clarifying questions, in a gentle, caring tone.
Take their word for it
On the flip side of unreported elder abuse are accounts of abuse that are dismissed or disbelieved. If the person being cared for says they are being abused, assume they are telling the truth. Even if they have dementia, paranoia, or confusion, it is important to take their word for what is happening. There is plenty of opportunity for any inaccuracies to come to light as the authorities investigate.
Start your part of the conversation by telling them that you believe them. If you skip this step, they may take your questions as an interrogation meant to trip them up. Assure them that you have no doubt that what they are saying is true. Tell them that you are very concerned, that you are on their side, and that you are going to help set things right.
If you have reason to suspect elder abuse, you can take action even if the person won’t tell you about it.
- If you think the person is in immediate danger, call 911 or the local police.
- If the person is not in immediate danger but you think they are being abused, call the local Adult Protective Services (APS). Find the reporting number by going to the State Resources section of the National Center on Elder Abuse website.
- If the person is in an assisted living facility, nursing home, or other type of care home, contact the local Long Term Care Ombudsman (required in every state) by going to the locator on the website of the National Consumer Voice for Quality Long-Term Care.
Assisted living facilities
Having the elder fraud talk
Preventing elder abuse
Skilled nursing facilities (nursing homes)
Types of elder abuse
What to do if elder abuse occurs
External supporting content
1 Research Statistics and Data. National Center on Elder Abuse.
2 Elder abuse: How to spot warning signs, get help, and report mistreatment. American Psychological Association.
3 Elder Abuse. New England Journal of Medicine.