Preventing elder abuse
Elder abuse is a widespread problem. This article lists some of the common signs that an older adult may be being abused. It then describes steps to take to prevent different types of elder abuse.
The elder abuse problem
Elder abuse is a widespread problem. About 1 in every 10 adults over the age of 60 who live at home is abused, neglected, or exploited in some way.1 Additionally, nearly 25% of residents in nursing homes reported being physically abused.2 All told, up to 5 million older adults are abused in the United States.3
Elder abuse takes many forms: physical, psychological, financial, and sexual. It also includes self-neglect and caregiver neglect. Because of this, detecting and preventing elder abuse requires knowledge and diligence.
Know the signs
There are different kinds of elder abuse and neglect and so also different signs. Some common signs are:
- The person becoming withdrawn, agitated, or secretive
- Neglected hygiene and grooming (for example, teeth not brushed, body odor detectable) or bedsores
- Weight loss or dehydration
- Symptoms consistent with medications not being taken regularly
- Unclean or unsafe living conditions
- A caregiver refusing to let others see the older adult alone
- Unpaid bills, suspicious withdrawals from the person’s bank account, or sudden changes to their will
- Signs of the person being restrained or punished, such as bruises, burns, or rope marks
- The person with financial power of attorney refusing to answer questions about the person’s finances
- Bleeding from genitals
Preventing abuse and neglect by family caregivers
Six out of ten reported cases of elder abuse are committed by family caregivers.4 Many of these cases are neglect, whether intentional or unintentional. However, family caregivers (as well as professional caregivers) also abuse older adults physically, mentally, financially, and, to a lesser extent, sexually. The caregiver may or may not realize that their behavior qualifies as abuse. To lower the chances of a family caregiver abusing an older adult, attend to caregiver stress and prevent social isolation.
Attend to caregiver stress
Stress is a major factor in caregivers becoming abusive. Therefore, a key step in preventing elder abuse is to keep an eye on the caregiver’s sense of burden and make sure a strong support system is in place. This should include a detailed care plan and regularly scheduled respite breaks. Caregivers should also track their stress levels by using the Burden Scale for Family Caregivers.
Those giving care to older adults with certain conditions, such as dementia and kidney disease, often have significantly higher stress levels than other caregivers.5 These caregivers, along with the older adults and others involved, should make a particular effort to create a strong support system.
Prevent social isolation
When caregivers and the older adults they are caring for become isolated, abuse is not only more likely to happen6 but less likely to be detected and halted. In fact, keeping an older adult isolated is considered to be a type of psychological elder abuse in itself.
Some ways to keep the caregiver and older adult from becoming isolated are:
- Have an extensive list of friends, family members, and others to keep the older adult company
- Enroll the older adult in a social group or adult day care
- Make sure the caregiver belongs to a support group
- Arrange for the caregiver to have access to a therapist or other mental health professional
Preventing physical and emotional abuse in care facilities
In a global survey, 2 out of 3 staff in care facilities such as assisted living facilities and nursing homes reported committing abuse against older adults.7 Physical and verbal abuse are the kinds of abuse most often found in care facilities.8 Additionally, about 12% of nursing-home staff say they have neglected residents, while 95% of nursing home residents say they have experienced or witnessed neglect.9
Another risk for older adults living in care facilities is resident-to-resident physical and sexual abuse. This most often happens when there are many residents with Alzheimer’s disease or other dementias living together. Dementia can cause aggressiveness and hypersexual behavior in some people, spurring them to attack other residents.
Actions for preventing abuse in care facilities include:
- Asking about hiring and training practices, including background checks (about 50% of people who abuse older adults have criminal records10)
- Asking about staff turnover rates: a high rate may mean poor working conditions and inexperienced staff
- Checking staff-to-resident ratios to make sure staff are not stressed by overwork
- Asking what the process is for administrators to oversee staff members
- Finding out procedures for monitoring interactions between residents, especially those with dementia
- Visiting and calling the older adult often
Preventing financial abuse and exploitation
Financial abuse includes scams and consumer fraud. Financial exploitation refers to when a family member or another trusted person in the older adult’s life misuses their finances or steals money from them. The large majority of financial elder abuse is committed by people the older adult knows.11
Some effective ways for a caregiver to reduce the risk of financial abuse and exploitation are to help the older adult do the following:
- Take care to name a trustworthy person as financial power of attorney (POA)
- Use an eldercare lawyer to help customize and limit the POA’s role and access to finances
- Give a trusted person “view-only” access to bank accounts and set up a schedule for reviewing accounts for questionable activity
- Set up notifications or sign up for services that track bank accounts, credit cards, and investments
- Avoid becoming isolated
- Be cautious of new “friends,” especially if they are unusually helpful or seem to be cutting the adult off from other family members and friends
- Make hired caregivers aware that attention is being paid to their actions
If you have reason to suspect elder abuse, you can take action:
- 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.
10 things you should know about caregiving
Assisted living facilities
Get help and support
Having the elder abuse talk
Having the elder fraud talk
Investigate long term care options
Join a caregiver community
Overview of elder fraud
Preventing elder abuse
Preventing elder fraud
Provide care while ensuring dignity
Skilled nursing facilities (nursing homes)
Types of elder abuse
What to do if elder abuse occurs
What to do if elder fraud occurs
External supporting content
1 Fast Facts: Preventing Elder Abuse. CDC.
2 Nursing Home Abuse Statistics. Nursing Home Abuse Justice.
3 Get the Facts on Elder Abuse. National Council on Aging.
4 Elder abuse: How to spot warning signs, get help, and report mistreatment. American Psychological Association.
5 The challenge for the caregiver of the patient with chronic kidney disease. Nephrology Dialysis Transplantation; Family caregivers of people with dementia. Dialogues in Clinical Neuroscience.
6 Elder Abuse in the Time of COVID-19—Increased Risks for Older Adults and Their Caregivers. American Journal of Geriatric Psychiatry.
7 Abuse of older people. World Health Organization.
8 Nursing Home Abuse Statistics. Nursing Home Abuse Justice.
9 Nursing Home Neglect. Nursing Home Abuse Center.
10 Recognizing Abusers. Elder Abuse Guide for Law Enforcement.
11 Spot the Red Flags of Elder Financial Abuse. AARP.