Types of elder abuse
Summary
The term “elder abuse” includes physical, psychological/verbal, financial, and sexual abuse. It also includes self-neglect on the part of the older adult and neglect or abandonment by the caregiver. This article defines the main types of elder abuse.
What is elder abuse?
The term “elder abuse” includes physical, financial, psychological, verbal, and sexual abuse. It also includes self-neglect on the part of the older adult and neglect or abandonment by the caregiver.
Most elder abuse happens at home: family caregivers commit 6 out of 10 cases of elder abuse.1 However, professional caregivers at facilities such as nursing homes, assisted living facilities, and even hospitals can also commit elder abuse, as can other residents of these facilities.
The most common types of elder abuse, in order of frequency,2 are self-neglect, caregiver neglect and abandonment, psychological/verbal abuse, physical abuse, financial abuse/elder fraud, and sexual abuse.
Self-neglect
An older adult is considered to be suffering from self-neglect if they fail to carry out basic activities to meet their health care and activities of daily living (ADL), such as bathing, getting themselves food, dressing, and taking their medication. Nearly half of all reported cases of elder abuse are self-neglect.3
The exact definition of self-neglect is not consistent across eldercare and legal fields. For example, some researchers consider it self-neglect for a capable older adult to refuse to bathe themselves or eat enough; others only include people who are mentally or physically incapable of doing such activities. Some definitions include hoarding or keeping a house in poor repair, while others do not.
Whichever definition is used, elder self-neglect leads to worse mental health, greater physical and mental deterioration, increased hospitalization, and earlier death.4
Caregiver neglect and elder abandonment
About 15% of reported cases of elder abuse come in the form of a family or professional caregiver neglecting or abandoning the older adult.5 For every case of elder neglect that is reported, there are thought to be 57 that go unreported.6
Caregiver neglect can happen in a home setting or a facility, and can be either unintentional (also known as “passive neglect”) or deliberate (also known as “willful deprivation”).7 It happens when a caregiver fails to:
- Give older adults adequate food and hydration
- Give older adults medication consistently and properly
- Take care of older adults’ hygiene (bathing, teeth-brushing, grooming)
- Change older adults’ bedding and clothes
- Take older adults to appointments or to follow up on them
- Seek appropriate and timely treatment for older adults
Elder abandonment refers to instances where a caregiver who has taken on responsibility for the older adult permanently leaves the older adult on their own,8 whether in the home or in a care facility. This may include dropping them off at a care facility or hospital and deserting them or taking them to a public place, such as a park or shopping mall, and leaving them there. In many cases, the person has dementia and is unable to give professionals information about their identity, home address, or medical condition.9
Psychological/verbal abuse
Psychological or verbal abuse, also called emotional abuse, is when someone speaks or behaves in ways that cause a person emotional pain, fear, or distress. It includes nonverbal behaviors such as10:
- Keeping a person from seeing or talking on the phone with family members or friends
- Giving a person “the silent treatment”
- Keeping a person socially isolated
It also includes verbal behaviors such as:
- Yelling at someone
- Calling someone names
- Treating someone like a child
- Cutting someone off from social activities
One common example is when an adult child who is the main caregiver prevents a sibling from visiting or talking on the phone with their parent, possibly out of sibling rivalry or resentment. Unless the caregiver in this case has both power of attorney and a medical reason for limiting visits, restricting the older adult’s access to a loved one in this way is considered psychological elder abuse.
Physical abuse
Physical elder abuse means causing an older adult physical pain or injury. It includes:
- Constraining or isolating a person when there is no medical reason to do so
- Giving inappropriate medications—for example, giving someone with dementia an antipsychotic or sedative drug not meant for that condition
- Slapping a person
- Yanking at a person’s arm
- Holding a person down
Financial abuse/elder fraud
There are two broad categories of elder financial abuse/elder fraud: scams from the outside, such as phone or online scams, and financial exploitation.
Some forms of scams are:
- Telling a person they have won a prize or lottery that requires them to grant access to their bank account
- Persuading a person to donate to a fake charity
- Getting a person to invest in phony, illegal, or high-risk schemes
- Setting up a “romance scam,” where the scammer pretends to have common interests and be romantically interested in the older adult, and then asks for money to get out of an emergency
- Pretending to be from a government agency, such as the IRS or Medicare, and claiming that the older adult owes money
Financial exploitation occurs when someone the older adult knows, such as a family member, steals or misuses their money. Exploitation is especially easy for the person with financial power of attorney to commit. It can include:
- Misusing a person’s credit card or savings
- Investing a person’s money for the profit of an exploiter
- Persuading a person to change their will in favor of the exploiter
Sexual abuse
Elder sexual abuse is any kind of unwanted sexual contact with an older adult. It can include:
- Touching or molesting a person, including touching their breasts or genital area
- Having non-consensual sex with a person, or having any kind of sexual contact with a person who is unable to give consent because of a health condition such as advanced dementia
- Masturbating or watching pornography in a person’s presence
- Forcing a person to be naked
- Taking pictures of a person when they are not fully clothed
- Talking to a person about sex or a sexual relationship
The most common form of elder sexual abuse in assisted living facilities and nursing homes is dementia-caused sexual abuse of one resident by another.11 It occurs when a resident’s Alzheimer’s disease or another dementia has made them hypersexual and/or aggressive. Older adults who live in a facility with many other dementia patients are at higher risk for sexual abuse.12
Related information
Assisted living facilities
Having the elder abuse talk
Having the elder fraud talk
Overview of elder fraud
Preventing elder abuse
Skilled nursing facilities (nursing homes)
What to do if elder abuse occurs
End notes
1 Elder abuse: How to spot warning signs, get help, and report mistreatment. American Psychological Association.
2 Elder Abuse: Golden Years’ Lost Luster. National Library of Medicine: Missouri Medicine.
3 Elder self-neglect: research and practice. Clinical Interventions in Aging.
4 Elder self-neglect: research and practice. Clinical Interventions in Aging.
5 Elder Abuse Statistics and Facts. Griswold Home Care.
6 Elder Abuse Statistics. US Justice Department.
7 Get the Facts on Elder Abuse. National Council on Aging (NCOA).
8 The need for a stronger definition: Recognizing abandonment as a form of elder abuse across the United States. Aurora Health Alliance.
9 The need for a stronger definition: Recognizing abandonment as a form of elder abuse across the United States. Aurora Health Alliance.
10 Elder Abuse Surveillance: Uniform Definitions and Recommended Core Data Elements. CDC.
11 Sexual Abuse in Nursing Homes: What You Need to Know. The National Consumer Voice for Quality Long-Term Care.
12 Elder Sexual Abuse. ElderAbuse.org.
