What to do if elder abuse occurs
Summary
Elder abuse, neglect, and exploitation should never be ignored. Whether the abuse is physical, psychological, financial, or sexual, it rarely stops on its own. This article lists some of the main steps to take in responding to known or suspected elder abuse.
Responding to elder abuse
Elder abuse, neglect, and exploitation should never be ignored. Whether the abuse is physical, psychological, financial, or sexual, it rarely stops on its own. In fact, it usually gets worse over time.1
Victims are often afraid or ashamed to report abuse. They may not even understand that certain behaviors (for instance neglect or inappropriate use of their money) qualify as abuse. Therefore, others who know the older adult may need to take the initiative in bringing the problem to light and helping to get it resolved.
The most appropriate way to respond depends on the type and severity of the abuse. However, in most cases of abuse, two important steps are reporting the situation and supporting the older adult emotionally.
Report the abuse
Abusers are usually the most dangerous when their victims seek help or try to leave the abusive situation.2 Confronting an abuser can make the older adult more vulnerable. Therefore, in cases of physical, mental, or sexual abuse, caregivers should not confront the abuser themselves unless the older adult has given permission and can be moved immediately to a safe place.3
If it is not possible to speak to the older adult directly about the abuse, talk to a trusted professional, such as someone at Adult Protective Services (APS), a social worker, a member of the clergy, or a member of the older adult’s health care team.
Abuse that puts the older adult’s life or safety in danger should always be reported immediately to emergency responders.
Duty to report
In all 50 states, any person who suspects or knows about elder abuse is allowed to report it to authorities. However, in about 20 states, unpaid family caregivers are considered “mandated reporters” of elder abuse.4 This means that they, along with health care professionals and others, have a legal duty to report known or suspected elder abuse or neglect to authorities and can face fines or jail time if they fail to report abuse or neglect.
Family caregivers should look at the “duty to report” laws for their state to see if they are legally obliged to report. They can find their state law on the State Mandated Reporting page of the Elder Abuse Guide for Law Enforcement (EAGLE). If they are still unsure whether the mandated-reporter status applies to unpaid caregivers in their state, they should ask a professional at the local Area Agency on Aging or Adult Protective Services.
Call 911 or local police
If the older adult may be in immediate danger, they or another adult should call 911 immediately. It is a good idea to keep the street address, buzzer number (if applicable) and phone number written down in large print on or near the phone. This way, the caller can refer to the information if fear or cognitive decline blocks their memory.
Call an elder abuse or domestic violence hotline
In both emergency and non-emergency cases of abuse, the older adult or another adult can call an elder abuse hotline, a state domestic violence hotline, or the National Domestic Violence Hotline (1-800-799-7233) for help. If the hotline worker believes the abuse is an emergency situation, they will call 911. Hotline numbers can be found on the State Resources page of the National Center on Elder Abuse (NCEA) website.
Call Adult Protective Services (APS) or the Eldercare locator line
If the older adult is not in immediate danger but is or may be being abused, neglected, or exploited, and they are being cared for in the home, call the local Adult Protective Services (APS). The number can be found by going to the State Resources section of the National Center on Elder Abuse website. The caregiver can also call the national Eldercare Locator line (1-800-667-1116), a service of the federal government. Trained operators will provide information on local resources, including guidance for abuse cases.
The person reporting the abuse can remain anonymous, or ask that their call remain confidential, if they don’t want the abuser and/or anyone else involved to know they have reported abuse. APS actions can include investigating reports of elder abuse, passing the information on to the district attorney, developing a case plan, and arranging for medical care and supportive services.
Call the Long Term Care Ombudsman (LTCO)
If the older adult is in a care facility such as an assisted living facility or nursing home, contact the local Long Term Care Ombudsman, a service available in all states. The local LTCO number can be found by contacting the local Area Agency on Aging (AAA) or going to the state locator page on the website of the National Consumer Voice for Quality Long-Term Care.
Support the older adult emotionally
When an older adult has experienced abuse, it is important for caregivers to provide a supportive, sympathetic environment where they can rebuild their sense of self-esteem, safety, and trust. Even if Adult Protective Services or another agency arranges for the older adult to receive counseling, caregivers and other loved ones play an important part in helping the person recover. Some ways to support the person emotionally are to validate their perceptions and emotions, listen to them without judgment or blame, and help them feel safe and valued.
Validate their perceptions and emotions
In many cases, an older adult may feel guilty or blame themselves for what happened. They may accuse themselves of exaggerating the problem or “overreacting”—or the abuser may accuse them of “making something out of nothing” in an attempt to defend themselves. In other cases, the older adult may feel disbelieved, especially if they have talked about the abuse or neglect and action was not taken quickly.
The caregiver can ease self-blame or the distress of being disbelieved by validating that harm was being done, that taking action was needed, and that the fault lies with the abuser and not with the person who was being abused. It may be helpful to reinforce, “It was not your fault.”
Listen to them without judgment or blame
People who have been victimized often fear that they will be judged or criticized. It is important to listen to their story of what happened and how they are feeling without any suggestion of blame or criticism. Respond with gentle, sympathetic comments such as “That sounds really hard,” or “I’m so sorry that you’ve had to go through this.”
Help them feel safe and valued
All types of abuse and neglect damage a person’s sense of self-worth, confidence, and safety. Caregivers can help the person begin to rebuild their self-worth by frequently telling them that they are valued, loved, and worth protecting. They can assure the person that they are now safe, and that loved ones and authorities are there to help ensure it doesn’t happen again.
Related information
Having the elder abuse talk
Having the elder fraud talk
Overview of elder fraud
Preventing elder abuse
Provide care while ensuring dignity
Types of elder abuse
What to do if elder fraud occurs
External supporting content
Nursing home complaints? The ombudsman is on your side
What to do if you suspect nursing home abuse of seniors with dementia
How do I report elder abuse or abuse of an older person or senior?
National Adult Protective Services Association
National Center on Elder Abuse (NCEA): State Resources
Long-Term Care Ombudsman Program
End notes
1 Understanding and Responding to Elder Abuse. Government of British Columbia.
2 Understanding and Responding to Elder Abuse. Government of British Columbia.
3 Elder abuse: How to spot warning signs, get help, and report mistreatment. American Psychological Association.
4 Reporting Abuse. NCEA.
