The Care Company

empowered caregiving™

Elder abuse happens in the dark of the night and in the light of day. It happens in the subtlest and most obvious ways. It happens often and families are frequently the last to know or even notice. Often it’s family members who are inflicting the abuse! We feel it’s our obligation to inform you. We are not trying to frighten you, but rather enlighten you. Elders who are left alone or who have very few visitors are most likely to fall prey to abuse. Be present. Be aware. Make yourself seen and known. Be a warrior on behalf of your loved one. Be Empowered!

Types of Abuse
Physical abuse of elderly people is not uncommon; in fact, tens of thousands of seniors are being abused or harmed in some way. More than a half-million reports of abuse reach authorities each year, and millions more are thought to go unreported. Elder abuse occurs in general where the elder resides – in the home or in an assisted-living or institutional setting, especially long-term-care facilities. Often, it is family members who are engaging in the abuse for any number of reasons, but mostly because they think they can get away with it.  It is vital that you know the signs of physical and emotional abuse, as they are not always obvious.

Physical Abuse is considered non-accidental use of force resulting in physical pain, injury or impairment. This may involve, hitting, striking, beating, pushing, shoving, slapping and kicking, but also the inappropriate use of restraints, drugs or confinement. Numerous signs indicate this type of abuse:

• Unexplained bruises (especially in clusters) around the wrists, neck or groin area
• Welts or scars
• Broken bones, sprains or dislocations
• Wounds, cuts, scratches, punctures, black eyes
• Burns – usually on the buttocks, soles of feet or palms
• Broken eyeglasses
• A caregiver’s refusal to allow you to be alone with the elder

Sexual Abuse is possibly more detrimental than physical abuse, and it is on the rise. Frail, elderly patients are extremely vulnerable, and, sadly, not all facilities do a thorough background check on every employee. (See “Guide to Selecting a Long-term Care Facility” in The Care Company store.) Elders may not report such abuse because they are too afraid of retaliation, have serious cognitive impairment or are living in shame. Some of the signs are:

• Unexplained genital infection
• Bleeding, bruising or genital pain
• Bruised or bleeding breasts
• Torn and bloodied clothes
• Unusual fear or even terror

Emotional Abuse is the easiest type of abuse inflicted upon elders. It often goes undetected. Emotional abuse is the infliction of pain or distress through insults, intimidation, fear mongering, threats of neglect, harassment or humiliation. Elders are extremely susceptible to the power of words.

Symptoms include:

• Childlike behavior, such as talking to oneself, mumbling, rocking or biting
• Complete withdrawal
• Agitation and fearful behavior
• Controlling or intimidating behavior on the part of the caregiver that you witness – this means it’s worse when you aren’t present
• A reporting of this behavior on the elder’s part – take it seriously

Neglect is the most common form of elder abuse, accounting for 49 percent of all elder-abuse cases. Neglect is the failure of family members, staff or caregivers to fulfill obligations to the elder. Neglect may begin with the withholding of nutrition or hydration. It occurs when the caregiver (either professional or family member) does not provide adequate food, living conditions, medicine, personal safety, or protection from heat and/or cold, and when the caregiver ignores the patient’s special diet or does not provide proper medical attention. Neglecting an elder’s personal hygiene by failing to take the elder to the bathroom regularly, to clean soiled linens or clothing, or to wash and tend to the elder’s skin, also qualifies as neglect. A patient who is bed-ridden needs to be turned every two hours to avoid developing decubitis ulcers or pressure sores. Signs of neglect include:

• Extreme weight loss
• Dehydration
• Malnutrition
• Unsafe or unsanitary living conditions
• Bed sores (Check the elder’s body when you visit.)
• Being left dirty or unbathed
• Leaving the elder alone in public

Reporting Elder Abuse

Encourage the elder to speak up (if possible) and tell a trusted family member about any abuse that occurs. As a family caregiver, you must be vigilant about keeping the elder safe. There are 500,000 plus cases of abuse that are reported each year and this does not begin to scratch the surface of the prevalence of elder abuse in our society. Authorities suspect that millions of cases go unreported. All fifty states have laws protecting elders from abuse, and these offenses are punishable by law. Some violations are so egregious that those who commit them are subject to criminal prosecution.

You have a moral obligation to report elder abuse. Do not let fear of retaliation stop you. Contact your local police department and then Adult Protective Services (APS). Their role is to investigate suspected or known abuse, to intervene and to offer free advice. You must understand, however, that APS is a government-run agency that has an enormous workload. You might also consider securing outside legal advice. In addition, each state has at least one toll-free elder abuse hotline. You should find this number for your local area and keep it in the elder’s notebook and on the emergency phone list.

The Care Company recommends that you review the information available at The National Center on Elder Abuse. It is a valuable resource.  http://www.ncea.aoa.gov/ncearoot/Main_Site/index.aspx.