Recognizing the Risks and Red Flags of Elder Abuse

Those who are assisting older loved ones likely try to do everything they can to keep that loved one safe, such as making sure they have a list of emergency contacts or assessing whether they can still safely operate a vehicle. However, sometimes the greatest threats to a loved one can be a person, whether family members, fellow caregivers, medical staff, complete strangers or even themselves. According to the National Council on Aging, approximately one in ten Americans aged 60 or older have experienced some form of elder abuse.

What is elder abuse?

The Centers of Disease Control and Prevention defines elder abuse as “an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult” aged 60 or older. Elder abuse can come in varying forms, such as:

• Physical, emotional, psychological or sexual abuse
• Financial exploitation
• Neglect, which involves a caregiver failing to attend to an older adult’s needs, whether medical, hygienic, nutritional, dietary, financial or emotional
• Self-neglect, which involves an older adult failing to attend to their own physical, psychological or social needs

How do I know if my loved one is at high risk?

Though any older adult can experience elder abuse, there are certain risk factors that can make some older adults more susceptible than others. In 2001, a team including Benjamin Rose Institute on Aging’s Dr. Farida Kassim Ejaz and Dr. David Bass developed a Risk of Abuse tool, which identified factors for abuse commonly associated with older adults (Ejaz, F. K., Rose, M., & Anetzberger, G. (2017). Development and implementation of online training modules on abuse, neglect, and exploitation. Journal of Elder Abuse & Neglect, 29(2–3), 73–101). According to this research, a loved one may be at higher risk for abuse if:

• They have a history of experiencing abuse or abusing others
• They are experiencing relationship problems, such as coercive, manipulative or possessive relationships, or relationships with strict gender roles or unrealistic expectations
• They lack support or have low socioeconomic status
• They live in an environment that presents safety risks such as a dangerous neighborhood, a home with hazardous conditions or a home with access to weapons
• They are experiencing physical, emotional or mental health-related problems. These can include:
  • Trauma
  • Behavioral problems
  • Cognitive or physical impairments or disabilities
  • Alcohol, drug or medication dependency

What are some red flags that my loved one is being abused?

In some cases, a loved one may feel comfortable discussing potential abuses with us, but in others they may feel ashamed or afraid and cannot comfortably talk about their experiences. In these cases, it can be helpful to know how to recognize some of the red flags of abuse for ourselves. 

Signs of neglect or self-neglect can include:

• Lack of medical aids and necessities
• Lack of basic hygiene, food or clean clothing
• Lack of care or supervision for a loved one who has dementia or is bed ridden
• A home with inadequate heating, cooling or electricity
• A cluttered or dirty home with potential fire or safety hazards 

Signs of emotional, physical or sexual abuse can include:

• Sudden changes in behavior
• Withdrawal or social isolation
• Unexplained fractures, bruises, sores, welts, cuts or burns
• Closeness to someone who is demeaning, controlling or aggressive

Signs of financial abuse can include:

• Unexplained financial or property transfers
• Lack of funds available for necessities a loved one should be able to afford
• Unexplained purchases of expensive items or gifts

How can I report elder abuse?

If we know or suspect that a loved one is being abused, we should make a report to Adult Protective Services (APS). To find contact information for your state, visit the National Adult Protective Services Association website.

If we have concerns that a loved one may be at high risk, the Cuyahoga County Division of Senior and Adult Services recommends checking in on a loved one regularly and making sure they have the support they need and that they are in a comfortable, safe environment. It may also help to communicate any concerns we have to a loved one’s doctor, so they can also be on the lookout for potential signs of abuse when treating them.

How can I help prevent elder abuse?

A great way to prevent elder abuse on a global scale is by spreading awareness and advocating for older adults. The Ageless Alliance is a national non-profit organization which unites advocates of all ages to take a stand against elder abuse through awareness, advocacy and action. The organization is free to join and offers resources to get involved in the fight to eliminate elder abuse.