How To Recognize Elder Abuse

Midnight Sun Home Care is dedicated to providing the safest and most comfortable care to our elder clients. This involves addressing the very real threat of elder abuse.  This month’s blog posts will focus on helping elders and their loved ones to recognize, prevent and end elder abuse. 

We’ve already talked about what elder abuse is and its many faces. And while having awareness of the issue is the key to addressing it, in practice, sometimes it’s hard to see it clearly and even harder to know what to do about it. So, let’s take some time to talk about the signs of elder abuse and the factors that can keep us from recognizing them.

Be Careful of Assumptions

First, it’s important to know that our elders can be abused in their own homes, in their relative's homes and yes, in care facilities. Don’t assume that because they are in a place that is supposed to put their needs first they are not being abused. Of course, there are many elders who are getting the loving care they deserve—but the point is, if you suspect abuse, don’t dismiss it simply because their locality implies a certain standard of care.

Secondly, if an elderly person in your life is acting in an unusual way—perhaps they are a little skittish or less inclined to interact with you—don’t dismiss it.  We all tend to focus on the idea that forgetfulness or odd behavior are just part of being older, but in reality, those behaviors may indicate that the person is being victimized in some way. It can be a challenging thing to differentiate between signs of mental deterioration and abuse, but dismissing the possibility of abuse based on this assumption or on a caregiver’s opinion can have a tragic cost.

Thirdly, family does not equate safety. Many of us can’t fathom causing our family members any harm, but in reality, nearly 90% of the people who abuse our elders are actually family members: adult children, grandchildren, spouses, partners, siblings . . . This is a sad fact that can make it difficult to recognize abuse—because we want to believe that our families will protect, not harm us. 

General Indications of Abuse

• Changes in personality or behavior of the elder.
• Frequent arguments or tension between the elder and their caregiver.

These indications are enough for you to suspect something and a clue to you to start looking for clusters of physical and behavioral signs that would help confirm your suspicions.

Specific Signs of Abuse

As we talked about before, elder abuse has many faces.  We’ve broken down the signs, based on types of abuse. Keep in mind that this is a summary of signs and that there are many more. The State of Alaska provides a comprehensive list—but this will help to get you in the mindset for recognizing abuse.

Physical 

• Unexplained injuries like bruises, welts, signs of restraint or recent scars. Symmetry (appearing on both sides of the body) is a strong indication of deliberate wounds.
• More severe injuries like broken bones, sprains and dislocations.
• Frequent injuries.
• Obvious failure to take medication or reports of overdose.
• Broken eyeglasses or other aid devices.
• Caregiver’s refusal to allow the elder to see you alone.

Emotional

• Behavior from the caregiver that appears threatening, bullying, belittling or controlling.
• Behavior (especially sudden changes in it) from the elder that could be viewed as dementia—including rocking, sucking, erratic mood swings or talking to oneself.
• Demonstrated fear of the caregiver from the elder.
• Unexplained fear.

Sexual

• Unexplained injuries, like those described above, but also specific to breast and genital areas.
• Unexplained venereal diseases or infections.
• Intense fear reaction to individuals or groups of people.
• Depressive behavior.
• Poor self-esteem.
• Unusual comments that could be interpreted as disclosure.

Neglect

• Untreated physical conditions, like bedsores.
• Foul smelling or dirty clothing, or lack of personal grooming.
• Inappropriate clothing for weather and climate.
• Unkempt household or living conditions.
• Unexplained weight loss or dehydration.
• Lack of needed aid devices like glasses, hearing aids, walkers, etc.

Financial

• Items or cash missing from elder’s household.
• Suspicious charges to accounts or changes in will, power of attorney, titles, etc.
• Unpaid bills or lack of care, even though there is money to pay for them.
• Duplicate billings for medical services or devices.
• Unnecessary goods, services or descriptions.
• Sudden appearance of previously uninvolved relatives or friends.

Hopefully, this will help you to better recognize the signs of elder abuse. We’ll talk next about what to do, in the unfortunate case that you come to suspect it.