SIGNS AND SYMPTOMS OF ELDER ABUSEElder abuse includes physical abuse, sexual abuse, emotional abuse, neglect, abandonment, self-neglect, and financial abuse. It is not always easy to detect signs of abuse in an older person. Older people have skin that tears easily. They may have bruises from frequent falls. They may have pain and swelling from chronic conditions such as arthritis. They may be confused or have health problems that make it difficult for them to hear or speak. Some types of abuse, such as emotional abuse, are hard to detect.
Outlined below is a description of different types of abuse and signs and symptoms for each one. The signs and symptoms suggest possible abuse. Sometimes these signs and symptoms are present when abuse has not occurred. Watch for these signs of possible abuse as you care for clients each day.
Physical abuse takes place when force is used to cause pain or injury. Examples of physical abuse include hitting, slapping, biting, burning, and pushing. About 25% of elder abuse is physical abuse.
What are the signs and symptoms of elder physical abuse? The victim may have bruises, cuts, or burns. He/she may have broken bones. Bruises and burns that happen by accident usually don’t have regular shapes and patterns. Bruises and burns that have regular shapes and patterns may be a sign of abuse. Look for bruises in odd places such as the ears, neck, upper thighs, and stomach. If the abuser pulls the victim’s hair, you might see bald patches, redness, or swelling of the scalp.
The victim’s eyeglasses, dentures or teeth may be broken. The older person may receive too much or too little prescribed medicine. Caregivers may refuse to let visitors see the client alone.
Sexual abuse does not only mean the act of having forced sex. Sexual abuse of an older person means any kind of unwanted sexual contact that is forced upon the person without his or her consent. Although most victims of sexual abuse are women, older men can be sexually abused too.
What are the signs and symptoms of elder sexual abuse? You may notice bruises or scratches around the breasts or genital areas, genital infections or venereal disease, and vaginal or anal bleeding. The person’s clothing may be torn and stained with blood or semen.
Emotional abuse occurs when the older person is threatened with harm, humiliated, left alone for long periods of time, or kept away from family and friends. Other forms of emotional abuse include treating the person like an infant, not talking to the older person, and not letting them take part in regular social activities.
Emotional abuse accounts for 35% of reported cases of elder abuse.
How does an older person who is being emotionally abused behave? The older person may be upset, anxious, depressed, or very quiet. Some abused elders are afraid of strangers. Others are eager to get attention from visitors or healthcare workers.
Neglect of the older person
Neglect takes place when the caregiver doesn’t give the older person enough food, clothing, a place to live, medical care, or help with things like bathing and dressing. Neglect occurs in 49% of the cases of proven elder abuse.
Below are some of the most common signs and symptoms of elder neglect:
• The victim may be dirty and sloppy.
• Clothing may be soiled.
• The victim looks as if he/she is not getting enough to eat or drink.
• The victim may be forced to live in a place that is dirty and/or dangerous.
• The victim may have fleas, lice, or bedsores.
• The victim’s glasses, false teeth, hearing aid, walker, and other important items may be missing.
• The victim may be very tired and passive.
• The victims (or their friends and neighbors) may report that they are being left alone and neglected.
Abandonment occurs when the person taking care of the older person deserts him/her. Older people may be left in a hospital, nursing home, or other institution. Sometimes older adults are left in a public area such as a shopping mall or grocery store. They are left alone without knowing if they will ever go home again.
Self-neglect occurs when older adults behave in ways that are bad for their health or safety. They might not eat or drink enough to stay healthy. They may not wear proper clothing or bathe. They may take too much or not enough of their medications. The older person may be very thin, dirty, and unkempt. Some live in places that are not safe or clean. They may not have toilets or safe drinking water. They might not have important things like eyeglasses, hearing aids, false teeth, and walkers.
Financial abuse takes place when an older person’s money, property, or other valuables are misused or stolen by family or others. It occurs in about 30% of all cases of elder abuse. Examples include stealing and cashing checks or forging signatures to get money. Door-to-door con artists or illegal telemarketing are other examples of financial abuse. Older people may be forced to sign wills or forced to give away money, property, or valuables. Sometimes the financial abuser is the older person’s lawyer, accountant, or investment advisor.
The following is a list of signs and symptoms that may indicate that the older person is being financially abused:
• Large sums of money taken from bank accounts by family or other caregivers with no explanation
• Sudden changes in a will
• Missing valuables
• Bills suddenly not being paid when the older person should have enough money to pay them
• Family members who have not had much to do with the older person suddenly show up and want to control money and valuables