The elderly are regarded for their innumerable life experiences and perceived wisdom. Younger generations often turn to their elders for advice, tapping into their vast knowledge base for guidance through tough situations. The elderly also turn to younger generations for guidance. As they age and their health deteriorates, the elderly may seek the help of a spouse or family member to provide care.
Taking care of an elderly family member or spouse could mean taking them into your home and providing round the clock care, hiring a nurse to provide at-home care, or placing them in a nursing home. Whichever route you take, you hope your loved one is well-cared for, happy and comfortable. Too often, however, the elderly are taken advantage of by the very people they have grown to love and trust.
What is elder abuse?
The National Center on Elder Abuse (NCEA) defines elder abuse as intentional actions that cause harm or create a serious risk of harm to a vulnerable elder by a caregiver or other person who stands in a trust relationship.
Elderly Americans — those 65 years of age or older — make up just fewer than 15 percent of the population, according to the 2014 census data. Thanks to a continually aging baby boomer population, that number is expected to rise to 20 percent by 2050. 
With such a large elderly population in the United States, how prevalent is elder abuse?
One study suggests that about 7.6 percent to 10 percent of elderly adults said they have experienced some form of abuse. Female elderly adults seem to be abused at a higher rate than male elderly adults, and elders with a disability, including those with dementia, also have an increased risk.
Sadly, in the vast majority of cases (about 90 percent), elder abuse is committed by a family member or spouse. But other caregivers are also perpetrators of abuse, including those who work in nursing homes.
Abuse in the nursing home
In 2014, roughly 1.4 million Americans were living in a nursing home, another 835,200 lived in residential care communities and 282,200 were enrolled in adult day services.
A survey group of 2,000 nursing home residents interviewed in 2000 indicated a high level of abuse in nursing homes. Of the 2,000 interviewed, 44 percent said they had been abused in their nursing home and 95 percent said they had been neglected or seen another resident being neglected.
The egregious incidence of elder abuse in nursing homes is shocking. What’s also shocking is a 2010 survey of nursing home staff, over 50 percent of whom admitted to mistreating older patients. That mistreatment included physical violence, mental abuse and neglect. Over two-thirds of the incidents were neglect, according to the survey.
There are more than 15,000 nursing homes in the United States. If the nursing home receives benefits from the government, it is subjected to an annual report card highlighting deficiencies within the facility. These report cards are filled out by regulators who tour the facilities.
A May 2008 study by the U.S. General Accountability Office found that state surveys underestimate problems within facilities. According to the study, 70 percent of surveyors missed at least one deficiency, and 15 percent missed actual harm that could result in immediate jeopardy for residents.
This means families need to be extremely vigilant if their loved one is living in a nursing home. Knowing what types of abuse their loved one could be subjected to and the signs and symptoms of that abuse is paramount to ensuring their loved one is properly cared for.
Types of abuse
There are different types of abuse that the elderly can be subjected to by caregivers or others inside a nursing home. These include:
- Physical
- Sexual
- Psychological
- Financial
- Neglect
- Resident to resident
Physical abuse
The NCEA defines physical abuse as the use of physical force that may result in bodily injury, physical pain or impairment.
Physical abuse may include striking with or without an object, hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching or burning. Physical abuse can also include the inappropriate use of drugs and physical restraints, force-feeding and physical punishment of any kind.
In 2010, physical abuse accounted for about 29 percent of reported elder abuse inside nursing homes.
Signs or symptoms of physical abuse
Signs or symptoms of physical abuse can include the following:
- Bruises, black eyes, welts, lacerations, rope marks
- Bone fractures, broken bones, skull fractures
- Open wounds, cuts, punctures, untreated injuries in various stages of healing
- Sprains, dislocations, internal injuries or bleeding
- Broken eyeglasses, physical signs of being subjected to punishment, signs of being restrained
- Laboratory findings of medication overdoses or underutilization of prescribed drugs
- Elder’s report of being hit, slapped, kicked, mistreated
- Elder’s sudden change in behavior
- Caregiver’s refusal to allow visitors to see the elder alone
Sexual abuse
Sexual abuse is defined as non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person who is incapable of giving consent is also considered sexual abuse, according to the NCEA.
Sexual abuse can include unwanted touching, sexually explicit photographing and all types of sexual assault or battery, like rape, sodomy and coerced nudity.
Sexual abuse accounted for about seven percent of reported abuse in nursing homes in 2010.
Signs or symptoms of sexual abuse
Signs or symptoms of sexual abuse may include:
- Bruises around breasts or genital area
- Unexplained venereal disease or genital infections
- Unexplained vaginal or anal bleeding
- Torn, stained or bloody underclothing
- An elder’s report of being sexually assaulted or raped
Emotional or psychological abuse
Emotional or psychological abuse is defined as the infliction of anguish, pain or distress through verbal or nonverbal acts, says the NCEA.
Emotional or psychological abuse can include verbal assaults, insults, threats, intimidation, humiliation and harassment. Treating an elder like an infant; isolating an elderly person from his or her family, friends or regular activities; giving an older person the “silent treatment;” and enforced social isolation are also examples of emotional or psychological abuse.
Emotional and psychological abuse made up about 21 percent of all reported elder abuse in nursing homes in 2010.
Signs or symptoms of emotional or psychological abuse
Signs or symptoms of emotional or psychological abuse can include:
- Being emotionally upset or agitated
- Being extremely withdrawn and non-communicative or non-responsive
- Unusual behavior, usually attributed to dementia (sucking, biting, rocking)
- An elder’s report of being verbally or emotionally mistreated
Neglect
The NCEA defines neglect as the refusal or failure to fulfill any part of a person’s obligation or duties to an elder.
Neglect usually means refusing or failing to provide an elder with necessities like food, water, clothing, shelter, personal hygiene, medicine, comfort and personal safety. It can also mean failing to fulfill financial responsibilities, like paying for necessary homecare services.
Neglect accounted for about 14 percent of all elder abuse in nursing homes in 2010.
Signs or symptoms of neglect
Signs or symptoms of neglect include:
- Dehydration, malnutrition, untreated bed sores, poor personal hygiene
- Unattended or untreated health problems
- Hazardous or unsafe living conditions or arrangements (improper wiring, no heat, no running water)
- Unsanitary or unclean living conditions (dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing)
- An elder’s report of being mistreated
Financial abuse/exploitation
Financial abuse or exploitation is defined as the illegal or improper use of an elder’s funds, property or assets.
Examples of financial abuse include cashing an elderly person’s checks without permission; forging an older person’s signature; misusing or stealing an older person’s money or possessions; coercing or deceiving an older person into signing a document, like a will or other contract; and the improper use of conservatorship, guardianship or power of attorney.
In 2010, financial abuse made up seven percent of all elder abuse in nursing homes.
Signs of financial abuse/exploitation
Signs of financial abuse or exploitation may include:
- Sudden changes in bank account or banking practice, including unexplained withdrawal of large sums of money by a person accompanying an elder
- The inclusion of additional names on an elder’s bank signature card
- Unauthorized withdrawal of the elder’s fund using the elder’s ATM card
- Abrupt changes in a will or other financial documents
- Unexplained disappearances of funds or valuable possessions
- Substandard care being provided or bills unpaid despite the availability of adequate financial resources
- Discovery of an elder’s signature being forged for financial transactions or for the titles of his or her possessions
- Unexplained transfer of assets to someone outside the family
- An elder’s report of financial exploitation
Resident-to-resident abuse
Resident-to-resident abuse can include all of the aforementioned types of abuses, but the abuse is inflicted on a resident of the nursing home by another resident, as opposed to by a caregiver.
Resident-to-resident abuse accounted for about 22 percent of all reported elder abuse in nursing homes in 2010.
The emotional, physical and fiscal cost of elder abuse
Elders who are abused have a 300 percent higher risk of death compared to those who are not. They also have higher levels of psychological distress, lower perceived self-efficacy, and additional healthcare problems. Those healthcare problems include increased bone and joint problems, digestive problems, depression and anxiety, chronic pain, high blood pressure and heart problems.
Elder abuse is not only costly emotionally and physically for those who are abused, it also costs Americans roughly $5.3 billion annually in added health expenditures.
Elderly victims of financial exploitation were also estimated to lose about $2.9 billion in 2009.
What to do if you suspect elder abuse
If you suspect your loved one is being abused by a caregiver at his or her nursing home there are tools and resources you can use to stop it.
Notify Adult Protective Services
If your loved one is in immediate, life-threatening danger, call 911.
If you suspect your loved one is being abused, you can call your state’s Adult Protective Services program. To find your state’s program, visit: www.ncea.aoa.gov/Stop_Abuse/Get_Help/State/index.aspx
You can also call the Eldercare Locator at 1-800-677-1116 to speak with a trained operator who can refer you to a local agency that can help.
When you call, be prepared to provide your loved one’s name, address and contact information, as well as the details of why you are concerned. You do not need to prove abuse is occurring.
Hire a lawyer
When your loved one is abused, you want to seek justice and hold those responsible accountable. Nursing home abuse lawyers can help you do just that. The attorneys at Hood National Law Group are experienced in cases of nursing home abuse and neglect. If you suspect your loved one is being abused, do not hesitate to call us at 1-800-214-1010 for a free initial consultation.
Source: National Center on Elder Abuse http://www.ncea.aoa.gov/library/data/
