When Karina Singer, a 48-year-old Las Vegas woman, visited her dad in his assisted living facility, something seemed off. The air conditioner was on the lowest setting and a fan was on full blast, and he was shivering without a blanket. Another time she came, she realized he hadn’t had his teeth brushed in a while, and he was wearing dirty clothes. Over time, she suspected that her dad’s weight loss came from “caregivers” heavily sedating patients, and going through the motions of placing meals in front of them, but taking them away untouched.
Her father, Steven Singer, had been diagnosed in 2000 with multiple sclerosis, a “primary progressive” type that would steadily worsen, as it did until his death in 2020. But Karina doesn’t attribute his death to just the disease, but the elderly abuse he endured along the way.*
“Unfortunately, I have learned that this corruption is not isolated,” she says. “In many cases, family members take advantage of an elderly relative, confining them in a secured facility where they are heavily medicated and isolated, only to then strip them of every asset and abandon them until their passing.”
A 2021 study found that 1 in 5 older adults experienced elder abuse during the pandemic. This was an increase from previous data that found that 1 in 10 adults over the age of 60 experienced elder abuse. The World Health Organization now estimates that 1 in 6 adults over the age of 60 have experienced elder abuse.
Lawyers, senior advocates and health care professionals know the signs and symptoms of physical, emotional, financial and sexual abuse. Here’s what they look for.
[READ: How to Manage Sibling Conflict Over Care of Elderly Parents]
What Is Elder Abuse?
Researchers have different ideas of who is considered a “senior,” but the National Institute of Health considers those 65 and older to be “older adults,” “seniors” or in some studies, “elders.” This age group is at particular risk for various types of abuse as they navigate dementia, chronic health conditions, accessibility issues and other challenges.
Types of Elder Abuse
Elder abuse is sometimes broken down into five types, including:
— Financial abuse
— Physical abuse
— Psychological or emotional abuse
— Neglect
— Sexual abuse
One of the most recent studies conducted on elder abuse in nursing homes found that 64.2% of staff in elder care facilities admitted to elder abuse within the past year. The highest form of abuse was psychological abuse (33.4%), followed by physical (14.1%) and financial (13.8%).
“Factors contributing to the highest prevalence of senior abuse include isolation, debilitating medical conditions, relationships with intense interpersonal violence between the senior and caretakers or staff and mental disability or dementia,” says Dr. Mayra Mendez, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center in Santa Monica. “The highest rates of abuse are reported in populations, of all ages, diagnosed with disabilities.”
[SEE: Ways an Elder Law Attorney Can Help Families]
Financial abuse
When you put your care in someone else’s hands, you hope that they will do the right things with the money you’ve saved throughout your life to make sure your last decades are comfortable. But, this isn’t always the case. Financial abuse includes scams, stolen funds, poorly managed trusts and accounts, stealing social security checks and irresponsible spending, among others. What’s worse is that the shame around not knowing it happened can prevent some seniors from pursuing legal action when they’ve experienced financial exploitation.
A 2023 report from AARP found that victims of elder financial exploitation (EFE) lost $28.3 billion each year. Of that, 72% or $20.3 billion came from fraud committed by people the victims knew.
Jennifer VanderVeen, a certified elder law attorney at VanderVeen Elder and Special Needs Law, specializing in protecting older and disabled individuals in Indiana and Michigan, shares that “defensiveness” is one aspect to watch out for and if someone is “becoming secretive about finances” it can be a red flag that a relative, friend or other abuser could be misusing a senior’s funds.
Recognize signs when your parent or elderly relative is being victimized financially, Susan Hoy, CEO and founder of Nevada Guardian Services, LLC in Las Vegas recommends, including:
— Sudden change in how a senior handles money
— Frequently taking trips to the bank to facilitate wire transfers and other unusual transactions.
— Comments that they owe a friend money or a friend needs help that the solution is with money (their money) and a new friend, someone you may not know or your loved one is vague about how they met.
— Purchase of gift cards at high dollar amounts, and/or texting or emailing the card details to unknown persons
“As court appointed guardians, we experience firsthand the effects that exploitation can have on an elderly individual. Many times, the victim, our most vulnerable citizens are left destitute, ashamed and confused as to what is going on with their lives,” Hoy says. “Their confusion has been an opportunity for the exploiter. Instead of helping, the exploiter has been helping themselves.”
Psychological or emotional abuse
As if seniors aren’t enduring enough navigating health conditions and other hardships, one of the most prevalent types of abuse is emotional or psychological abuse.
This type of abuse includes ignoring them or overtly harming them emotionally, such as yelling, shaming and other humiliating behaviors.
Mendez shares that signs of emotional abuse include:
— Avoidant behaviors, especially directed at a specific person or certain caregiver
— Heightened displays of anger or aggression that is out of character
— Withdrawal, fear, or despondency
— Clinginess or stating they don’t want to be left alone with a certain caregiver
— Excessive crying, depressive symptoms, or a sense of despair
“If the senior/dependent adult lives in a residential facility, call the long-term care ombudsman for the home or area if concerns arise that are not addressed effectively by the caretaking staff. The ombudsman is there to support and advocate for the senior and has the power to intervene,” Mendez says. “Voice preferences and concerns about the senior/dependent adults’ needs. Speak up for the rights of senior/dependent adults.”
She also adds that directly educating the senior about their own rights can be important too.
Neglect
Neglect may include ignoring physical, emotional and social needs, or withholding food or medications.
For example, Karina says, her father’s nursing home staff was “leaving him in soiled conditions and neglecting his hygiene,” so she’d sometimes take him to get his nails done, or clean him up herself. This is an example of how sometimes neglect doubles as emotional abuse.
Neglect can also be recognized in the home of a caregiver who doesn’t have the skill or knowledge to properly care for the older person.
Physical abuse
While you might picture a “caregiver” or nursing home worker physically beating up a senior citizen, sometimes physical abuse is more subtle and not as noticeable.
The National Council on Aging (NCOA) shares that it might even look like passive physical neglect, such as not tending to bedsores from someone spending long time periods in the same position, or other types of absent medical care. In Karina’s case, she says her father was given heavy sedative medication from a doctor who gave all the seniors similar medication.
Mendez says more broadly, the signs of physical abuse include:
— Bruising
— Unusual bleeding
— Excessive or atypical weight loss
— Burns, broken skin, broken or fractured limbs or joints
— Isolation in unusual places such as a closet or a room without an escape option
— Confinement to a bed or chair, such as being tied or restrained
— Living in unsanitary or infested conditions
Sometimes an incompetent healthcare staff can lead to inadvertent physical abuse as well.
Karina says, “I didn’t know how many meals were missed or how long it had been happening, but I could see my dad was getting really skinny. I found out he had lost about 65 pounds in a single year. Every time I asked the caregivers about his meals, they acted clueless and said they gave him an Ensure every day.”
Sexual abuse
NCOA also shares that sexual abuse is something caregivers should learn about, including “touching, fondling, intercourse or any other sexual activity with an older adult, when the older adult is unable to understand, unwilling to consent, threatened or physically forced.”
Though the World Health Organization points to it being the least frequent type of abuse, caregivers can watch for specific signs, such as pelvic injuries, bleeding, bruising, sexually transmitted diseases and other emotional symptoms.
[SEE: Why Power of Attorney Is Important for Senior Health Care]
Where Does Elder Abuse Happen?
You might picture a care facility, where an elderly person is alone in their room all day, without their needs met or suffering at the hand of a caregiver. While this absolutely does happen, there are other environments where elder abuse is a concern.
The NIH shares that elder abuse can happen anywhere, including in the older person’s home, a family member or friend’s home, a nursing home or assisted living facility. It can also happen digitally, through a person’s financial accounts, email inboxes and other digital apps or sites.
Elder abuse might be a single incident, a gradual mistreatment or even decades of problems — all important and worth learning how to spot, prevent or remedy.
What Loved Ones Can Do to Detect and Prevent Abuse
In the stress of watching an elderly family member or friend age, battle health conditions and navigate financial or other issues, it can be easy to overlook a key sign of abuse of any type. Pay attention to your gut instinct, but also gather more information to see if your feelings might be correct.
Ask directly
Though there’s a culture of shame and secrecy around reporting abuse, you can directly ask your loved one how well they are being taken care of by their caregivers.
You can be specific and ask if they are getting all of their physical needs met, if they are ever yelled at or if they ever feel scared or threatened. Sometimes, a trusted person asking is enough to get the information across to help intervene.
“Communicate openly with seniors/dependent adults and encourage sharing about their experiences and interactions with others,” Mendez says.
Hoy adds, “Talk about money. Share news stories about how predators work and encourage open conversations about if someone is asking them for money.”
Report abuse
“Report abuse concerns immediately to Adult Protective Services,” Mendez says. You can also report to the leader of the care facility, if relevant, as Karina did, and gather evidence. But don’t stop there. Note that specific counties and states might have different reporting processes.
Carefully consider guardianship decisions
Karina wanted to move her father out of the facility where she says he was abused.
“I tried,” she says, but she did not have guardianship. She adds that the issue of physical abuse leads back to a “larger issue” on guardianship. “Guardianship is how elder abuse starts. These problems stem from the guardianship court. Once they have the senior locked in to a secured facility, you can’t get them out without a court order (if you don’t have guardianship).”
Show up unannounced
VanderVeen says to vary the time of day you show up to visit, or drop in unannounced. This can help uncover the real situation going on, rather than allowing an abuser time to make everything seem like things are going well. She adds that you can enlist help from family and friends to visit more often, or involve a geriatric care manager if you don’t live locally.
Look into alternative caregiving setups
If you aren’t confident in the quality of care your loved one is receiving at a facility or with a specific caregiver, look into other options if possible.
U.S. News has recognized Best Senior Living Communities. Our ratings are based on our analysis of more than 400,000 resident and family member surveys.
Mendez shares additional resources to get information about placing their loved one in the right type of care facility or with a quality provider:
— National Alliance for Caregiving
— Alzheimer’s Association
— Administration on Aging
— Centers for Medicare and Medicaid Services (CMS)
— National Council on Aging
— State Social Services Department for Senior/Dependent Adults
VanderVeen reminds people of a few truths, sometimes misunderstood: “Everyone who is dependent on someone for help isn’t being abused. (And) people who are independent and competent can still be victims of abuse.”
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Elder Abuse: Signs, Types and What to Do originally appeared on usnews.com
