Social workers share key signs of elder abuse and neglect, along with tips to prevent it

• Elder abuse can be physical, sexual, emotional, or financial, and abusers are often family members.
• Signs of abuse may include bruises, weight loss, seeming withdrawn or fearful, and unpaid bills.

Every person deserves to be treated with respect and care, no matter their age.

But in the US, about one in 10 older adults living at home have experienced elder abuse. This intentional harm, mistreatment, or neglect often happens at the hands of a caregiver or another adult who has regular contact with the person.

Elder abuse can include withholding someone's medications, using their credit cards, saying hurtful things to them, or flat-out ignoring them. No matter the type, elder abuse can have serious consequences for physical and mental health and well-being.

People more likely to experience elder abuse include anyone who has:

• A disability
• Low income
• Poor physical or mental health
• A lack of social support, according to Steve Carleton, a licensed clinical social worker and the Executive Clinical Director at Gallus Detox

What's more, people with dementia or other cognitive impairments are less likely to recognize or report abuse.

Whether you're worried about a loved one or concerned about your own risk, learning to recognize the different kinds of elder abuse can help you get support.

Types of elder abuse

Different types of elder abuse include:

• Physical abuse: The intentional use of physical force to harm or control someone, such as hitting, slapping, kicking, shaking, pushing, or physically restraining them.
• Emotional abuse: Any behaviors that cause fear, distress, or other emotional pain, such as yelling, making threats, making disrespectful or hurtful comments, or preventing someone from seeing loved ones.
• Financial abuse: Taking advantage of someone's money and resources, such as taking their social security benefits, using their credit cards without permission, forging their checks, or changing the names on their will or life insurance policy.
• Sexual abuse: Forced participation in sexual acts, such as unwanted touching or pornography viewing.
• Neglect: Intentionally or unintentionally failing to meet an elder's basic needs — including shelter, food, water, medications, clothing, and hygiene.

Elder abuse can happen at the hands of friends, acquaintances, neighbors, paid caregivers, medical professionals, or even complete strangers — for example, in the case of financial scams targeting older adults, according to Alicea Ardito, a licensed clinical social worker in private practice.

Note: In about 60% of elder abuse cases, the abuser is a family member — typically, an adult child or spouse.

Signs of elder abuse

According to Jeanette Lorandini, a licensed clinical social worker and director of Suffolk DBT, an older person experiencing abuse may have or experience:

• Unexplained bruises, cuts, burns, or other marks
• Changes in mood or behavior, such as increased depression or agitation
• An unclean or unkempt appearance
• Changes in sleep or appetite
• Unexplained weight loss
• Preventable injuries like bed sores

An older adult living at home may:

• Have unpaid bills, even when they have financial resources
• Have unusual credit card or banking activity
• Be living in unsafe or unclean conditions
• Lack necessary medical aids like a walker, dentures, hearing aid, or glasses

An older adult experiencing abuse nursing home or assisted living facility may:

• Show unusual fear or anxiety around certain people, such as particular staff members or residents
• Suddenly avoid previously enjoyed activities
• Withdraw from friends and loved ones
• Show changes in behavior and personality, such as apologizing excessively

The effects of elder abuse

Elder abuse can have serious and lasting consequences.

According to a 2020 study in Japan, older adults who experienced abuse are 2.28 times more likely to have symptoms of depression three years later.

Another 2020 study linked elder abuse to a lower quality of life.

According to Carleton and Lorandini, other negative effects of elder abuse may include:

• Physical injuries and pain
• Malnutrition or other health conditions
• Emotional distress
• Anxiety
• Post-traumatic stress disorder
• Low self-esteem
• Financial hardship
• Social isolation
• Premature death

Understandably, those who experience elder abuse may also develop trust issues and general fear or wariness of others.

How to handle it

If an older adult in your life is in immediate, life-threatening danger, Lorandini advises calling 911 or the local police.

Otherwise, consider finding a time to talk one-on-one with them and express your concerns. Let them know what changes or issues you've observed, and consider asking if they feel all of their current needs are being met.

After this conversation, if you still suspect abuse, you can report it by:

• Calling the local Adult Protective Services agency in the state where the older adult lives
• Visiting the Eldercare Locator website or calling the Eldercare Locator at 1-800-677-1116
• Contacting the local Long-Term Care Ombudsman, if the person lives at a long-term care facility, like a nursing home or assisted living community

On the other hand, if you're the one experiencing abuse, know you're not alone and help is available. Candace Kotkin-De Carvalho, a licensed social worker and Clinical Director at Absolute Awakenings, suggests sharing your experiences with a trusted family member, friend, or doctor.

Your doctor is legally obligated to report the abuse and take steps to help ensure your safety.

However, if you don't feel comfortable telling anyone about the abuse, you can also:

• Report it by calling Adult Protective Services
• Call the National Domestic Violence Hotline (1-800-799-SAFE) or the Institute on Aging's Friendship Line (1-800-971-0016) for free, compassionate guidance and support

When an elder abuse case involves legal issues, Carleton recommends using The National Academy of Elder Law Attorneys directory to find legal assistance in your area.

Note: Financial scams targeting older adults are becoming increasingly common — and costly. In 2021 alone, more than 92,371 older adults lost a total of $1.7 billion due to these scams. If you or someone you know experienced elder fraud, call the free National Elder Fraud Hotline at 833-FRAUD-11.

Preventing elder abuse

Elder neglect isn't always intentional. Sometimes, overworked caregivers — including family members — may end up inadvertently neglecting older adults simply because they don't have enough time or resources to help them.

Caregiver stress or burnout, along with a lack of social support, can contribute to elder abuse, Lorandini says.

If you're a caregiver, Carvalho strongly advises reaching out for assistance when you need it rather than attempting to take on more responsibility than you can handle.

It's also important to practice self-care. You can't take care of someone else unless you're meeting your own basic physical and emotional needs first.

But you still have options to consider if you can't provide adequate care for an older adult in your life.

If they can safely live independently, Larandino suggests:

• Reaching out to other family members for help
• Hiring a home health aide, personal care assistant, or another professional caregiver. If they're eligible for Medicaid or Supplemental Security Income, they may qualify for additional in-home assistance, Carleton says.
• Contacting your local elder services office to find out if your loved one qualifies for programs that provide assistance with meal preparation, transportation, and other daily living tasks — like Meals on Wheels.
• Contacting your local Area Agency on Aging to learn more about available resources and services.

If an older adult in your life needs more intensive care, you may want to explore the possibility of moving them to an assisted living or skilled nursing facility.

If you need financial assistance to help with caregiving costs, Carleton suggests contacting your state's Department of Social Services to explore your options.

Finally, these tips can help you protect your older loved ones from abuse:

• Know the signs: The more alert you are to potential red flags, the more likely you'll spot abuse and neglect.
• Check in often: This means staying connected to your loved one and making sure they have easy, convenient methods for getting in touch with you if something is wrong. If you can't check in on a regular basis, designate other family members to share the responsibility and stay in frequent contact with each other about your observations.
• Ask questions: Staying curious about the person's well-being — especially if you sense something is off — can ensure you don't miss any signs of mistreatment or neglect, according to Lorandini.

Insider's takeaway

Elder abuse can take many forms — from physical and emotional to financial and sexual. Even neglect, whether intentional or not, falls under the umbrella of elder abuse.

Regardless of the type, elder abuse can have lasting negative effects on physical and mental health and well-being. That's why it's crucial to pay attention to the signs and take action as soon as you suspect it's happening.

Caring for an older adult may feel overwhelming, but remember: you're not alone in trying to care for your loved one. You have many options for resources that can help you meet their needs without neglecting your own.