Each year, many older adults come to an Emergency Department (ED) with injuries purportedly related to a fall or other accidents. However, we know that many of these injuries are the result of elder abuse and neglect. This ED visit presents a key opportunity for elder abuse to be detected, to have evidence collected, to report to the authorities, and to initiate appropriate interventions, yet emergency physicians receive little training in elder abuse and have few tools to assist them in detecting abuse. More →
Types of Abuse, Neglect and Financial Exploitation
The following provides information on the ways older adults are abused, neglected and exploited, although this is not meant to be an exhaustive list. Often these acts are utilized by abusers to coerce and control older adults to further abusers’ personal goals and/or fulfill abusers’ personal needs and desires.
Every situation is unique and often abuse types co-occur.
Physical Abuse is any behavior that results (or is likely to result) in injuries to the body, such as bruises, cuts, or broken bones. Examples include hitting, pushing, choking, burning, punching, throwing objects at a person and/or forcibly restraining. These behaviors also instill great fear in the person being hurt.
Example: Mrs. Rose’s 37-year-old son, Derek, who has a drug problem, pulled a fist full of his mother’s hair out of her head during an argument when she refused to give him money.
Sexual Abuse is any behavior that hurts you sexually or includes unwanted sexual content without your consent. Examples include inappropriate touching, fondling or kissing, rape, taking photographs in sexually explicit ways, and/or exposure to explicit sexual content without your approval.
Example: Mrs. Noonan’s 32-year-old stepson forced her to watch pornography with him and exposed himself.
Psychological and Emotional Abuse subjects a person to a behavior that results in fear, mental anguish or emotional pain. This can include intimidation, harming pets, destroying property, name-calling, “the silent treatment,” infantilizing, isolating, threatening, undermining spiritual or religious practices, devaluing cultural identity and/or public humiliation (e.g., taking the older person’s dentures and then forcing the person go out in public without teeth).
Example: Mr. Koff’s 44 year-old-mentally ill daughter, Karen, threatened to rip the phone out of the wall and nail his bedroom door shut while he sleeps if her father didn’t let her boyfriend spend the night.
Neglect is a failure to fulfill a caretaking obligation and can be active (intentional) or passive (unintentional), resulting in a wide-range of problems, including bedsores, dehydration, poor hygiene, poor nutritional status – and can lead to death.
- Intentional neglect is usually motivated by greed or other forms of self-interest.
- Unintentional neglect is usually based on factors such as ignorance or denial that an older person needs as much care as he or she does, or due to the provider’s lack of time, emotional resources or physical or cognitive ability to provide the needed care, often resulting in reckless endangerment or worse.
- Intentional and unintentional neglect can co-occur.
Neglect can include not providing items needed for daily living – e.g., not purchasing glasses or a needed wheelchair or refusing access to transportation for a mobility impaired person – not providing heat, adequate nutrition, hydration or medication, or not following medical recommendations, e.g. a person might be prescribed physical therapy after an injury but is not given it.
Example: Mr. Simon is cared for by his wife, who often yells at him. She blames him for ruining her life and is frequently too busy or “forgets” to give him dinner.
Financial Exploitation involves the unauthorized or improper use of funds, property, or assets. This can include coercing the change of a will, bank account, or property transfer, using cash or credit cards without permission or knowledge, and/or forging signatures on checks.
Example: Mrs. Goffard’s 21-year-old granddaughter, Ivy, sold her grandmother’s jewelry without permission and used the money to pay back a debt to her friend.