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Elder abuse: A growing epidemic in our nation

Each year hundreds of thousands of older persons are abused, neglected, and exploited. Many victims are people who are older, frail, and vulnerable and cannot help themselves and depend on others to meet their most basic needs. Abusers of older adults are both women and men, and may be family members, friends, or “trusted others.”

In general, elder abuse is a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult. Legislatures in all 50 states have passed some form of elder abuse prevention laws. Laws and definitions of terms vary considerably from one state to another, but broadly defined, abuse may be:

  • Physical Abuse - inflicting physical pain or injury on a senior, e.g. slapping, bruising, or restraining by physical or chemical means.
  • Sexual Abuse - non-consensual sexual contact of any kind.
  • Neglect - the failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.
  • Exploitation - the illegal taking, misuse, or concealment of funds, property, or assets of a senior for someone else's benefit.
  • Emotional Abuse - inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts, e.g. humiliating, intimidating, or threatening.
  • Abandonment - desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.
  • Self-neglect – characterized as the failure of a person to perform essential, self-care tasks and that such failure threatens his/her own health or safety.

    While one sign does not necessarily indicate abuse, some tell-tale signs that there could be a problem are:

    • Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.
    • Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
    • Bruises around the breasts or genital area can occur from sexual abuse.
    • Sudden changes in financial situations may be the result of exploitation.
    • Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.
    • Behavior such as belittling, threats, and other uses of power and control by spouses are indicators of verbal or emotional abuse.
    • Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.
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    Most importantly, be alert. The suffering is often in silence.
    If you notice changes in a senior’s personality or behavior, you should start to question what is going on.

    Remember, it is not your role to verify that abuse is occurring, only to alert others of your suspicions. Please visit the webpage What If I Suspect Abuse, Neglect, or Exploitation? to learn what you should do if you are concerned that someone you know is being abused. 

    What If I Suspect Abuse, Neglect, or Exploitation?

    If someone is in immediate danger, call 911 or the local police for immediate help.

    If the danger is not immediate, but you suspect that abuse has occurred or is occurring, please tell someone. To report elder abuse, contact the Adult Protective Services (APS) agency in the state where the elder resides. You can find the APS reporting number for each state by:

    If you have been the victim of abuse, exploitation, or neglect, you are not alone. Many people care and can help. Please tell your doctor, a friend, or a family member you trust, or call the Eldercare Locator help line immediately. You can reach the Eldercare Locator by telephone at            1-800-677-1116      . Specially trained operators will refer you to a local agency that can help. The Eldercare Locator is open Monday through Friday, 9 a.m. to 8 p.m. Eastern Time.

    When making the call, be ready to give the elder's name, address, contact information, and details about why you are concerned. You may be asked a series of questions to gain more insight into the nature of the situation. For example:

    • Are there any known medical problems (including confusion or memory loss)?
    • What kinds of family or social supports are there?
    • Have you seen or heard incidents of yelling, hitting, or other abusive behavior?

    You might also be asked for your name, address, telephone number, etc., but most states will take the report even if you do not identify yourself.

    The APS agency screens calls for potential seriousness, and it keeps the information it receives confidential. If the agency decides the situation possibly violates state elder abuse laws, it assigns a caseworker to conduct an investigation (in cases of an emergency, usually within 24 hours). If the victim needs crisis intervention, services are available. If elder abuse is not substantiated, most APS agencies will work as necessary with other community agencies to obtain any social and health services that the older person needs.

    APS agencies provide social services to insure the safety and well-being of elders and adults with disabilities who are in danger of being mistreated or neglected, are unable to take care of themselves or protect themselves from harm, and have no one to assist them. Interventions provided by APS include, but are not limited to:

    • Receiving reports of adult abuse, exploitation or neglect
    • Investigating these reports
    • Case planning, monitoring and evaluation
    • Assistance arranging for medical, social, economic, legal, housing, law enforcement or other protective, emergency, or supportive services.

    It’s important to remember that the older person has the right to refuse services offered by APS. The APS agency provides service only if the senior agrees or has been declared incapacitated by the court and a guardian has been appointed. The APS agency only takes such action as a last resort.

    Although Adult Protective Services is generally the “first responder” to reports of elder abuse, neglect, or exploitation, many other agencies and nonprofit organizations work actively to protect vulnerable elders.

    Adult Protective Services

    APS is the principal public agency responsible both for investigating reported cases of elder and vulnerable adult abuse and for providing victims with treatment and protective services. Usually, the Adult Protective Services Unit, Area Agency on Aging, or County Department of Social Services is designated as the agency to receive and investigate allegations of elder abuse and neglect. If the investigators find abuse or neglect, they arrange for services to help protect the victim.

    Law Enforcement

    Local police, sheriffs, and prosecuting attorneys may investigate and prosecute abuse, particularly in cases involving sexual abuse or assault. In states whose statutes make elder abuse a crime, there may be a requirement to report suspected abuse to a law enforcement agency.

    Long Term Care (LTC) Ombudsman

    State LTC ombudsman programs investigate and resolve nursing home complaints, and in some areas, complaints about board and care facilities and professional home care providers. If you are concerned about abuses, check the state Long Term Care Ombudsman  program in your area for help.

    Eldercare Locator

    Visit the Eldercare Locator website, or call             1-800-677-1116      , to find resources for older adults in any U.S. community. Just one phone call or Website visit provides an instant connection to resources that enable older persons to live independently in their communities. The service links those who need assistance with state and local area agencies on aging and community-based organizations that serve older adults and their caregivers. Operators can be particularly helpful in finding services that can help prevent abuse and neglect.

    AoA Prevention of Elder Abuse, Neglect, and Exploitation program

    What is Elder Abuse?

    National Center on Elder Abuse for more information on what elder abuse, neglect, and exploitation, please visit the Long Term Care Ombudsman  to report nursing home abuse

    Eldercare Locator

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