April 2003
The Tell-Tale Signs of Elder Abuse
By Shirley Cohen
Each year, hundreds of thousands of our country's seniors are abused. Because a large portion of elder abuse incidents go unreported, the exact number of cases is difficult to quantify, but most experts agree that approximately 4% of seniors age 65 or over - more than half a million people altogether - suffer some form of abuse. Sometimes it's at the hands of a staff member in a nursing or retirement home; other times it's at the hands of a con artist taking advantage of an elder's trust. But more often than not, it happens at the hands of a person who the senior loves and trusts more than anyone else: his or her spouse, their child, or some other family member who is caring for them.
Elder abuse takes on many forms, from physical and sexual abuse to emotional and financial exploitation. The key to recognizing abusive situations is learning to identify the symptoms of each different kind of abuse. Let's take a look at the symptoms for the most common forms of elder abuse.
Physical abuse
One of the most frequent ways in which elders are mistreated is by physical abuse, defined as the use of force resulting in bodily injury, pain or impairment. Physical abuse can happen when close relatives or caregivers don't control their stress, when domestic violence carries over into a couple's old age, when nursing homes don't run thorough enough background checks on their entire staff, or under many other circumstances. It can be detected by looking for signs of bodily injuries such as bruises, black eyes, welts, lacerations, broken or fractured bones, wounds, untreated injuries, sprains or dislocations. Sometimes these symptoms are covered by clothing or difficult to detect, so it's important to also look for signs such as a sudden change in the senior's behavior or the caregiver's refusal to allow visitors to see the senior alone. Either of these cases would warrant looking into the situation further.
Emotional Abuse
Emotional abuse involves the infliction of anguish, pain or distress through verbal or nonverbal acts such as insults, threats, humiliation, harassment or other abusive behavior. Seniors are subject to are typically perceived as not being able to fight back. Oftentimes seniors are treated like infants, or they are isolated from their family and friends, or they are given the "silent treatment" by their primary caregiver. Watch out for these or other examples of elder abuse by keeping an eye on the senior and noticing if they seem frequently upset or agitated, if they are extremely withdrawn and unusual behavior usually attributed to dementia (such as sucking, biting or rocking). Get help if you recognize any of these symptoms.
Neglect
Neglect is the refusal or failure to fulfill a person's obligation to an elder. This obligation may be as a caregiver, as a fiduciary, as a son or daughter or some other role, but in most cases neglect refers to cases in which a senior does not receive life necessities such as food, water, clothing, shelter, hygiene, medicine or safety. It's important to remember that neglect can also be self-inflicted, as what happens when seniors fail to adequately care for themselves. The symptoms of neglect among older persons include dehydration, malnutrition, poor personal hygiene, untreated health problems, hazardous or unsafe living conditions (such as improper wiring, no heat, or no running water) or unsanitary living conditions (such as dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing).
Financial Abuse
Financial abuse occurs when an elder's funds, property or assets are used illegally or improperly. Examples of financial abuse include cashing a senior's checks without their permission, forging their signature, and deceiving them into signing documents such as a contract or will. To detect financial abuse, look for signs such as a sudden changes in bank account or banking practices, the inclusion of additional names on an elder's bank signature card, unauthorized withdrawal of the elder's funds using the elder's ATM or credit card, abrupt changes in a will or other financial documents, unexplained sudden transfer of assets to a family member or someone outside the family, or the provision of services that are not necessary. Sexual Abuse Sexual abuse among elders, as is the case when a person of any age is sexually abused, is defined as any kind of non-consensual contact with an elderly person. What we must be particularly watchful for among seniors is any sexual contact that occurs to someone incapable of giving their consent. This often happens with patients suffering from dementia or other conditions that would inhibit their ability to ward off unwanted sexual advances. You can identify sexual abuse in seniors by looking for signs such as bruises around the breasts or genital area, unexplained venereal disease or genital infections, unexplained vaginal or anal bleeding, and torn, stained, or bloody underclothing.
What To Do If You Suspect Elder Abuse
If you detect any of these signs in an elder, take action right away. Don't wait until you see further symptoms; by then it could be too late. You might try talking to the senior directly, but be aware that many seniors won't want to address their abuse, choosing instead to ignore or cover up the problem.
Your first point of contact for all cases involving elder abuse should be Adult Protective Services, a government agency set up in every state to investigate and prevent elder abuse. San Francisco's Adult Protective Services department can be reached at (415) 557-5230 or (800) 814-0009. You might also call your local police department or county hotline. In San Francisco, the hotline phone number is (415) 557-5230. For a suspected financial abuse matter, call ElderAngels, a non-profit organization helping that's been assisting victim's of elder financial abuse since 1997, at (415) 284-1160. Unfortunately, too many cases of elder abuse go unreported. Of those that are turned in, many more are difficult to prove. But as long as those of us who come in contact with seniors and caregivers every day are vigilant and watchful, we can make a difference. By learning to recognize the symptoms of elder abuse and knowing where to turn when we suspect it, we can free elders from abusive situations. Even if it's one senior at a time.
Shirley Cohen is the founder and executive director of Home Sweet Home Care, Inc., a home care agency providing personal nurses, companions and homemakers to seniors and convalescing adults in the San Francisco Bay Area.
***
About
Home
Sweet
Home
Care,
Inc.
Based
in
San
Francisco,
Home
Sweet
Home
Care
is
a
private
duty
home
care
agency
that
has
provided
quality
home
care
aide
services
to
seniors
and
convalescing
adults
since
June
of
1990.
The
company's
success
is
owed
to
its
strong
consumer
orientation,
its
personal
involvement
with
each
client,
and
its
ability
to
recruit
and
retain
high-caliber
care
providers,
each
of
whom
are
thoroughly
screened
and
qualified
before
they
are
sent
on
assignment.
Home
Sweet
Home
Care
is
fully
bonded
and
insured
and
has
been
commended
by
the
Better
Business
Bureau
for
its
"Complaint-Free"
status
year
after
year.
***
For
more
information,
contact:
shirley@eldercarexperts.com
(415)
776-7337
