Many older people are victims of elder abuse. It is the mistreatment of an older person, usually by a caregiver. It can happen within the family. It can also happen in assisted living facilities or nursing homes.

The mistreatment may be

• Physical, sexual, or emotional abuse
• Neglect or abandonment
• Financial abuse - stealing of money or belongings

Possible signs of elder abuse include unexplained bruises, burns, and injuries. There may also be bed sores and poor hygiene. The person may become withdrawn, agitated, and depressed. There may be a sudden change in the person's financial situation.

Elder abuse will not stop on its own. Someone else needs to step in and help. If you think that an older person is in urgent danger, call 9-1-1. Otherwise, contact adult protective services.

Elder abuse can happen in the home, in a nursing home or assisted living facility, or in public. It can include any type of abuse, such as physical, sexual, emotional, verbal, and financial, against an older person. Elder abuse is more likely to happen when an older person is dependent on other people for daily activities of living, such as eating, bathing, using the toilet, dressing, or managing money.

Elder abuse also includes neglect and taking advantage of an older person.

Experts aren’t sure how common elder abuse is, because many victims of elder abuse may not report it or may not be aware of it. Studies suggest that elder abuse may affect one in 10 older adults. More women than men experience elder abuse, in part because women live longer.

Emotional and verbal abuse and financial abuse are the most common types of elder abuse.

There are many types of abuse:

• Physical abuse happens when someone causes bodily harm by hitting, pushing, or slapping. This may also include restraining an older adult against his/her will, such as locking them in a room or tying them to furniture.
• Emotional abuse, sometimes called psychological abuse, can include a caregiver saying hurtful words, yelling, threatening, or repeatedly ignoring the older adult. Keeping that person from seeing close friends and relatives is another form of emotional abuse.
• Neglect occurs when the caregiver does not try to respond to the older adult's needs. This may include physical, emotional, and social needs, or withholding food, medications, or access to health care.
• Abandonment is leaving an older adult who needs help alone without planning for his or her care.
• Sexual abuse involves a caregiver forcing an older adult to watch or be part of sexual acts.
• Financial abuse happens when money or belongings are stolen from an older adult. It can include forging checks, taking someone else's retirement or Social Security benefits, or using a person's credit cards and bank accounts without their permission. It also includes changing names on a will, bank account, life insurance policy, or title to a house without permission.

Financial abuse is becoming a widespread and hard-to-detect issue. Even someone you've never met can steal your financial information using the telephone, internet, or email. Be careful about sharing any financial information over the phone or online — you don't know who will use it.

In addition to the theft of an older person’s money or belongings, financial abuse also includes:

Financial neglect occurs when an older adult’s financial responsibilities such as paying rent or mortgage, medical expenses or insurance, utility bills, or property taxes, are ignored, and the person’s bills are not paid.

Financial exploitation is the misuse, mismanagement, or exploitation of property, belongings, or assets. This includes using an older adult’s assets without consent, under false pretense, or through intimidation and/or manipulation.

Health care fraud can be committed by doctors, hospital staff, or other health care workers. It includes overcharging, billing twice for the same service, falsifying Medicaid or Medicare claims, or charging for care that wasn't provided. Older adults and caregivers should keep an eye out for this type of fraud.

Most victims of abuse are women, but some are men. Likely targets are older adults who have no family or friends nearby and people with disabilities, memory problems, or dementia.

Abuse can happen to any older adult, but often affects those who depend on others for help with activities of everyday life — including bathing, dressing, and taking medicine. People who are frail may appear to be easy victims.

You may see signs of abuse or neglect when you visit an older adult at home or in an eldercare facility. You may notice the person:

• Stops taking part in activities he or she enjoys
• Looks messy, with unwashed hair or dirty clothes
• Has trouble sleeping
• Loses weight for no reason
• Becomes withdrawn or acts agitated or violent
• Displays signs of trauma, like rocking back and forth
• Has unexplained bruises, burns, cuts, or scars
• Has broken eyeglasses/frames, or physical signs of punishment or being restrained
• Develops bed sores or other preventable conditions
• Lacks medical aids (glasses, walker, dentures, hearing aid, medications)
• Has an eviction notice for unpaid rent, notice of late mortgage, or home eviction
• Has hazardous, unsafe, or unclean living conditions
• Displays signs of insufficient care or unpaid bills despite adequate financial resources

If you see signs of abuse, try talking with the older adult to find out what's going on. For instance, the abuse may be from another resident and not from someone who works at the nursing home or assisted living facility. Most importantly, get help or report what you see to adult protective services. You do not need to prove that abuse is occurring. Professionals will investigate.

Elder abuse comes in many forms. Below are the types of elder abuse and signs to watch for.

Physical abuse

Hitting, slapping, beating, pushing, shoving, kicking, pinching, and burning

Signs:

• Bruises and black eyes
• Marks on the body, like welts, cuts, and open wounds
• Sprains, dislocated joints (like a shoulder), and broken bones
• Injuries that are healing but were never treated by a doctor or nurse
• Rope marks or burns on hands and feet (could mean an older person has been tied up or restrained)
• Broken eyeglasses or frames
• Sudden change in behavior
• Not wanting to be alone with the caregiver
• Not being allowed to have visitors when the caregiver is not present
• Running out of prescription medicine too quickly or having prescription medicine that looks like it is not being taken as it should be (the bottle being too full)
• Telling you they are being physically hurt

Emotional and verbal abuse

Verbal assaults, threats, intimidation, harassment, and isolating the person from regular activities, family, and friends

Signs:

• Being in an upset or agitated state
• Becoming withdrawn and not wanting to talk or interact with anyone
• Unusual behavior, like rocking, biting, or sucking (usually thought to be symptoms of dementia)
• Telling you they are being mistreated

Sexual assault and abuse

Any sexual contact that is not agreed to, such as unwanted touching

Signs:

• Bruises on or around the breasts or genitals
• Unexplained sexually transmitted infections (STIs) or vaginal or anal bleeding
• Repeated urinary tract infections (UTIs) because they do not want to have a catheter changed
• Torn, stained, or bloody underwear
• Telling you they were sexually assaulted or raped

Neglect

Knowingly not taking proper care of an older person, including physical care (food, clothing, shelter, medicine, personal hygiene) and financial care (not paying for living arrangements, care, and other bills)

Signs:

• Poor hygiene, dehydration, malnutrition, and, for a bedridden person, bed sores that aren’t being treated
• Health problems that aren’t being treated
• Unsafe living conditions (no heat, electricity, or water and faulty wiring)
• Poor living conditions (dirt, fleas, soiled bedding, clothes and bedding smelling like urine or feces, improper clothing, lice)
• Telling you they are being neglected

• Physical abuse is more likely to come from partners (spouses or romantic partners).
• Financial abuse is most often committed by family members, friends and neighbors, and home health care aides. Living with an adult child who is unemployed or has a history of substance abuse raises a person’s risk for financial abuse.
• Emotional or verbal abuse or neglect is more likely to come from caregivers of the person being abused.

Someone who abuses an older adult is more likely to have mental or physical health problems, financial problems, a history of substance abuse, or to be experiencing major stress.

Most physical wounds heal in time. But elder abuse can lead to early death, harm to physical and psychological health, destroy social and family ties, cause devastating financial loss, and more.

Any type of mistreatment can leave the abused person feeling fearful and depressed. Sometimes, the victim thinks the abuse is his or her fault. Adult protective service agencies can suggest support groups and counseling that can help the abused person heal the emotional wounds.

Elder abuse can be very harmful to a woman’s health, especially if it continues after a single event. Researchers have found that any type of elder abuse can shorten a person’s life, regardless of any other health problems they might have. Studies show that if an older person also has dementia (serious problems with thinking and remembering), the risk of early death after abuse is even higher.

If you are an elderly or older person:

• Keep in touch. Be socially active and don’t spend too much time alone. Being cut off from other people can increase the risk of abuse. Keep in touch with family and friends.
• Speak up. If abuse is happening in the home, try to find the courage to speak up. We all have a right to a safe environment. If a family member is abusive, consider speaking with other family members or friends who you think can help you.
• Call police. Call the police if you are in immediate danger. The police can help stop violence and connect you with other community services.
• Report. If abuse is happening in a long-term care facility, report it to facility management as well as family members. If no family members can help, contact the state’s long-term care ombudsman. The ombudsman’s purpose is to be an advocate and help.
• Plan for the future. Plan for your financial future with a trusted person or persons. Make sure that your finances are in order. Tell family, caregivers, and doctors your health care wishes.

If you or someone you know has been the victim of elder abuse, seek help from family, friends, or community organizations. Talk to a doctor or other health care professional.

Many states have 24-hour toll-free numbers for confidential reports of abuse. The National Center on Elder Abuse can help you find services in your community.

Elder abuse may be more likely to happen if the older person has dementia or any other type of serious problem with thinking or remembering. Family members and friends of an older adult can help to prevent abuse by:

• Calling and visiting as often as you can. Keep in contact with the person. If the person is in a facility, keep in touch with staff there. You may also want to make surprise visits.
• Watching for warning signs that might signal abuse.
• Making sure that the older adult is eating properly and taking required medicines. A weakened older person may not be able to think clearly about their care or to communicate any abuse experienced.
• Looking at the person’s bank accounts and credit card statements, with their permission, for unauthorized transactions

Many states have 24-hour toll-free numbers for confidential reports of abuse. The National Center on Elder Abuse can help you find services in your community.

Call 911 if the older person is in immediate danger.

If the older person can speak, ask about any signs of abuse you see such as bruises, unusual financial activity, or fear of caregivers. If possible, document any signs of abuse with photos, videos, or written statements. Contact the local police.

You can also report elder abuse to the local adult protective services agency, similar to child protective services. Each state has an adult protective services agency. If the older person is in a facility like a nursing home, you can report abuse to an ombudsman, whose job is to resolve disputes.

Elder abuse will not stop on its own. Someone else needs to step in and help. Many older adults are too ashamed to report mistreatment. Or, they're afraid if they make a report it will get back to the abuser and make the situation worse.

If you think someone you know is being abused — physically, emotionally, or financially — talk with him or her when the two of you are alone. You could say you think something is wrong and you're worried. Offer to take him or her to get help, for instance, at a local adult protective services agency.

Many local, state, and national social service agencies can help with emotional, legal, and financial abuse.

The Administration for Community Living has a National Center on Elder Abuse where you can learn about how to report abuse, where to get help, and state laws that deal with abuse and neglect. Go to https://ncea.acl.gov for more information. Or, call the Eldercare Locator weekdays at 800-677-1116.

Most states require that doctors and lawyers report elder mistreatment. Family and friends can also report it. Do not wait. Help is available.

If you think someone is in urgent danger, call 911 or your local police to get help right away.