Signs of Elder Abuse: What Every Caregiver Should Know
It's hard to imagine anyone would hurt your elderly parent. But elder abuse is shockingly common—and most cases go unreported. Whether from paid caregivers, family members, or facility staff, abuse can happen to anyone's loved one.
Knowing the signs could save your parent from ongoing harm.
Americans over 60 experience some form of elder abuse. Only 1 in 24 cases are reported.
Types of Elder Abuse
Physical Abuse
Intentional use of force that causes injury, pain, or impairment. Includes hitting, pushing, slapping, burning, improper use of restraints, or giving inappropriate medications.
- Unexplained bruises, burns, or injuries
- Injuries in various stages of healing
- Broken bones, sprains, or dislocations
- Bruises in unusual locations (upper arms, inner thighs, torso)
- Injuries that don't match the explanation given
- Signs of being restrained (rope marks on wrists)
- Fear of certain caregivers or family members
- Reluctance to undress or be examined
Emotional/Psychological Abuse
Behavior that causes emotional pain, distress, or anguish. Includes verbal attacks, threats, intimidation, humiliation, or isolation.
- Unusual depression, withdrawal, or fearfulness
- Behavior changes (rocking, sucking, mumbling)
- Avoiding eye contact or seeming afraid of certain people
- Unusual agitation or mood swings
- Not wanting to speak openly
- Reports of verbal abuse or threats
- Sudden reluctance to speak or participate
Financial Abuse/Exploitation
Illegal or improper use of an elder's funds, property, or assets. The most common form of elder abuse.
- Unexplained withdrawals or transfers of money
- Missing valuables, cash, or property
- Changes to wills, powers of attorney, or property titles
- Unpaid bills despite adequate funds
- New "best friends" who show unusual interest in finances
- Signing documents they don't understand
- Unusual credit card activity
- Forged signatures on checks or documents
- Sudden changes in banking practices
Neglect
Failure to provide necessary care, supervision, or assistance. Can be intentional or unintentional (from an overwhelmed caregiver).
- Poor hygiene (dirty, unwashed, strong odor)
- Bedsores or pressure ulcers
- Dehydration or malnutrition
- Unsafe or unsanitary living conditions
- Lack of necessary medical care, aids, or glasses
- Untreated health problems
- Inappropriate clothing for the weather
- Being left alone for extended periods
Sexual Abuse
Any non-consensual sexual contact, including with those unable to give consent due to dementia.
- Unexplained genital injuries or bleeding
- Unexplained STIs or genital infections
- Torn or bloody undergarments
- Unusual difficulty walking or sitting
- Reports of sexual assault or rape
Abandonment
Desertion of an elderly person by someone who has assumed responsibility for care.
- Being left at a hospital, mall, or public place
- Caregiver suddenly not showing up
- Desertion at any location
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Recommended Safety & Monitoring Tools
- Medical Alert System Direct line to emergency help
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- Get It Together: Organize Your Records Track finances and monitor for exploitation
- Cross-Cut Paper Shredder Protect sensitive information from theft
Who Abuses Elders?
Abusers are often known and trusted:
- Family members: Adult children, spouses, grandchildren (most common)
- Paid caregivers: Home health aides, nursing home staff
- Friends or acquaintances: Neighbors, "new friends"
- Professionals: Financial advisors, attorneys, others with access
Abuse is more likely when the elder has dementia or cognitive impairment, is socially isolated, is financially dependent on others, or has an abuser who is stressed, has substance abuse issues, or has mental health problems.
Why Elders Don't Report Abuse
- Fear of retaliation
- Fear of being moved to a nursing home
- Dependence on the abuser for care
- Love for the abuser (especially if it's family)
- Shame or embarrassment
- Cognitive impairment—they may not understand or remember
- Belief that no one will help
- Physical inability to report (can't call, can't leave)
What to Do If You Suspect Abuse
1. Talk to Your Parent Privately
If possible, speak with them alone. Ask open-ended questions: "How are things going with your caregiver?" "Is anyone making you feel uncomfortable?" Don't lead or pressure—just listen.
2. Document Everything
Take photos of injuries, write down what you observe (dates, times, what was said), and keep copies of financial records if you suspect exploitation.
3. Get Medical Attention
If there's physical harm, get your parent to a doctor. Medical professionals are mandatory reporters and can document injuries officially.
4. Report to Adult Protective Services
Every state has an Adult Protective Services (APS) agency that investigates elder abuse. You can report anonymously. They have the authority to investigate and intervene.
5. Report to Appropriate Authorities
- Police: For crimes (assault, theft, sexual abuse)
- Long-Term Care Ombudsman: For nursing home or assisted living abuse
- State licensing board: For facility complaints
6. Ensure Immediate Safety
If your parent is in immediate danger, remove them from the situation. This might mean bringing them to your home, changing caregivers immediately, or moving them from a facility.
Eldercare Locator
Connect to local Adult Protective Services and resources. Available Monday-Friday 9am-8pm ET.
Preventing Elder Abuse
Stay Connected
- Visit regularly and at unexpected times
- Maintain phone or video contact
- Know who is providing care and build relationships with them
- Encourage your parent to stay socially active
Monitor Finances
- Set up online banking alerts for large transactions
- Review statements regularly
- Consider a financial power of attorney with oversight
- Be wary of new people in their life who seem interested in money
Screen Caregivers
- Run background checks on all caregivers
- Check references thoroughly
- Use reputable agencies that screen employees
- Consider nanny cams (know your state's laws on recording)
Plan Ahead
- Have legal documents in place while your parent can participate
- Choose trustworthy people for powers of attorney
- Consider having multiple people oversee finances as a check
Caregiver stress can lead to neglect or even abuse. If you're at your breaking point, please get help. Respite care, support groups, and counseling exist for this reason. Contact the Eldercare Locator (1-800-677-1116) for resources.
Abuse in Nursing Homes and Facilities
Abuse can happen in facilities too. Watch for:
- Unexplained injuries or frequent "accidents"
- Changes in behavior after certain staff are present
- Fear of certain staff members
- Reluctance to speak openly when staff are present
- Poor hygiene or untreated bedsores
- Missing personal belongings
If you suspect abuse in a facility, report to:
- The Long-Term Care Ombudsman program (advocates for residents)
- The state licensing agency
- Adult Protective Services
- Police (for criminal abuse)
Emergency Contact Card
Keep important contacts handy—including Adult Protective Services and local police—for you and your parent.
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