Elder Abuse can happen to anyone, in any setting. Research suggests that 1 in 10 Americans 60 and over have experienced some form of elder abuse- but this doesn’t take into account cases that go unreported. Some estimates range as high as 5 million seniors are abused each year. Due to the statistics and media exposure, many seniors and their families have a misconception that elder abuse is most often perpetrated by formal (paid, hired) Caregivers, rather than informal caregivers (family, friends). The facts are that two thirds of perpetrators in elder abuse cases are adult children, spouses or other family members. The numbers makes sense, as the bulk of senior caregiving in the United States is performed by informal, family caregivers. In fact an estimated 78% of aging adults living in the community depend on family and friends as their only source of help.
Abuse doesn’t always mean physical harm which is often what comes to mind. Abuse can also be emotional, financial, sexual, confinement such as intentionally isolating, passive neglect or abandonment. Social isolation and cognitive deficits (such as Alzheimer’s disease ) are risk factors for elder abuses. Recent studies show that nearly half of those with dementia have experienced some form of abuse or neglect. Elders with more advanced forms of dementia will have difficulty communicating, and this makes them even more susceptible to abuse.
Sometimes people do need to engage with home health aides for assistance in order to age in place independently. It is always a good idea to use a licensed, accredited agency rather than hiring independently. There are many more instances of elder abuse involving a private direct hire than there are with w2 Agency Employees. This is likely due to the background checks that agencies are required to do annually in addition to the agency supervision of the staff.
Since home care aides are spending a lot of time in vulnerable elder’s homes, it is important that all home health workers are familiar with the signs of elder abuse and are empowered to report it. Elder abuse unfortunately goes significantly underreported. Home caregivers should be vigilant in what to look for. If an elder client seems depressed, socially withdrawn, fearful, or acting out elder abuse is something to be considered. Some conditions the elder might present in, if he or she is being abused include malnutrition, dehydration, unclean or unkept, or inappropriate dress for weather. Skin tears, bruises, pressure sores and scratches can also be indicators of abuse however this is a grayer area because elderly skin is more thin and frail and these things do happen more often than in younger people even when there is no abuse occurring. But if these injuries are recurring especially without logical explanation it can definitely be a sign that abuse is going on.
Signs of another form of abuse, financial exploitation, could include missing checks, credit, or debit cards, missing valuable items, and bills not being paid (debt collectors calling).
It can also be helpful to be aware of common characteristics of typical abusers. Abusers can be both male and female, although males account for a higher number of abuse cases. Many abusers are financially dependent upon the elder individual, perhaps living with the elder adult and not working themselves. Abusers are often very private, and can become defensive if anything is questioned.
If elder abuse is suspected, it is crucial that a report be made to the appropriate authorities in a timely fashion. While regulations will vary from state to state, reporting elder abuse immediately could prevent repeat occurrences or even in some situations a fatality. As a health care worker, if you are uncertain whether you are noticing elder abuse but have any suspicion, you should report it immediately to your supervisor or director. Reporting any and all suspicions is the only means of prevention.
About the Author: Pam Reynolds, CMC is the President and co-owner of Allegiance Aging Care Services. Pam has spent almost fifteen years working in senior care including long term care facilities and home health care. Her higher education is in Social Work, and she has been credentialed as both a certified Geriatric Care Manager and Licensed Assisted Living Administrator. Read more about Pam and her team of Aging Care Professionals here.