The National Council on Aging estimates that one in 10 Americans aged 60+ has been subject to some form of elderly abuse. Elder abuse is not simply random physical violence against old people. Abuse of the elderly may look very different from one individual to another. It can happen obviously or covertly, slowly or rapidly.
This article will explore the common forms of elderly abuse, and how you can recognize and report suspected abuse.
Table of Contents
What Is Elder Abuse and Neglect?
Elderly abuse is an umbrella term that includes physical violence, mental abuse, sexual abuse, emotional abuse, financial abuse, and even romantic abuse. It can also involve neglect in care and nutrition. In some cases, the victim may not understand that they are being abused or realize the extent of the abuse. Many cases of senior abuse or geriatric abuse go unreported – as victims may not report them due to confusion, dementia, fear, or unawareness.
Below are three very different elder abuse examples:
- Scenario #1: Sally is a resident in an RCFE (Residential Care Facility for the Elderly), which provides room and board, meals, personal care assistance, and supervision. Sally’s daughter Joy comes to visit on Sunday afternoons. On one visit, she notices that Sally seems lethargic and much more withdrawn than normal, and can barely stay awake. Joy calls her county Adult Protective Services (APS) agency and reports that she believes her mother is being given drugs that she has not been prescribed. An investigation reveals multiple residents at the facility are being over-medicated and unnecessarily sedated.
- Scenario #2: Robert lives alone at home with limited mobility. When Robert sold his car last year, he put $7,000 in cash from the sale in his safe. He has home healthcare come to his home three times a week for four hours. His caregiver Anna learned of his safe passcode two months ago when Robert asked her to get cash out to put in his granddaughter’s birthday card – and told her where the safe passcode was located. Over the course of her visits, Anna has been taking several hundred dollars whenever Robert is napping. Robert is not aware that he is a victim of financial abuse (financial exploitation) and criminal theft.
- Scenario #3: Gladys lives in a nursing home and is bedridden. Over time, she develops blood circulation problems and pressure sores on the sides of her hips, knees, and ankles. Her ulcerations are difficult to heal and require extensive medical attention. Unfortunately, her nursing home is short-staffed, and her caregivers are overworked and underpaid. They do not give her the care she needs, and it is only when she develops pneumonia and has to be taken to a nearby hospital by ambulance, that the extent of the infected pressure sores is realized.
Elderly abuse includes nursing home abuse (as described in Scenario #3), but many forms of elderly abuse occur outside of nursing homes. Rates of abuse increased during the COVID-19 pandemic, both in communities and in institutions, according to the World Health Organization (WHO).
Who Is Most Likely to Abuse the Elderly?
There is no profile for an elder abuser – except that most perpetrators of abuse know their victim in some capacity. Family members and caregivers are common perpetrators. Abusers can be male, female, and of any age or socioeconomic status. Abuse can happen anywhere, but the most common places are the victim’s own home or a facility where they live.
Elder Abuse California Laws
California Penal Code 368 PC defines physical or mental abuse – as either willful or criminally negligent. In California, elder abuse is a “wobbler” offense meaning it can be charged as a misdemeanor or a felony, depending on the scope of the crime and the amount of money stolen (in financial abuse cases). People charged with elder abuse are often simultaneously charged with other crimes, including battery, embezzlement, petty theft, and grand theft.
A criminal case against a perpetrator of elder abuse will not compensate a victim and their family for the medical bills, physical pain, and emotional suffering they endure. A separate civil claim can be filed for these damages. Along with the perpetrator, their employer may be liable. For some victims and their families, this is the most important (or the only) element of justice and healing after abuse.
Most Common Types of Elder Abuse
The Centers for Disease Control defines elder abuse as an “intentional act or failure to act that causes or creates a risk of harm to an older adult. Below are some of the most common types of abuse in elderly adults:
Financial or Material Exploitation
Elderly abuse can occur without the victim’s awareness in the form of financial abuse. It can be theft made to look like generous gifts, overspending on online shopping, or use of a credit card or checkbook for personal expenses. This can be one of the hardest types of abuse to identify, as there is no obvious elder mistreatment and it can be combined with legitimate, necessary tasks, such as shopping for medical supplies or paying bills for an elderly individual.
Physical Elder Abuse
Use of physical force resulting in bodily injury is abhorrent – and recovery from physical wounds may take much longer for older adults than younger people. Physical elder abuse examples include:
- Punching, hitting, or slapping;
- Using inappropriate restraints;
- Using unnecessary force.
Perpetrators of elder abuse can include in-home health aids, family member caregivers, nursing home employees, nursing home volunteers, and other nursing home residents.
Emotional or Psychological Elder Abuse
Psychological abuse is the most common type of elder abuse. Emotional abuse is a definite spectrum and may be combined with other types of elder abuse. Psychological abuse may be covert – such as classic FOG manipulation (fear, obligation, and guilt), or more explicit verbal threats, harassment, and interpersonal isolation.
Sexual Elder Abuse
Elderly adults, especially women, are often vulnerable and may not be able to identify their abusers, which makes them targets for forced or unwanted sexual interaction. In the majority of cases, the abuser is the primary caregiver.
Healthcare Fraud and Abuse
The FBI has an entire unit dedicated to health care fraud – which has been identified in clinics, hospitals, medical equipment providers, and home health agencies. While medical insurance companies are victims of fraud – elderly adults are also victims when fraud comes at their expense. Healthcare fraud can take many forms, including:
- Altering or manufacturing bills or receipts;
- Billing for unnecessary services;
- Submitting multiple claims for one service;
- Submitting claims for medical services or prescription medications that weren’t received;
- Using another individual’s insurance coverage or insurance card.
The California Welfare & Institutions Code defines “Abandonment” as ” the desertion or willful forsaking of an elder or a dependent adult by anyone having care or custody of that person under circumstances in which a reasonable person would continue to provide care and custody”. Abandonment is a form of abuse. One notable case of abandonment in California was when Valley Springs Manor shut down when it lost its operating license. All employees except for a janitor and a cook left. They were heralded as heroes for staying to care for 16 elderly residents. The incident led to California’s passing of the Residential Care for the Elderly Reform Act of 2014. Although this addressed abandonment of elderly adults in care facilities, abandonment of elderly adults can occur in home settings.
Because there are many types of elder abuse, the signs and symptoms of elder abuse vary widely. You may observe signs of physical abuse or neglect, behavior, or personality changes. If a loved one is a victim of financial abuse or exploitation, there may be money missing from bank accounts or possessions missing from the home.
Why Does Elder Abuse Happen?
There is not always a clear understanding of what causes elderly abuse – and there are different perspectives on why people commit elder abuse. Some abusers are overwhelmed by their jobs or frustrated with an individual’s needs or demands. In other instances, abusers are struggling with alcohol or drugs. Elder abuse can be a single act or a repeated act.
Risk Factors for Elder Abuse
The demands and stress of caregiving and the extensive needs of elderly adults can create an environment susceptible to elder abuse. Caregivers – especially nonprofessional caregivers who haven’t been trained in managing stress and burnout prevention are susceptible to abuse. However, abuse can and does occur in institutional settings. Some of the recognized risk factors for elder abuse include:
- Caregiver substance abuse;
- Caregiver depression;
- Caregiver burnout;
- Caregiver history of domestic violence;
- Caregivers working in poor conditions;
- Lack of emotional support or respite care for caregivers;
- Elderly person’s dementia;
- Elderly person’s declining health;
- Elderly person’s tendency toward aggression (verbal or physical).
How to Prevent Abuse of the Elderly?
If you have older adults in your life, such as a parent, grandparent, aunt, or uncle, you can prevent elder abuse in a few ways:
- If you are an elder, try to stay socially engaged with family and close friends, and keep them informed of your physical and mental condition and the status of your legal and financial affairs. Family and friends should visit or call often, always looking for changes in the elder’s mood and mental capacity.
- Do a thorough background check on any caregivers allowed in the home. Obtain the written permission of the caregiver and pay for a professional background check.
- Only rely on longstanding financial and legal advisors. It should be deeply concerning if an elder works with a new lawyer, financial advisor, or accountant late in life. If an elder ends a long-standing relationship with an advisor, a family should ask why.
- Elders should consider resigning as trustees of their trust. This is hard for most people-to recognize that they are getting older and will someday soon be unable to manage their finances. But many cases of elder abuse would be avoided if more elders turned the management of their financial affairs over to their children before they showed signs of dementia or diminished capacity. By doing so, the elder’s major financial assets are retitled in the name of their successor trustee. This makes it impossible for a predator to gain control of the elder’s assets without the successor trustee’s knowledge.
- Program the elder’s phone to identify all callers by name. If the elder does not recognize the caller they should not answer the phone.
- Elder abuse attorneys often advise family and friends to “look, listen, and smell” every time they visit. Look for signs of physical abuse, including bruising, weight loss, burns, bedsores, or a loss of mobility. Always look in the refrigerator and cupboards. Are they clean and well-stocked? Has any food expired? Is the food appropriate for the elder, or the caregiver? Listen patiently for longer than you think is necessary. Elders with diminished capacity often “mask” their impairment. They may return to topics they are most familiar with or tell a joke rather than answer a direct question. Often only an extended conversation will reveal that an elder is slipping. Be alert for any foul odors from the kitchen, bathroom, or the elder themselves, which could be signs of rotting food, unsanitary conditions, or a problem with incontinence or toileting.
- A report to Adult Protective Services is often necessary, but victims of abuse should not rely only on the police or APS. According to the San Francisco Examiner:
“[Elder] abuse in San Francisco rose by 33 percent from 2014 to 2015, but police investigations into such crimes have been in decline in recent years because of a consolidated and paired down unit tasked with looking into such matters.”
- Above all, friends and family should be present as much as possible. It’s hard for an elder abuser to operate when loved ones are constantly calling and visiting, and it’s much less likely that an elder will become dependent on an abuser if they know they can always depend on family and friends.
What to Do If You Suspect Elder Abuse?
While certain individuals are required to report elder abuse (mandated reporters), anyone can and should report abuse. California takes abuse of seniors seriously, but the courts cannot take action if they do not know. If you are in Contra Costa County, you can report abuse to some agencies:
- Police – call 911 in any emergency. For non-emergencies, you can contact your local law enforcement agency.
- Adult Protective Services – any suspected elder abuse should be reported to APS.
- Long Term Care Ombudsman Suspected abuse that occurs in a long-term care facility should be reported to the LTCO.
If a loved one is being abused in any capacity, advocate for them. Along with reporting abuse, a victim may obtain an Elder or Dependent Adult Abuse Restraining Order. Barr & Douds has successfully obtained these for many of our clients who are victims of elder abuse.
Talk to a Northern California Elder Abuse Lawyer
If you need a California elder abuse attorney, contact Barr & Douds to arrange a free consultation. We represent clients throughout the San Francisco Bay Area, Oakland, Walnut Creek, and Danville. If you have questions about what is elderly exploitation and what you can do to prevent elderly abuse, contact us to discuss your legal rights and options.