There are many forms of abuse. Common forms of abuse include: hitting, pushing, shaking, beating, yelling, verbal
harassment, coercive behavior, intimidation and other acts that cause harm.
Elder abuse is any form of mistreatment that results in harm or loss to an older person. It is generally divided into
the following categories:
Pushing, striking, slapping, kicking, pinching, restraining, shaking, beating, burning, hitting, shoving or other acts
that can cause harm to an elder.
Emotional or Psychological Abuse
Verbal berating, harassment, intimidation, threats of punishment or deprivation, criticism, demeaning comments,
coercive behavior or isolation from family and friends.
Financial or Material Exploitation
Improper use of an elder's funds, property, or assets; cashing checks without permission; forging signatures; forcing
or deceiving an older person into signing a document; using an ATM/debit card without permission.
Sexual abuse is any form of non-consensual physical contact. It includes assault or battery, rape, sodomy, coerced
nudity or sexually explicit photographing.
Neglect and Self-Neglect
Neglect is the failure of a caregiver to fulfill his or her care giving responsibilities. Self-neglect is when individuals
fail to provide themselves with whatever is necessary to prevent physical or emotional harm or pain.
Signs of Physical Abuse
Physical signs may include cuts, puncture wounds, burns, bruises, welts, dehydration or malnutrition,
poor coloration, sunken eyes or cheeks, soiled clothing or bed, or lack of necessities such as food, water, or utilities.
Behavioral signs may include fear, anxiety, agitation, anger, isolation, withdrawal, depression,
non-responsiveness, resignation, ambivalence, contradictory statements, implausible stories, hesitation to talk openly, confusion or
Many of the indicators listed here can be explained by other causes (e.g. a bruise may be the result of an accidental
fall) and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or clusters of indicators that suggest
- Sprains, dislocations, fractures, or broken bones.
- Burns from cigarettes, appliances, or hot water.
- Abrasions on arms, legs, or torso that resemble rope or strap marks.
- Internal injuries evidenced by pain, difficulty with normal functioning of organs, and bleeding from body orifices.
- Bruises. The following types of bruises are rarely accidental:
- Bilateral bruising to the arms (may indicate that the person has been shaken, grabbed, or restrained).
- Bilateral bruising of the inner thighs (may indicate sexual abuse).
- "Wrap around" bruises that encircle an older person's arms, legs, or torso (may indicate that the person has
been physically restrained).
- Multicolored bruises (indicating that they were sustained over time).
- Injuries healing through "secondary intention" (indicating that they did not receive appropriate care).
- Signs of traumatic hair and tooth loss.
- Injuries are unexplained or explanations are implausible (they do not "fit" with the injuries observed).
- Family members provide different explanations of how injuries were sustained.
- A history of similar injuries, and/or numerous or suspicious hospitalizations.
- Victims are brought to different medical facilities for treatment to prevent medical practitioners from observing a pattern of abuse.
- Delay between onset of injury and seeking medical care.
Signs of Emotional or Psychological Abuse
Indicators are signs or clues that abuse has occurred. Physical indicators may include somatic changes
or decline, while behavioral indicators are ways victims and abusers act or interact. Some of the indicators listed below can be explained
by other causes and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or clusters of indicators
that suggest a problem.
- Significant weight loss or gain that is not attributed to other causes.
- Stress-related conditions, including elevated blood pressure.
- Isolates the elder emotionally by not speaking to, touching, or comforting him or her.
- Has problems sleeping.
- Exhibits depression and confusion.
- Cowers in the presence of abuser.
- Is emotionally upset, agitated, withdrawn, and non responsive.
- Exhibits unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking).
Signs of Financial or Material Exploitation
Indicators are signs or clues that abuse has occurred. Some of the indicators listed below can be
explained by other causes or factors and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or
clusters of indicators that suggest a problem.
- Unpaid bills, eviction notices, or notices to discontinue utilities.
- Withdrawals from bank accounts or transfers between accounts that the older person cannot explain.
- Bank statements and canceled checks no longer come to the elder's home.
- New "best friends."
- Legal documents, such as powers of attorney, which the older person didn't understand at the time he or she signed them.
- Unusual activity in the older person's bank accounts including large, unexplained withdrawals, frequent transfers between accounts, or ATM
- The care of the elder is not commensurate with the size of his/her estate.
- A caregiver expresses excessive interest in the amount of money being spent on the older person.
- Belongings or property are missing.
- Suspicious signatures on checks or other documents.
- Absence of documentation about financial arrangements.
- Implausible explanations given about the elderly person's finances by the elder or the caregiver.
- The elder is unaware of or does not understand financial arrangements that have been made for him or her.
Signs of Sexual Abuse
Indicators are signs or clues that abuse has occurred. Physical indicators may include injuries or
bruises, while behavioral indicators are ways victims and abusers act or interact with each other. Some of the indicators listed below can be
explained by other causes (e.g. inappropriate or unusual behavior may signal dementia or drug interactions) and no single indicator can be
taken as conclusive proof. Rather, one should look for patterns or clusters of indicators that suggest a problem.
- Genital or anal pain, irritation, or bleeding.
- Bruises on external genitalia or inner thighs.
- Difficulty walking or sitting.
- Torn, stained, or bloody underclothing.
- Sexually transmitted diseases.
- Inappropriate sex-role relationship between victim and suspect.
- Inappropriate, unusual, or aggressive sexual behavior.
Signs of Neglect and Self-Neglect
Indicators are signs or clues that neglect has occurred. Indicators of neglect include the condition
of the older person's home (environmental indicators), physical signs of poor care, and behavioral characteristics of the caregiver and/or
older person. Some of the indicators listed below may not signal neglect but rather reflect lifestyle choices, lack of resources, or mental
health problems, etc. One should look for patterns or clusters of indicators that suggest a problem.
Signs of Neglect Observed in the Home
- Absence of necessities including food, water, heat.
- Inadequate living environment evidenced by lack of utilities, sufficient space, and ventilation.
- Animal or insect infestations.
- Signs of medication mismanagement, including empty or unmarked bottles or outdated prescriptions.
- Housing is unsafe as a result of disrepair, faulty wiring, inadequate sanitation, substandard cleanliness, or architectural barriers.
- Poor personal hygiene including soiled clothing, dirty nails and skin, matted or lice infested hair, odors, and the presence of feces or urine.
- Unclothed, or improperly clothed for weather.
- Decubiti (bedsores).
- Skin rashes.
- Dehydration, evidenced by low urinary output, dry fragile skin, dry sore mouth, apathy, lack of energy, and mental confusion.
- Untreated medical or mental conditions including infections, soiled bandages, and unattended fractures.
- Absence of needed dentures, eyeglasses, hearing aids, walkers, wheelchairs, braces, or commodes.
- Exacerbation of chronic diseases despite a care plan.
- Worsening dementia.
Observed in the caregiver/abuser:
- Expresses anger, frustration, or exhaustion.
- Isolates the elder from the outside world, friends, or relatives.
- Obviously lacks care giving skills.
- Is unreasonably critical and/or dissatisfied with social and health care providers and changes providers frequently.
- Refuses to apply for economic aid or services for the elder and resists outside help.
Observed in the victim:
- Exhibits emotional distress such as crying, depression, or despair.
- Has nightmares or difficulty sleeping.
- Has had a sudden loss of appetite that is unrelated to a medical condition.
- Is confused and disoriented (this may be the result of malnutrition).
- Is emotionally numb, withdrawn, or detached.
- Exhibits regressive behavior.
- Exhibits self-destructive behavior.
- Exhibits fear toward the caregiver.
- Expresses unrealistic expectations about their care (e.g. claiming that their care is adequate when it is not or insisting that
the situation will improve).
The National Center on Elder Abuse states that elder abuse
is a widespread problem; possibly affecting hundreds of thousands of elderly people across the country. It is estimated that 1.5 to 1.84
million Americans fall victim to elder abuse each year.
Florida has 4.63 million residents age 60 and older (U.S. Census, 2010). There were approximately
44,029 cases of alleged mistreatments against elders in Florida in 2010.