Elder Abuse

Definitions of Abuse

Physical Abuse
Any physical pain or injury which is willfully inflicted upon and elder by a person who has care or custody of, or who stands in a position of trust with that elder, constitutes physical abuse. This includes, but is not limited to, direct beatings, sexual assault, unreasonable physical restraint, and prolonged deprivation of food or water.

Possible indicators of physical abuse
* Cuts, lacerations, puncture wounds
* Bruises, welts, discoloration
* Any injury incompatible with history
* Any injury which has not been properly cared for ( injuries are sometimes hidden    on areas of the body normally covered by clothing)
* Poor skin condition or poor skin hygiene
* Absence of hair and hemorrhaging below the scalp
* Dehydration and or malnourished without illness-related cause
* Loss of weight
* Burns: may be caused by cigarettes, caustics, acids, friction from ropes or chains,    or contact with other objects
* Soiled clothing or bed

Financial Abuse
Any theft or misuse of an elders money or property, by a person in a position of trust with an elder, constitutes financial abuse.

Possible indicators of Financial Abuse
* Unusual or inappropriate activity in bank accounts
* Signatures on checks, etc., that do not resemble the older persons signature, or    signed when older person cannot write
* Power of attorney given, or recent changes or creation of will, when the person    is incapable of making such decisions
* Unusual concern by caregiver that an excessive amount of money is being expended    on the care of the older person
* Numerous unpaid bills, overdue rent, when someone is supposed to be paying the    bill for a dependent elder
* Placement in nursing home or residential care facility which is not commensurate with    alleged size of estate
* Lack of amenities, such as TV, personal grooming items, appropriate clothing, that    the estate can well afford.
* Missing personal belongings such as art, silverware, or jewelry
* Deliberate isolation, by a housekeeper, of an older adult from friends and family,    resulting in the care giver alone having total control

Neglect
The failure of any person having the care or custody of an elder to provide the degree of care which a reasonable person in a like position would provide constitutes neglect. This includes, but not limited to:
    1) Failure to assist in personal hygiene or the provision of clothing for an elder.
    2) Failure to provide medical care for the physical and mental health needs of an         elder. This does not include instances in which an elder refuses treatment.
    3) Failure to protect an elder from health and safety hazards.

Possible indicators of Neglect by Caregiver
* Dirt, fecal/urine smell, or other health and safety hazards in elder’s living    environment.
* Rashes, sores, lice on elder
* Elder is inadequately clothed
* Elder is malnourished or dehydrated
* Elder has an untreated medical condition

Self Neglect
Failure to provide for self through inattention or dissipation. The identification of the type if case depends on assessing the elder’s ability to choose a life-style versus a recent change in the elder’s ability to manage.

Possible indicators of Self-Neglect
* Inability to manage personal finances, e.g. hoarding, squandering, giving money    away or failure to pay bills
* Inability to manage activities of daily living, including personal care, shopping, meal     preparations, housework, etc.
* Suicidal acts, wanderings, refusing medical attention, isolation, substance abuse
* Lack of toilet facilities, utilities or animal infested living quarters ( dangerous    conditions)
* Rashes, sores, fecal/ urine smell, inadequate clothing, malnourished, dehydration,    etc.
* Changes in intellectual functioning, e.g. confusion, inappropriate or no response,    disorientation to time and place, memory failure, incoherence, etc.
* Not keeping medical appointments for serious illness

Psychological/Emotional Abuse
The willful infliction of mental suffering, by a person in a  position of trust with an elder, constitutes psychological/emotional abuses. Example of such abuses are: verbal assaults, threats, instilling fear, humiliation, intimidation, or isolation of an elder.

Possible indicators of psychological/ Emotional abuse
Helplessness                            Fear
Hesitation to talk openly          Withdrawn
Implausible stories                    Depression
Confusion or disorientation       Denial
Anger                                      Agitation

Abandonment
Abandonment constitutes the desertion or willful forsaking of an elder by any person having the care and custody of that elder, under circumstances in which a reasonable person would continue to provide care of custody.

Possible indicators of Abuse from a Caregiver
* The elder may not be given the opportunity to speak for him or herself, or see    others,  without the presence of the caregiver( suspected abuser)
* Attitudes of indifference or anger toward the dependent person, or the obvious    absence of assistance
* Family member of caregiver blames the elder (e.g. accusation that incontinence is a    deliberate act)
* Aggressive behavior (threats, insults, harassment) by caregiver toward the elder
* Previous history of abuse to others
* Problems of alcohol or drugs
* Inappropriate display of affection by the caregiver
* Flirtations, coyness, etc. as possible indicators of inappropriate sexual relationship
* Social isolation of family, or isolation or restriction of activity of the older adult within    the family unit by the caregiver
* Conflicting accounts of incidents by family, supporters, or victim
* Unwillingness or reluctance by the caregiver to comply with service providers in    planning for care and implementation
* Inappropriate or unwarranted defensiveness by caregiver