Around the world each year, more than 15 percent of seniors suffer some type of abuse. And, seniors residing in nursing homes and assisted living facilities suffer abuse at an even higher rate. Can you spot the signs of elder abuse? Would you know if an aging loved one had suffered abuse? To develop an understanding of the common signs of elder abuse, consider the following scenarios:
Margie resides in a “premium” nursing home facility with an expensive monthly rate. She has plenty of friends, and her children and grandchildren come to visit her on a regular basis. Maggie develops relationships with the facility’s nurses and staff, listening to their stories and offering support and friendship to them and their families. Maggie loves to provide little gifts for caregivers who experience life accomplishments, and she’s always willing to share advice and life experience with anyone who needs it. Everyone at the facility seems to love Ms. Maggie; in fact, her reputation has earned her the title of best grandma on the floor.
Ed lives at home by himself and has become increasingly lonely over the past several years. As his physical condition deteriorates, his family members struggle to provide him with the level of care he requires to maintain his independence. Nevertheless, Ed insists on staying in his own home. He is not attracted to the idea of moving into a nursing home facility, as he feels as if seniors just go to those places to die. Despite his resistance, his family finally convinces him to allow a caregiver into his home to assist him for a few hours each day.
The at-home caregiver is responsible for monitoring and administering Ed’s daily medications. After a few months, family members begin to notice that Ed’s prescription refills seem to stretch a little longer than they should. However, the caregiver assures Ed’s family that all tasks Ed requires each day are fully completed, and Ed also insists that the caregiver provides everything he needs. In addition, the caregiver is required to report to his or her supervisor regularly, so the family has no reason to question the quality of care Ed is receiving.
Alice lives with her daughter and son-in-law in their home. Several years ago, she moved in with them to save money and have her family close by in case of an emergency. The family relies on Alice to provide after-school care for the children every day. In exchange for helping with the kids, the family pays for groceries, and Alice is not expected to pay rent.
Alice only has a few friends that do not live nearby, so she does not have many reasons to leave the house. For the most part, she only sees other family members on the holidays, but she greatly enjoys interacting with her grandchildren. Alice frequently makes comments that she doesn’t know what she would do if she didn’t have her daughter to take care of her.
A few years ago, Sarah suffered from a broken hip, and as a result, she can’t move about without a wheelchair. Following the injury, Sarah never completely regained her strength. As her physical condition deteriorated, she spent more and more time in bed. Despite her physical limitations, Sarah has always maintained a cheerful demeanor. Eventually, she could no longer care for herself, so she moved into a nursing home facility that could provide her with high-quality care.
Sarah has one primary nurse, Justin, who takes care of most of her physical needs each day. Justin is responsible for maintaining her personal hygiene—bathing, dressing, and grooming—as well as ensuring she is comfortable when transferring to and from her wheelchair and bed. Justin has a great reputation at the nursing home for always being willing to take care of patients who need a little extra care.
George’s family did extensive research before deciding on a nursing home facility. The family decided on a nursing home that had a fantastic reputation and apparently caring staff representing diverse backgrounds. When he initially settled in at the facility, George had a good relationship with the caregivers and staff, and he made several new friends among the facility’s residents.
However, lately, George’s family has noticed that he has sustained a few more injuries than expected. When questioning George about how he sustained the injuries, he brushed it off, stating that his own clumsiness was the culprit. Family members begin to notice that George has grown increasingly withdrawn over the past several months. However, they believe his behavioral changes are a result of his hearing loss and declining cognition.
Bob’s family couldn’t afford an expensive high-end nursing home, and, unfortunately, his retirement fund ran out earlier than anticipated. As a result, he had to opt for a more affordable nursing home located nearby his home. Bob gets along well with the staff, caregivers, and residents at the facility.
Initially, Bob was thriving and the facility seemed to be a great fit for him. While the nursing home itself may appear to be a bit worn-down, the caregivers and staff seem to genuinely care about the seniors who live in the nursing home. All the residents appear to be relatively happy and healthy, and Bob’s family assumes that he receives the care that he needs.
Which Scenario Is Most Likely to Indicate Elder Abuse?
Unfortunately, the seniors in each of the scenarios described above are vulnerable to various types and degrees of elder abuse. Despite the appearance of adequate care and attention to residents’ well-being, many elders, nonetheless, suffer abuse in nearly identical circumstances.
Oftentimes, discovering and recognizing signs of elder abuse requires attention and diligence from family and friends. As soon as abuse is suspected, action must be taken to prevent any further harm. When deciding whether abuse may have occurred, consider the individuals described above in the following scenarios:
One day, a new nurse, Ellie, comes into Margie’s room at the nursing home. She knows that Margie, like the other residents of this upscale nursing home, has a substantial sum of money at her disposal. Ellie is also aware that Margie has a reputation for responding caringly and compassionately to others in need.
Ellie plans and reveals a sob story about an unplanned pregnancy and having no money to raise a child. Ellie expresses that her current financial situation will not be enough to make it through the maternity leave period the facility provides. Naturally, after learning of Ellis’s unfortunate circumstances, Margie offers some money to help her through such a difficult time. Ellie leaves happier with cash in her pocket; however, it is not long before she returns to visit Margie.
When Ellie visits, she never asks for money directly, but also never spares any details when describing her personal problems to Margie, many of which can be solved by “just a little” financial help. Before long, Ellie has accepted a considerable amount of money donated from Margie, and then Ellie suddenly disappears. Because of Margie’s compassionate nature, she was a target for financial abuse from a selfish caregiver.
Ed’s quality of life slowly but substantially decreases over time. He isn’t shaving as regularly as he typically would—a grooming task that should be managed and performed by his caregiver regularly. Ed has developed a persistent odor, and the refrigerator in his unit is never stocked with food. His family has noticed some food items in the pantry, but it is never food that Ed likes. Finally, Ed falls ill unexpectedly: a combination of a pre-existing heart problem that was previously managed with medication and apparent malnutrition.
Eventually, the family members discover that Ed’s caregiver is not showing up as often as he is being paid to, and he does not provide the services he promised he would. The first sign of potential abuse was the caregiver’s failure to timely fill Ed’s prescriptions. However, the lack of care became more serious when the caregiver failed to provide Ed with even basic assistance, such as ensuring he was eating.
Despite Ed’s diminished physical capacity, the caregiver continued to neglect Ed by failing to provide adequate care. Unfortunately, Ed’s family was unaware of the severity of the abuse for a long period of time, in part, because Ed’s generation simply doesn’t complain about themselves, fearing to express any weakness. At times, Ed even took steps to hide that neglect from his family members.
Alice’s son-in-law constantly tells her that she is a financial burden to the family and that she is a waste of space. He bullies her and makes her feel unwelcome in their home, which is supposed to also be Alice’s home. Not only that, he refuses to allow her to have any friends over to visit, and makes her feel incapable when she mentions going out to meet them. Alice has suffered emotional abuse from her son-in-law for several years. Unfortunately, reporting her daughter’s husband abuse could be a bit awkward, so she chooses to keep quiet. And, with no other place to go, she chooses to stay and endure the abuse.
While Justin appears to take great care of Sarah, his hands constantly slip as he works with her. He has fondled her private areas on multiple occasions. She often finds him leering at her while she waits for him to dress her. Sarah does not want to mention this sexual abuse, because she fears that no one will believe her. Besides, she’s not sure he has actually raped her. Nevertheless, Sarah has suffered years of sexual abuse at the hands of this man.
George’s injuries continue to worsen over time. One day, he turns up with a black eye that clearly did not come from “stumbling into a wall.” Finally, his family learns that he has suffered abuse by one caregiver, who pushes him around and pinches him to make him follow instructions. George chose to suffer this abuse in silence because it made him feel “weak.”
While Bob receives the essentials for taking care of himself, as his physical condition deteriorates, he is not provided adequate care. Medical problems may go undiagnosed for several days before he is seen by a doctor or offered medical treatment. Bob experiences rapid degression.
After he ends up bedridden, Bob frequently gets bedsores due to inattention. He also starts to show signs of malnutrition over time, and his family discovers that he frequently misses meals because the nurses forget to deliver it to him. The staff at the nursing home genuinely cares for him and their other patients; however, they struggle to maintain a high standard of care because they are understaffed and receive inadequate training.
Each year, far too many seniors suffer abuse at the hands of their caregivers, just like those described above. Although abuse occurs more frequently in nursing homes, whether residing at home or in a facility, elders who require caregiver assistance are at risk of abuse.
Common Signs of Elder Abuse
Elder abuse is almost always difficult to discover.
Friends and family should know some common signs of abuse, including:
- Unexpected injuries and bruising. Many victims of abuse have unexplained injuries or suffer more frequent injuries than they should, given their current physical capabilities.
- Missing money. Financial abuse may become apparent when an elder’s money is unexpectedly missing. If an adult child takes over the senior’s bills and accounts, and the senior’s bills do not get paid, it may be indicative of financial abuse.
- Withdrawal. Many seniors express symptoms of withdrawal when suffering from abuse. They may feel ashamed due to their inability to stop the abuse and be embarrassed to reach out for help. Many seniors will not report abuse and may even deny it when directly questioned.
- Signs of deteriorating physical health. In cases of physical abuse and neglect, friends and loved ones may notice the senior’s physical health begins to deteriorate. The senior may, for example, show signs of malnutrition or dehydration. Seniors who previously managed medical conditions with medication or by following doctors’ orders may suddenly have much more trouble managing that condition.
- Deteriorating quality of life. A senior who shows signs of declining quality of life may no longer be bathed, changed, or groomed. A senior living at home might not have adequate food in the cabinets, or might have a fridge filled with expired food. Living spaces may be in disarray and daily tasks may be ignored.
- Adverse reactions to specific caregivers. Seniors may show signs of distress when abusive caregivers enter the room, or request that specific caregivers not enter their room.
- The senior mentions abuse. In some cases, including seniors with Alzheimer’s or dementia, family members might brush off allegations of abuse or assume the senior exaggerated. Family members and friends should always take allegations of abuse seriously and investigate it quickly.
Seniors often grow more vulnerable to abuse and neglect as they age. Friends and family members should carefully watch for any signs of abuse and take allegations of abuse seriously. If you suspect abuse of a senior loved one, contact an experienced elder abuse attorney as soon as possible to learn more about your next steps.