Elder Abuse: Know the Signs

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KEY POINTS

Many older adults require care and are vulnerable to violence perpetrated by a caregiver or someone they trust.

More research is needed to uncover the causes for, and solutions to, violence against older adults.

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What is older person abuse?

Older person abuse is an intentional act or failure to act that causes or creates a risk of harm to an older adult. An older adult is someone aged 60 or older. 

The abuse occurs at the hands of a caregiver or other trusted person. Common types of abuse include:1

• Physical abuse is illness, injury, functional impairment, or death resulting from the intentional use of physical force. Examples include hitting, kicking, or pushing.
• Sexual abuse is forced or unwanted sexual interaction. Examples include unwanted sexual contact or penetration or non-contact acts such as sexual harassment.
• Emotional or psychological abuse refers to verbal or nonverbal behaviors that inflict anguish, fear, or distress. Examples include humiliation, threats, or harassment.
• Neglect is the failure to meet an older adult’s basic needs. These needs include food, water, shelter, clothing, hygiene, and essential medical care.
• Financial abuse is the illegal, unauthorized, or improper use of money, benefits, property, or assets for the benefit of someone other than the older adult.

For more information about elder abuse definitions please see Elder Abuse Surveillance: Uniform Definitions and Recommended Core Data Elements. 

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Quick facts and stats

The older adult population is growing faster in the U.S. than are younger populations. The data underestimate the problem because the number of nonfatal injuries is limited to older adults who are treated in emergency departments. The information doesn’t include those treated by other providers or those that do not need or do not seek treatment. Additionally, many cases are not reported because the older adult is afraid or unable to tell police, friends, or family about the violence. 

Abuse, including neglect and exploitation, is experienced by about 1 in 10 older adults who live at home.2 From 2002 to 2016, more than 643,000 older adults were treated in the emergency department for nonfatal assaults and over 19,000 homicides occurred.3

Compared with women, men had higher rates of both nonfatal assaults and homicides.34 The rate for nonfatal assaults increased more than 75% among men (2002–2016) and more than 35% among women (2007–2016). The estimated homicide rate for men increased 7% from 2010 to 2016.3 Compared to non-Hispanic Whites, non-Hispanic Black or African American persons, non-Hispanic American Indian/Alaskan Natives, and Hispanic or Latino persons have higher homicide rates (2002–2016).3

Overall and firearm-specific older adult homicide rates increased between 2014 and 2017. Of the 6,188 victims, 62% were male. The perpetrator was an intimate partner in 39% of firearm homicides and 12% of non-firearm homicides. Common contexts of firearm homicides were familial or intimate partner problems, robbery or burglary, argument, and illness-related (e.g. the homicide was perpetrated to end the suffering of an ill victim, both victim and perpetrator had an illness, or the perpetrator had a mental illness).4

Outcomes

Abuse can have several physical and emotional effects on an older adult. Victims are fearful and anxious. They may have problems with trust and be wary of others.5

Many victims suffer physical injuries. Some are minor, like cuts, scratches, bruises, and welts. Others are more serious and can cause lasting disabilities. These include head injuries, broken bones, constant physical pain, and soreness. Physical injuries can also lead to premature death and make existing health problems worse.45678

Prevention

Violence against older adults can be prevented. Certain factors may increase or decrease the risk of perpetrating or experiencing abuse. Preventing violence requires understanding and addressing the factors that put people at risk for or protect them violence. 

We can all help prevent violence against older adults:9

• Listen to older adults to understand their challenges and provide support.
• Educate yourself and others about how to recognize and report abuse.
• Learn how the signs of abuse differ from the normal aging process.
• Check-in on older adults who may have few friends and family members.
• Encourage or assist persons (caregivers or older adults) who have problems with drugs or alcohol in getting help.

It is also possible to provide over-burdened caregivers with support. This can include help from friends, family, or local relief care groups, adult day care programs, or counseling. 

Knowledge about what works to prevent violence against older adults is growing. However, most prevention strategies and practices have not yet been rigorously evaluated to determine their effectiveness. In the absence of proven prevention strategies, program planners may consider the following sources to strengthen their approach: Applying the Principles of Prevention: What do Prevention Practitioners Need to Know About What Works and What Works in Prevention: Principles of Effective Prevention Programs.

CONTENT SOURCE:

National Center for Injury Prevention and Control

REFERENCES

1. Hall JE, Karch DL, Crosby AE. Elder Abuse Surveillance: Uniform Definitions and Recommended Core Data Elements For Use In Elder Abuse Surveillance, Version 1.0. Atlanta (GA): National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 2016. https://www.cdc.gov/violenceprevention/pdf/ea_book_revised_2016.
2. Acierno R, Hernandez MA, Amstadter AB, Resnick HS, Steve K, Muzzy W, Kilpatrick DG. (2010).Prevalence and Correlates of Emotional, Physical, Sexual, and Financial Abuse and Potential Neglect in the United States: The National Elder Mistreatment Study. American Journal of Public Health; 100:292–7. doi: 10.2105/AJPH.2009.163089.
3. Logan JE, Haileyesus T, Ertl A, Rostad WL, Herbst JH. Nonfatal Assaults and Homicides Among Adults Aged ≥60 Years – United States, 2002-2016. MMWR Morb Mortal Wkly Rep. 2019 Apr 5;68(13):297-302. doi: 10.15585/mmwr.mm6813a1.
4. Shawon, R, Adhia, A, DeCou, C et al. (2021). Characteristics and patterns of older adult homicides in the United States. Inj. Epidemiol. 8(5). https://doi.org/10.1186/s40621-021-00299-w.
5. Anetzberger, G. The Clinical Management of Elder Abuse. New York: Hawthorne Press, 2004.
6. American Medical Association white paper on elderly health. Report of the Council on Scientific Affairs. (1990). Archives of internal medicine, 150(12), 2459–2472.
7. Lachs MS, Williams CS, O’Brien S, et. al. (1998). The Mortality of Elder Mistreatment. Journal of the American Medical Association; 280:428-32. doi: 10.1001/jama.280.5.428.
8. Lindbloom EJ, Brandt J, Hough L, Meadows SE. (2007). Elder Mistreatment in the Nursing Home: A Systematic Review. Journal of the American Medical Directors Association; 8(9):610-16. doi: 10.1016/j.jamda.2007.09.001.
9. Fearing G, Sheppard CL, McDonald L, Beaulieu M, Hitzig SL. (2017). A systematic review on community-based interventions for elder abuse and neglect. J Elder Abuse Negl.; 29(2-3): 102-133. doi: 10.1080/08946566.2017.1308286.

Information source: CDC

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