How To Answer Those Tough Questions

About ElderAbuse

NEGLECT | FINANCIAL EXPLOITATION | EMOTIONAL ABUSE | PHYSICAL ABUSE
NEGLECT | FINANCIAL EXPLOITATION | EMOTIONAL ABUSE | PHYSICAL ABUSE

HOW TOANSWER THOSE TOUGHQUESTIONS ABOUT

ELDER ABUSE

This booklet is designed as a reference for your

organization when responding to inquiries about

elder abuse, neglect, and exploitation. Many times,

the inquiries pose some hard-to-answer questions,

and this booklet pulls together what is known

about elder abuse to provide suggestions on how

you could respond. Remember that in addition to

questions about the topic in general, you should

be able to answer this question: “What is your

organization doing about the problem?” Taking a

quick inventory of your organization’s efforts as well

as those at the state and local levels will help you to

be prepared for such a question.

WhatIsElderAbuse?

Elder abuse refers to intentional or negligent acts by

a caregiver or trusted individual that causes harm to

a vulnerable elder. Elder abuse takes many forms,

including:

• Neglect

• Physical abuse

• Sexual abuse

• Financial abuse and exploitation

• Emotional or psychological abuse and neglect

(including verbal abuse and threats)

• Abandonment

• Self-neglect

Each state defines elder abuse differently. (You may

wish to look up your state’sstatutes to see how elder

abuse is defined. For assistance, contact the NCEA.)

According to available data, financial exploitation is

the most common type of elder abuse.

There issome debate overwhether mistreatment

by strangers, rather than by a person in a trust

relationship to the victim such as spouse, child,

or friend, also constitutes elder abuse, neglect, or

exploitation.

Who Is at Risk for Abuse, Neglect,

and Exploitation?

Elder abuse can happen to anyone—a loved one, a

neighbor, and when we are old enough, it can even

happen to us.

Elder abuse affects seniors across all socio-economic

groups, cultures, and races.

Elder abuse can occur anywhere:

• Ina person’sown home

• Innursing homes, assisted living facilities, and

other institutionalsettings

• Inhospitals

Based on available information, women and

“older”elders(80 and older) aremore likely to

be victimized, and mistreatment is most often

perpetrated by the victim’s own family members.

Elder abuse affects seniors

across all socio-economic

groups, cultures,and races.
NEGLECT | FINANCIAL EXPLOITATION | EMOTIONAL ABUSE | PHYSICAL ABUSE

Some common risk factors:

• Dementia

• Mental health orsubstance abuse issues(victim,

perpetrator, or both)

• Social isolation

• Poor physical health, which increases vulnerability and therefore may increase risk

Just How Big Is the Problem?

Unfortunately, we simply do not know for certain.

Although there has been relatively little research on

incidence and prevalence of elder abuse, a recent

study indicated that approximately 11 percent of

U.S. elders surveyed had experienced some type

of abuse or potential neglect during the previous

year. It is important to note that this survey did

not include elders with dementia, a segment of the

population believed to be at even greater risk for

mistreatment, or eldersliving in long-term care

facilities.1

Research suggests that elder abuse is significantly

underidentified and under-reported, and that as few

as 1 in 14 cases of elder abuse come to the attention

of authorities.2

The most recent national statistics for Adult

Protective Services (APS) programs indicate that, in

2003, there were approximately 381,430 reports of

elder abuse, neglect, or exploitation made to APS

across the country.

3

Even when suspicions are reported, the outcomes of

the cases are difficult to track.

Why Does Elder Abuse Remain Such

an“Invisible”Problem?

Like other forms of interpersonal violence, elder 

abuse usually occurs behind closed doors.

Many victims are reluctant to report abuse because

they may:

• Feel ashamed and embarrassed, particularly if a

family member is the abuser

• Be afraid that the abuser will get in trouble

• Worry that they will be forced to live in a nursing home—and this sometimes happens

• Feel guilty or somehow to blame

• Be in denial that the abuse is occurring, or

unaware that what they are experiencing is abuse

or neglect

• Be afraid that if they report, the abuse will get

worse

Some victims are unable to speak out due to

dementia or other impairments, or may not be

believed when they do.

Although this theory hasn’t been fully researched,

there are indications that a culture of ageism

and a fear of growing old may keep older people

marginalized and undervalued in our society, hence

their problems remain invisible or are viewed as

unimportant.

1 Acierno,R. et al., 2010. “Prevalence and Correlates ofEmotional,Physical, Sexual, and FinancialAbuse and PotentialNeglectin the United States:

The National Elder Mistreatment Study.” American Journal of Public Health, Vol. 100, 292-297.

2 National Elder Abuse Incidence Study. (1998.) Washington, D.C.: National Center on Elder Abuse at American Public Human Services Association.

3The 2004 Survey of State Adult Protective Services: Abuse of Adults 60 Years of Age and Older.(2006.) National Center on Elder Abuse.

Manyvictimsarereluctantto

reportabusebecausetheymay

feelashamedandembarrassed.
NEGLECT | FINANCIAL EXPLOITATION | EMOTIONAL ABUSE | PHYSICAL ABUSE

Aren’t Some People Required

byLaw to Report?

Each state has its own reporting requirements, and

manyprofessionalswhoworkcloselywithelders

are“mandatoryreporters”bystate statute.Youmay

wish to look up who in yourstate is designated by

state statute as a mandated reporter. For assistance,

contact the NCEA.

Unfortunately, many mandated reporters may not

make reports, asthey:

• May not receive regular training and education

toaccuratelydistinguishthesignsof“normal”

aging from elder abuse or neglect

• May be in denial about the prevalence of elder

abuse, and therefore not look for or identify

suspicious activities or symptoms

WhatIsNeededto Address

the Problem?

Publicawarenessandgrass-rootsinvolvement

tocreatechange that:

• Increases the identification and reporting of

abuse by the public, professionals, and victims

themselves

• Provides older victimswith a safe environment

to speak out and tell their stories

• Begins long-term prevention by raising awareness among students and young people

Enhanced services for victims:

• To help prevent abuse, more services to reduce

isolation should be available to those at risk for

abuse

• To intervene more effectively, elder shelters and

other support services, such as in-home help and

in-home medical attention, should be established and targeted to at-risk seniors to mitigate

the risk of abuse or to remove them from dangerous situations

• To protect their well-being and assets and to

prevent further harm, adequate services should

be targeted to victims

Enhanced system responses:

• To improve the training of state adult protective

services workers so they are prepared to respond

to increasing numbers of elder abuse reports

• To improve continuing education for mandated

reporters on:risk factors and red flags of elder abuse, what to do when they suspect elder 

abuse, where to report suspicions, and how to

respond most effectively

Research on:

• The scope of the problem (i.e., incidence and

prevalence)

• The causes of the problem

• The effectiveness of interventions and prevention strategies

• The impact and monetary costs of elder abuse

on the lives of seniors, families, communities,

and society in general

WhyShouldICareAbout

Elder Abuse?

The older population in America is continuing to grow

and will burgeon between the years 2010 and 2030,

when the baby boomer generation reaches age 65:

• By 2030, there will be about 72.1 million older

people, comprising almost 20 percent of the total population—nearly twice as many as in 2007

Tohelp prevent abuse, more services

to reduce isolation shouldbe

available tothoseatrisk forabuse.
NEGLECT | FINANCIAL EXPLOITATION | EMOTIONAL ABUSE | PHYSICAL ABUSE

• The 85-plus population is projected to increase

to 6.6 million in 2020, a 15 percent increase

from 20104

Seniors are living longer, but not necessarily

better. Potential declines in cognitive and physical

functions could make them more vulnerable to

victimization. Elders who experience abuse, neglect,

or self-neglect face a considerably higher risk of

premature death than elders who have not been

mistreated.5

It is estimated that elders throughout the United

States lose a minimum of $2.9 billion annually

due to elder financial abuse and exploitation.6

Elder abuse can happen to anyone—a loved one, a

neighbor, and when we are old enough, it can even

happen to us.

What CanPeopleDotoPrevent

Elder Abuse?

Reportsuspected mistreatment to your local adult

protective services agency or law enforcement.

Although a situation may have already been

investigated, if you believe circumstances are getting

worse, continue to speak out.

Ifyoubelievethatanelderisinalife-threatening

situation, contact 911 orthe local police orsheriff’s

department.

Learn more about the issue. Visit the National Center

on Elder Abuse website at www.ncea.aoa.gov.

Helpraiseawarenessby:

• Talking about the issue

• Challenging injustice and ageist stereotypes

• Writing letters to the editor

Bea“sentinel”:

• Keep in contact and talk with your older

friends, neighbors, and relatives frequently

• Be aware and alert for the possibility of abuse

• Look around and take note of what may be happening with your older neighbors and acquaintances

• Ask questions and listen

The baby boomers have been a generation of

activists,with a demonstrated ability to create

social change. The time isright to get involved by

promoting community involvement and social

engagement.

Where Can I Find More Information?

Visit the website of the National Center on Elder

Abuse (NCEA): http://www.ncea.aoa.gov/, or

contact us by email: ncea-info@aoa.hhs.gov; 

ncea@med.usc.edu by phone: 1-855-500-3537.

Disclaimer: This documentwas produced fortheNationalCenter

on Elder Abuse (NCEA) by the University of Delaware and was

supported in part by a grant from the Administration on Aging, U.S.

Department of Health and Human Services (DHHS) (90-AM-3146-

03).Grantees undertaking projects under governmentsponsorship are

encouraged to expressfreely theirfindings and conclusions.Therefore, points of viewor opinions do not necessarily represent official

Administration on Aging or DHHS policy.

4 A Profile of Older Americans: 2009. U.S. Administration on Aging. Department of Health and Human Services. Washington, D.C.

5 Dong, X. et al., 2009. “Elderself-neglect and abuse and mortality risk in a community-dwelling population,” JAMA,Vol. 302, 517-526; Lachs, M.S. et

al., 1998. “The mortality of elder mistreatment,” JAMA, Vol. 280, 428-432.

6 ElderFinancialAbuse:Crimes of Occasion,Desperation and Predation against America’sElders.2011. MetLife Mature MarketInstitute.

Keepin contact and talk with

yourolderfriends,neighbors,

and relatives frequently.