Elder abuse refers to any of several forms of maltreatment of an older person by a caregiver, family member, spouse, or friend.

Categories of elder abuse

The 1987 Amendment to the Older Americans Act identified three separate categories of elder abuse:

• Domestic elder abuse usually takes place in the older adult's home or in the home of the caregiver. The abuser is often a relative, close friend, or paid companion.
• Institutional abuse refers to abuse that takes place in a residential home (such as a nursing home), foster home, or assisted-living facility. The abuser has a financial or contractual obligation to care for the older adult.
• Self-neglect is behavior of an older adult that threatens his or her own health or safety. Self-neglect is present when an older adult refuses or fails to provide himself or herself with adequate food, water, clothing, shelter, personal hygiene, medication, and safety precautions.

Acts of elder abuse

Elder abuse can include:

• Acts of violence, such as hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. The inappropriate use of medications or physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse.
• Forced sexual contact or sexual contact with any person incapable of giving consent. It includes unwanted touching and all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photography.
• Emotional or psychological abuse, such as name-calling, insults, threats, intimidation, humiliation, and harassment. Treating an older person like a baby, giving an older person the "silent treatment," and isolating him or her from family, friends, or regular activities are examples of emotional or psychological abuse.
• Neglect, such as failing to provide an older person with food, clothing, personal shelter, or other essentials, such as medical care or medications. Neglect can also include failing to pay nursing home or assisted-living facility costs for an older person if you have a legal responsibility to do so.
• Abandonment or desertion of an older person by a person who has the physical or legal responsibility for providing care.
• Illegal or improper use of an older person's funds, property, or assets. This includes forging an older person's signature, stealing money or possessions, or tricking an older person into signing documents that transfer funds, property, or assets.

Risk factors for elder abuse

Abuse of elders is a complex problem with many contributing factors. Risk factors include:

• Domestic violence carried over into the elder years. A substantial number of elder abuse cases are abuse by a spouse.
• Personal problems of caregivers. People who abuse older adults (particularly their adult children) are often dependent on the older person for financial assistance and other support. This is often due to personal problems such as mental illness or other dysfunctional personality traits. The risk of elder abuse seems highest when these adult children live with the older person.
• Social isolation. Caregivers and family members who live with an older person have the opportunity to abuse and often attempt to isolate the older person from others to prevent the abuse from being discovered.

Signs of elder abuse