Congratulations to Aruntathi for winning our 2020 elder abuse scholarship! Below is the fantastic in-depth article that Aruntathi submitted on elder abuse and neglect:
We all have elderly relatives. Some are independent—they can still drive themselves around and remain as capable as they once were; some are completely crippled by disease and confined to a bed, perhaps living with a permanent caregiver.
According to the most recent United States Census data, over 40 million Americans are 65 years or older. The corresponding generation, the “baby boomers,” are one of the largest age brackets to date; they wield almost twelve times the average wealth that millennials do. This is a truly powerful age bracket—a whopping 26% of adults 65 and over live independent lifestyles, while only 5% live in traditional nursing homes.
Minorities, such as African and Asian Americans, tend to care for their elderly at home, while white Americans are more often placed in nursing homes. These statistics are quickly changing as the number of minority groups being placed into nursing homes is set to nearly double as immigration skyrockets and established immigrant communities grow older.
Brooke Astor was one of New York’s most prevalent socialites and philanthropists. She was known as the “Queen of New York,” and her net worth at her time of death totaled over $130 million. Her own son robbed her of necessary Alzheimer’s care while funneling nearly a million dollars from her estate into his pockets. Nobody, not even the strongest and most affluent older adults, is safe from the very real threat of elder abuse.
What is Elder Abuse?
Elder abuse or neglect is intentional action (or lack of action) by a caregiver that causes potential or actual harm to an older adult, sixty years of age or above. This type of abuse may occur in nursing homes, where the nurse is the abuser and the geriatric patient is the victim, but it is most often a domestic issue. Abusers range from an older adult’s children and grandchildren to their spouses. The definition is not limited to physical harm, either: elder abuse can be physical, sexual, emotional, neglectful, or financially fraudulent—all forms of elder abuse are equally crippling and can bring a seemingly independent parent or grandparent down easily.
Fortunately, elder abuse has clear signs that anyone can identify.
Elders who live alone, who are disabled, or who suffer from forms of dementia are the most vulnerable to elder abuse. It is important to remember that any adult, no matter how healthy, could potentially be suffering from elder abuse or neglect. Refer to the graphic for a brief overview of the most common symptoms of elder abuse.
Unexplained injuries are a major red flag as well. It is important to note that elder adults are fragile, often diagnosed with preexisting conditions that make them frail. Still, unexplained sores and bruises, especially around the genital areas, could be a sign of elder sexual abuse—elderly women are more likely to be abused than men at a rate of 3 to 2. If you suspect sexual abuse, check for sexually transmitted diseases as well.
Elders display symptoms of emotional abuse differently. In some cases, those who have been psychologically abused will appear withdrawn, avoiding eye contact and exhibiting low self-esteem. Other older adults may engage in self-injury, attempt to hurt others, experience sharp mood swings, or seem disturbed or terrified.
Neglect can be just as harmful as abuse—in some cases, it can be even more crippling. If you suspect an elder is being neglected, look for bed sores, dehydration, malnourishment, improper medication, as well as soiled clothing and sheets. A combination of many of these signs and symptoms, while not definite evidence that elder abuse is occurring, should be a cause for concern.
As a concerned friend or family member in the digital world, it is important to monitor a loved elder’s finances. Suspicious bank activity such as uncharacteristic withdrawals, unpaid or duplicated bills, or missing valuables could all be signs of fraud.
The Lasting Effects of Elder Abuse:
Due to the ethical constraints of performing invasive research on older adults, it is difficult to uncover the true consequences of elder abuse. In domestic abuse cases involving young, healthy adults, for example, all injuries and psychological issues sustained tend to result from the abuse. As previously mentioned, most elders are already ill and frail, making it difficult to differentiate between signs of abuse and what is simply a result of old age. Despite this, a few studies have been conducted to evaluate the extent of physical and emotional abuse on elders.
According to the National Council on Aging, older adults who have been abused have a 300% higher risk of death when compared to those who have not been mistreated. A 1998 study by the National Institute on Aging revealed that, after a thirteen-year period, only nine percent of a population of elders reported “abused” were still alive compared to forty percent of elders reported “not-abused.” This study’s results are supported by the Benjamin Rose Institute in Cleveland, who conducted the first research on the effects of elder abuse about thirty years prior.
Depression is one of the best-explored effects of elder abuse, though, the methodologies that accompany its study are questionable. It is, however, clear than elders who have been abused or neglected have higher rates of depression than those who have not. Other suggested psychological effects of elder abuse are guilt, shame, learned helplessness, and PTSD.
History of Elder Abuse:
In the earliest days of America, elder care was supplanted by all members of the community. As very few of the New World’s settlers would survive over the age of fifty, drawing aid from neighbors was a manageable, socially-obligated form of aid. This community-sourced care continued, growing increasingly more unmanageable until the early 20th century. In 1935, the Social Security Act established many programs to provide medical care, post-retirement funds, and supported the elderly and the retired.
During the 1950s, public support for older Americans grew as many elders became unable to live independently. “Protective services units” sprouted around the country, offering social services and legal assistance to adults without caretakers.
With the advent of geriatric care grew increasing reports of elder abuse. Congressional hearings at the time referred to the act as “granny battering,” marking the first known official discussion of elder abuse on the Senate floor. Congress made the decision to continue the protective services units and attempted to raise awareness of the issue rather than reboot the program completely. In 1989, the National Center on Elder Abuse introduced an amendment to the Older Americans Act that provided additional nurse certification requirements and expanded the availability of ombudsmen. This was another monumental moment in civil rights history, as it was the first instance that elder abuse was acknowledged in formal legislation. With the introduction of a bill, the concept of elder abuse was beginning to emerge as a significant issue in the eyes of the American public. The Surgeon General at the time, Louis Sullivan, brought up elder abuse alongside familial violence, introducing the topic to American medical professionals and criminal justice officials alike.
Congressional hearings have been held regarding elder abuse (these are usually organized by the Senate Special Committee on Aging). Most notably, the 108th Congressheld conferences on elder physical abuse and elder financial abuse in 2003. These hearings, which included testimony by renowned actor and rumored elder abuse victim Mickey Rooney, had a tremendous social impact by increasing public awareness on the issue.
As a result of increased awareness, reported cases of elder abuse are predicted to rise as the worldwide elderly population increases. Unfortunately, public knowledge on elder abuse remains decades behind child abuse and domestic violence research: a lack of reliable research on the everchanging elderly population leads to outdated information and public misconceptions. Fortunately, new laws and procedures have led to more and more cases surfacing and being properly handled every day.
The Government and Elder Abuse:
Elder abuse is no longer a problem that hides in the fringes of the American conscious—it is seen as an epidemic, and rightfully so.
The American government has instated legislature intended to protect elders from elder abuse. A chief example of this is the 2016 reauthorization of the Older Americans Act (OAA). Enacted in 1965 as a response to the lack of social services for senior citizens, the act supported home- and community-based services that allowed elders to live independently. The 2016 reauthorization of the bill included a new provision: the dedication of government funds to the prevention of elder abuse.
Furthermore, there are Mandatory Reporting laws in place for the times when elder abuse may be suspected. Though the laws vary from state to state, caregivers and healthcare providers are required to report suspected elder abuse or neglect to their state’s Adult Protective Services hotline. In general, state statutes require a criminal history check of to-be caregivers as an extra preventative measure against elder abuse. Physical abuse tends to be criminally prosecuted in states, while sexual abuse is charged as a violation of state sexual assault laws; schemes involving elder financial fraud are usually felonies.
Most recently, the Elder Justice Act (2010) is the first federal legislation to address the abuse and exploitation of elders. This groundbreaking legislation established the Elder Justice Coordinating Committee and provided grants for elder abuse research, updated care guidelines, and intervention education for caregivers.
Unfortunately, elder abuse often goes unreported. An estimated one in ten elders is abused or neglected in some way, but only one in fourteen cases of abuse are reported, according to the National Center of Elder Abuse. Elders may have no family to report abuse to. They may also feel ashamed that they are being abused or fear that their reports will cause further retaliation from their abusers. Many elders simply do not know how to report their abuse. In addition, there are small steps every older adult can take to ensure they do not fall prey to elder abuse or neglect. Refer to the graphic for a brief overview of these steps.
If an elder is healthy and active, they automatically present themselves as self-sufficient and not at all vulnerable. Abusers enjoy preying on the weak, so an independent elder is a less appealing target than a physically weak, socially isolated one. In addition, significant healthcare decisions like Do Not Resuscitate (DNR) orders must be notated in a living will or they may not be respected by a caregiver.
An elder, along with a trusted independent financial advisor, should also stay in control of their own finances and legal matters as much as possible. Keeping sensitive information (think banking passwords and e-mail accounts) secure will only further ensure that an elder’s financial decisions are willing. An elder’s will should be reviewed every five years at the absolute least and once after any major purchases or life events.
Knowing the signs of elder abuse and how to report cases is only the first step to eliminating the epidemic of elder abuse. In a digital society riddled with cunning telemarketers and online schemes, it can be easier than ever for criminals and con artists to exploit vulnerable elders.
If you are an elder currently suffering from abuse or neglect, you have no reason to be ashamed. You are not alone in the struggle: there are many people who are ready to help you and can help you seek justice. Speak to your state’s Adult Protective Services, a healthcare provider, a friend, or a family member. If you suspect that an elder you love is being abused or neglected, contact the Adult Protective Services in your state. If you suspect the abuse has occurred in a nursing home, contact your local Long-Term Care Ombudsman, who has the legal power to intervene.
Of course, if any elder in immediate danger, the priority should be alert 911 or emergency services as soon as possible.
“Elder abuse includes physical abuse.” (n.d). Elder Abuse Facts. National Council on Aging
Enguidanos, S. (2014) Multicultural voices: Attitudes of older adults in the United States about elder mistreatment. Ageing and society vol. 34,5; 877-903.
Feng, Z. (1 July 2011). Growth Of Racial And Ethnic Minorities In US Nursing Homes Driven By Demographics And Possible Disparities In Options. Project HOPE.
Howden, L.M., Meyer, J.A. (May 2011). Age and Sex Composition: 2010. 2010 Census Briefs.
“Passed in 2010, the Elder Justice Act is.” (27 September 2017). The Elder Justice Act. Administration for Community Living.
“Stetson University College of Law, by and through.“ (n.d.). Statutory Updates. Stenson University,
“The Older Americans Act (OAA), originally enacted.“ (3 October 2018). National Committee to Preserve Social Security and Medicare, Older Adult Act
“The Older Americans Act has.” (n.d.) The Older Americans Act of 1965. The Claude Pepper Center.
Wolf, R. (2003). Elder Abuse and Neglect: History and Concepts. In: National Research Council (US) Panel to Review Risk and Prevalence of Elder Abuse and Neglect; Bonnie RJ, Wallace RB, editors. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington (DC): National Academies Press (US). APPENDIX C. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK98805/
Have questions about a recent incident of elder abuse or nursing home abuse / neglect? Please feel free to reach out to the Peck Law Group for your complimentary case evaluation at (866) 999-9085 or use the contact form.
About the Author
Aruntathi Chezhian is our 2019 elder abuse article scholarship winner.