Guide to Elder Abuse and Home Safety

• Dr. Nancy Kusmaul, Associate Professor in the Baccalaureate Social Work program at the University of Maryland, Baltimore County
• Dr. Laura Mosqueda, Professor of Family Medicine and Geriatrics at the Keck School of Medicine of the University of Southern California, and American Society on Aging expert

What is Elder Abuse?

When we think of our seniors, we often picture them surrounded by love, respect, and care. However, there’s a hidden reality that isn’t quite as heartwarming: elder abuse. Elder abuse refers to any act that causes harm or distress to an older person, often taking place where they live or receive care. This abuse is usually perpetrated by someone known to the elder, making it all the more insidious. It’s crucial we understand its different forms and learn to recognize the signs.

Types of Elder Abuse

Elder abuse can take many forms. These are common ones:

• Physical Abuse: Imagine being unable to escape even as you’re hit, pushed, or slapped. Physical abuse occurs when a person inflicts bodily harm on or restrains someone against their will, like locking them in a room or tying them to furniture.
• Emotional Abuse: Emotional abuse can involve hurtful words, yelling, threats, or ongoing neglect. Cutting someone off from their close friends and relatives also falls under this category.
• Neglect: Neglect is characterized by a caregiver’s failure to meet essential physical, emotional, or social needs. This may include the denial of basic needs such as food, medication, or access to healthcare services.
• Financial Abuse: Financial abuse is the unauthorized appropriation or theft of a person’s financial resources or belongings. This may involve forgery, misuse of the individual’s accounts, or unauthorized alterations to legal documents.

Recognizing Signs of Elder Abuse

Seeing signs of abuse is critical to preventing it. Most victims are women, and older adults with disabilities, memory problems, or dementia are likely targets. Frail individuals can become victims due to their perceived vulnerability.

“A few things to notice [and] watch out for: your loved one has stopped responding or is not available to talk anymore, sudden change in mood, bruises on the face/head/neck…frequent phone calls asking for money, rapid decline in physical function,” said Dr. Mosqueda. 

So, what signs of elder abuse should you be looking for? The National Institute on Aging has a list. Some of the signs are:

• Changes in behavior like withdrawal from activities once enjoyed, agitation, or violent outbursts 
• Physical signs including unexplained injuries, bedsores, broken eyeglasses, or evidence of being restrained 
• A decline in personal hygiene
• Weight loss 
• Hazardous living conditions 

Any of these signs might indicate abuse. If you spot them, talk to the older adult, if possible, and report what you see to professionals. You don’t need hard evidence. Your voice can be the first step in ensuring an elder’s safety.

Creating a Safety Plan for Victims of Elder Abuse

Safety planning requires foresight and strategic preparation. For victims of elder abuse, it’s vital to have a safety strategy in place, regardless of their living situations. Below are some specific steps for various circumstances.

If You Are a Victim and Living With The Abuser

• Establish a Support Network: Create a network of reliable individuals who can provide aid in times of crisis.
• Memorize Important Numbers: Memorize emergency contacts or keep a hidden list. This way, help is always just a phone call away.
• Plan an Escape Route: Familiarize yourself with all accessible exits in your home and practice using them. If you plan to move, you can check these cheapest moving truck rental services.
• Have a Go Bag: Keep a bag of essentials (documents, medication, spare keys, cash) handy, ready to grab and go if the need arises.
• Use Code Words: Establish a code word with a trusted individual to signal distress discreetly.

If You Are a Victim Living Alone or Not Living With The Abuser

• Secure Your Home: Improve home security with measures such as security cameras, alarms, or additional locks.
• Stay Connected: Regularly communicate with a trusted friend or relative about your situation.
• Screen Callers: Exercise caution with unexpected visitors or callers.
• Keep Records: Document any instances of abuse, as this evidence may be needed later.
• Limit Information Shared: Be cautious about revealing personal information to potential abusers, as information can be exploited.

If You Are Helping An Older Victim

• Be Observant: Vigilantly monitor for signs of abuse and document them.
• Establish Trust: Earn the trust of the older person through consistency and empathy.
• Offer Support: Reassure the elder of your availability and that they are not alone in this situation.
• Educate: Provide elders with information about elder abuse and their rights, equipping them with knowledge to protect against abuse.
• Report Abuse: If abuse is suspected, report it to the appropriate authorities promptly.

Creating a safety plan can make a world of difference for victims of elder abuse. It’s like having a compass to guide them towards safety and freedom from harm.

Tips to Create a Safe Home and Reduce Elder Abuse

Ensuring safety and security in the home environment is essential to providing comfort and peace of mind for victims of elder abuse. Below we’ll explore some practical steps for enhancing the safety of elders’ living spaces, reducing opportunities for abuse.

Reduce Opportunities for Scams

Scams are nefarious acts designed to deceive and exploit, often leading to significant financial loss for unsuspecting individuals. Older individuals are frequently targeted due to their perceived vulnerability. If you’re a senior, to safeguard against scams it’s important to:

1. Educate yourself about common scams targeting seniors
2. Register with the National Do Not Call Registry to reduce telemarketing calls
3. Never share personal information over the phone or online unless certain of the recipient’s identity
4. Be cautious of anyone pressuring you for immediate action or payment
5. Utilize resources like the National Elder Fraud Hotline (833-372-8311) for help if you suspect a scam

Install Security Features For Your Home

If you’re an elder, your home should be your fortress — a place where you feel secure. Consider:

• Installing security systems such as alarms or cameras to monitor the home and deter potential intruders
• Securing all doors and windows with sturdy locks
• Using motion sensor lighting to illuminate dark areas around the home
• Keep emergency numbers in a prominent place where they’re easily accessible if needed
• Creating a safe room with a reinforced door where you can retreat to and call for help if necessary

Outside of security measures, seniors should also consider home improvements for their safety. “Lighting should be adequate in all areas, especially stairs and hallways, and should be put on motion sensors or be able to be easily turned on at night.  Bathrooms should have lots of grab bars, and people should never use towel bars, furniture, or items not designed to support a body’s weight for assistance,” said Dr. Kusmaul.

“Be prepared with names [and] contact information in case you need help with plumbing, electric, roof, etc. The idea is to have already vetted these folks before you need help so you have time to make sure they’re reliable and honest,” said Dr. Mosqueda.

Look Into General Protective Measures

These protective measures are like your shields, defending against potential harm. Some measures include:

• Regularly changing passwords for all online accounts, ensuring they are strong and unique
• Regularly monitoring financial accounts for any unusual activity
• Keeping confidential documents like social security cards, passports, and bank statements securely stored
• Making use of privacy settings on social media platforms to limit the information accessible to strangers

Build a Support System

Support systems serve as a dependable source of encouragement and advocacy for your well-being. As an elder, to maintain a strong support system:

• Maintain regular contact with friends and family through in-person visits, calls, or video chats
• Engage in community activities to expand your social network
• Connect with local senior services and community organizations for resources and support
• Formulate a plan with your support network for regular wellness checks
• Communicate openly about any issues or concerns you’re facing

Consider Getting a Pet or Service Dog

Pets can offer companionship, providing comfort and unconditional love and playing a vital role in an elder’s support system. It’s critical to take into account the following:

• Research and adopt a pet suitable to the lifestyle and physical abilities of the older person
• Service dogs can be considered, especially for those with physical limitations
• Ensure the pet’s needs, including veterinary care, feeding, and exercise, are met
• Look into local pet support services, which may offer training, pet food assistance, and more

How to Choose The Right Caregivers for Your Older Family Members

“Older adults face rising housing costs, a lack of accessible housing spaces, and fewer available family members and paid caregivers when support is needed,” said Dr. Kusmaul. Choosing the right caregivers, medical staff, or nursing facility for your older family members is a crucial task that requires a patient and thoughtful approach. 

Dr. Kusmaul advises consulting trusted sources such as the American Association for Retired Persons (AARP) and the local area agency on aging when choosing caregivers or facilities.  

“Work with an agency that is licensed and/or do a complete background check on any [individual caregiver] you are considering,” said Dr. Mosqueda. She further advises people to have their older family members interview potential caregivers, check references, and assess their suitability for the role.

Here are some guiding points to help you make the best care choice:

• Understand the Elder’s Needs: The first step is getting a clear understanding of your loved one’s needs. This will help you determine the level of care needed, which can range from help with daily activities to specialized medical care.
• Research and Shortlist: Conduct comprehensive research on potential caregivers and care facilities. Online reviews, feedback from friends or neighbors who have used similar services, or referrals from healthcare professionals can help. Shortlist the ones that meet your criteria.
• Look for Red Flags: Observe a potential caregiver’s interactions with your loved one and others in their care. Any signs of impatience, disrespect, or lack of empathy should be taken seriously. Excessive stress or depression in caregivers can sometimes lead to abusive behavior.
• Interview and Ask the Right Questions: Conduct a thorough interview, asking questions about candidates’ qualifications, experience, and approach to handling challenging situations. Ask how they manage stress and ensure that they use appropriate methods of conflict resolution.
• Check References and Background: Don’t skip this step — it’s vital to confirm the caregiver’s past performance and reliability. A background check will also reveal any criminal history.
• Involvement and Regular Check-ins: After hiring a caregiver, it’s important to stay involved. Regular check-ins and monitoring can help spot any issues early and ensure your loved one is receiving the care they deserve.

Choosing the right caregiver is a critical decision. It requires time and careful consideration, but with a well-planned approach, you can find the right fit for your loved one’s needs, ensuring their golden years are comfortable and safe.

How to Report Elder Abuse

Recognizing signs of elder abuse and understanding how to report it is crucial. It requires alertness and decisive action. If you’ve detected the signs we discussed earlier, it’s essential to act swiftly and firmly. 

Below are the steps you can take to report elder abuse.

Step 1 — Assess the Situation

Is the senior in immediate danger? If the answer is yes, don’t hesitate — dial 911 or contact local police right away.

Step 2 — Adult Protective Services

Adult Protective Services (APS) agencies are like The Avengers for elder care, ready to swoop in and help. If there’s no immediate danger, call the national Adult Protective Services Hotline at 833-401-0832 to be connected to the responsible APS agency in your locality. 

Step 3 — Report Financial Abuse 

If the abuse involves financial matters, reach out to your local district attorney’s office. It has the authority and responsibility to take legal action against those exploiting your loved one.

Step 4 — National Elder Fraud Hotline

In cases of suspected fraud, dial the National Elder Fraud Hotline at 833-372-8311. Launched by the U.S. Department of Justice, this service assigns a case manager to guide you through the recovery process, including filing a Federal Bureau of Investigation (FBI) report. 

You can also tap into resources like the Eldercare Locator, a public service of the U.S. Administration on Aging. It connects you to services for older adults and their families (call 800-677-1116). 

In the battle against elder abuse, we’re all on the same team. By taking steps to report abuse, you become an invaluable ally in safeguarding the well-being of our elder community.

Final Thoughts

Ensuring the safety, dignity, and well-being of our elders is a collective responsibility. When selecting caregivers or dealing with potential elder abuse, having knowledge of the range of resources available is crucial. By leveraging the assistance of these dedicated organizations, we can help safeguard our older adults from harm, ensuring their golden years are filled with respect, care, and peace. As our population continues to age, this commitment to elder care and justice becomes not just a choice but a vital necessity.

Our Experts 

Dr. Nancy Kusmaul: Nancy Kusmaul, Ph. D., M.S.W., is an Associate Professor in the Baccalaureate Social Work program at the University of Maryland, Baltimore County. She received her master’s degree in social work from the University of Michigan and her doctorate from the University at Buffalo. She was a nursing home social worker for more than a decade. Her research focuses on organizational culture, trauma-informed care, and the impact of trauma experiences on workers and care recipients. She is co-chair of the National Association of Social Workers – Maryland Committee on Aging and is a fellow of the Gerontological Society of America. Dr. Kusmaul was a 2019-2020 Health and Aging Policy Fellow. She has done podcasts on aging, trauma, and nursing homes on various platforms.

Dr. Laura Mosqueda: Laura Mosqueda, M.D., is a professor of Family Medicine and Geriatrics at the Keck School of Medicine at the University of Southern California, and a member and expert for the American Society on Aging. She currently serves as the Director of the National Center on Elder Abuse and is a former Health and Aging Policy Fellow. She is a principal investigator for two National Institute on Aging-funded studies on causes, consequences, and prevention of abuse of people with dementia.