Signs of elder abuse

• How can I tell if someone has been abused?
• What are the signs that may indicate elder abuse?
• What are the risk factors for elder abuse?

Elder abuse is often hidden. An older person may not identify what’s happening to them as abuse. They may cover up the signs due to fear of what may happen if anyone finds out or they might be unaware that the perpetrator’s actions are a form of abuse.

Be aware of the signs of elder abuse and watch for them in your work. Remember, abuse may be occur without any indicators or signs, and some signs may be caused by something other than abuse. Even if you are not sure, it is best to follow up on any suspicion of elder abuse.

See ‘What are the risk factors for elder abuse?‘ for more information.

Elder abuse can be emotional or psychological, physical, financial, social or sexual. Often more than one type of abuse can occur. See ‘What is Elder Abuse’ for information about the types of elder abuse that can occur.

Emotional (or psychological) abuse

Examples of emotional (or psychological) abuse include:

• pressuring, bullying, belittling
• name-calling
• threatening to harm the person, other people or pets
• refusing access to grandchildren

Signs of emotional (or psychological) abuse include:

• fear
• depression or low mood
• confusion
• loneliness
• feeling of helplessness

Neglect

Examples of neglect include:

• not giving the person the care they need such as adequate food, medical care, warmth, suitable accommodation or dental care
• receiving the Carers’ Allowance and not providing the care required

Signs of neglect include:

• an older person who is hungry, thirsty or has lost a lot of weight
• an older person who is wearing the wrong clothing for the weather conditions
• an older person who is living in an environment that is dirty or unsafe
• an older person whose health problems have worsened due to their medications being mismanaged
• an older person with unexplained conditions such as hypothermia, dehydration or pressure sores

Financial abuse

Examples of financial abuse include:

• moving into the home of an older person without their consent and failing to contribute to household costs.
• forcing, coercing or misleading an older person into signing paperwork concerning loans, property, wills or powers of attorney
• misusing powers of attorney to manage an older person’s finances stealing goods, whether expensive jewellery, electronic equipment or basic necessities such as blankets and food.
• using bank or credit cards without the person’s permission.
• promising to care for someone in exchange for their financial help, then not providing the care.

Signs of financial abuse include:

• missing belongings
• malnourishment
• not having money for basics such as food, clothing, transport costs and bills
• large withdrawals or big changes in banking habits or activities
• property transfers when the person is no longer able to manage their own financial affairs
• fear, stress and anxiety

Physical abuse

Examples of physical abuse include:

• pushing, shoving, slapping, biting, kicking, burning
• rough handling
• restraining with rope, belts, ties or locking them in a room, building or yard
• using chemical restraints such as alcohol, medications, household chemicals or poisons (a blood test would be required)
• holding a pillow over a person’s head

Signs of physical abuse include:

• pain or restricted movement
• bruises, bite marks, cuts, burns, scratches
• unexplained accidents
• unexplained injuries such as broken bones, sprains, punctures
• over or under-use of sedation
• fear or anxiety
• stories about injuries that conflict between the older person and others

Social abuse

Examples of social abuse include:

• preventing contact with family and friends
• withholding mail
• not allowing phone calls or listening into calls
• preventing involvement in religious, cultural, spiritual practices

Signs of social abuse include:

• anxiety, sadness or grief at loss of contact with others
• withdrawal or listlessness
• loss of self esteem

Sexual abuse

Examples of sexual abuse include:

• non-consensual sexual contact, language or behaviour
• inappropriate touching
• sexual assault
• rough or inappropriate cleaning or treatment of an older person’s genital area
• viewing sexually explicit material or making sexually explicit phone calls in the presence of an older person without their consent

Signs of sexual abuse include:

• unexplained sexually transmitted infections
• recent incontinence (bladder or bowel)
• internal injuries
• bruises, bite marks, pain, burn marks
• trauma including bleeding around genitals, chest, rectum or mouth
• torn or bloody underclothing or bedding
• anxiety when near, or contact suggested with the abuser

The complex dynamics in which abuse occurs makes it difficult to determine or identify all factors associated with an increased risk of abuse, however being aware of the risk factors can help you to identify potential elder abuse situations.

Below are a range of circumstances that increase the chance of abuse. The greater number of these factors that influence the situation, the greater the risk of abuse.

Combinations of these factors may indicate a need for additional support and services to reduce the risk of abuse. Remember, an older person who experiences none of these risk factors may still experience elder abuse.

Circumstances that may increase the chance of abuse:

• dependence
• family conflict or dysfunction
• family violence
• Isolation
• disability
• remote living situations
• stress in care relationships
• mature age children or dependents with a disability or health issues
• mental illness and dementia
• poor literacy and/or awareness of rights

‘Age’ itself is also risk factor. Ageism and attitudes to ageing/older people can place people at risk by causing actual abuse or other risk factors to be overlooked, dismissed or minimised. See ‘What is risk assessment’ [link] for more information on assessing someone’s risk.