What Are the “Warning Signs” of Elder Abuse?

By: Dana Walsh Sivak

NOTE: This article is Part 2 of our Elder Abuse Awareness series published in recognition of Elder Abuse Awareness Day. Visit our blog to read our other articles in this important series.

Once you understand why elderly people are at increased risk for becoming a victim of abuse or neglect, it’s important to understand what the warning signs of elder abuse and neglect look like - because recognizing the signs of potential elder abuse is the first step in taking the action necessary to bring help to victims and protect them from further harm.  

When an older person cannot speak up for themselves – or ask for help – whether due to cognitive decline, fear, isolation, or dependence on a caregiver, it falls to family members, friends, neighbors, and concerned professionals to recognize the signs of elder abuse and take action.   

The warning signs of elder abuse vary, depending on the type of mistreatment involved - and sometimes, signs of elder abuse or neglect can be “missed” or overlooked because of other “normal” aging processes that can look very similar to classic signs of elder abuse or neglect. By educating yourself about detecting signs of elder abuse, you can make a meaningful difference in an elder abuse victim’s life – and possibly even save it – and that starts with knowing what to look for, and when to investigate further. 

Common Signs of Physical Elder Abuse or Neglect

We know that elderly people are at an increased risk of suffering physical abuse, because of their physical vulnerability, dependence on caregivers, and social isolation, among other factors – so it’s important to look for signs that an elderly person may be suffering abuse, especially if they have injuries consistent with violent or abusive contact. 

Physical abuse against an elderly person can reveal itself in a number of ways, most often by physical observations of injuries, such as unexplained bruises, marks, burns, fractures, or repeated emergency room visits by the elderly person.     

In severe cases, signs of physical restraint (such as marks on the wrists, ankles or other parts of the body that may have been tied down to a chair or bed) or sexual activity (especially for an elderly person who is physically immobile or so cognitively impaired that they are incapable of meaningful consent) may indicate a likelihood of abuse, prompting further investigation by medical professionals and law enforcement authorities. Sexual abuse may be indicated by unexplained injuries, sexually transmitted infections, or torn or bloody clothing – any of which would warrant immediate and thorough investigation if discovered, especially in a cognitively-impaired elderly person who lacks the ability to consent. 

It can sometimes be difficult to discern whether physical signs like these are explainable by typical aging processes you would expect an older person to have, such as skin breakdown and other changes, more frequent bruising due to blood thinners, or increased falls due to gait unsteadiness that often happens due to aging. But where these signs are present, it’s important not to automatically discount them as “normal” or unattributable to potential abuse without at least investigating further to determine whether the individual is a victim of abuse.  

Elder Abuse vs. Elder Neglect – Both Require Investigation and Intervention

While not rising to the level of elder abuse, elder neglect is closely related, and can be just as dangerous for the health and safety of an elderly person. Neglect of an elderly person most often occurs in a caregiving situation, where a family member, home health aide, or long-term care facility caregiver is thought to be providing for the well-being of an elderly person, but is not appropriately attending to the individual’s needs.

While many of the warning signs of elder abuse and neglect are the same, there are some distinctions. Some of the signs of elder neglect, more specifically, include poor hygiene/grooming, untreated medical conditions, bedsores, malnutrition, dehydration, or unsafe living conditions. In some cases, potential signs of abuse, like repeated injuries, may be found, through further investigation, to be the result of neglect, such as in cases where an elderly person requiring support and supervision is left on his or her own, unsupervised, and suffers a fall or other dangerous injury.

Signs of Emotional or Psychological Abuse 

Emotional or psychological abuse is also very common in the elderly population; like physical abuse, signs of mental abuse can often be discounted as “sadness” caused by changes in circumstances in the life of an elderly person, versus some deliberate act of harm being perpetrated against them.  

However, behavioral signs in an older adult can be just as telling as physical ones. When an elderly person demonstrates a sudden withdrawal from social situations or normal activities, or shows signs of new or worsening anxiety, depression, or noticeable changes in mental health, these can be signs that something more serious is going on, and that the individual may be a victim of emotional or psychological elder abuse. If a once-social parent or grandparent becomes isolated, fearful around a particular caregiver, reluctant to speak openly, or shows a sudden decline in self-confidence or mental health, those changes warrant a closer look.  

Caregiver behavior matters, too: a caregiver or close family member or “friend” who controls who the older person speaks to, refusing to leave the room during medical visits, or showing hostility or indifference toward the older adult, are all red flags that something may be wrong. 

Detecting Signs of Financial Elder Abuse

Financial exploitation is the fastest-growing category of elder abuse and can be especially difficult to detect. Watch for sudden changes in banking activity, unexplained withdrawals, new names added to accounts or deeds, missing valuables, unpaid bills despite adequate resources, or new "friends" or caregivers who take an unusual interest in the older adult's finances. Be alert, as well, to scams targeting older adults by phone, email, and text, including fake government calls and fraudulent investment pitches. And if an elderly person suddenly mentions a “new girlfriend” or “boyfriend” who seems too good to be true, especially if there is a significant age gap, a disparity in wealth, and/or a long-distance or online component to the relationship – if any financial gifts or transfers are being carried out, these signs of potential financial elder abuse should be thoroughly investigated in case the “relationship” is really a predatory financial scheme against an elderly person.

Who Should Be On “High Alert” for Signs of Potential Elder Abuse and/or Neglect?

Part of the reason why abusers target elderly people is that the abuse can often remain hidden, especially when the victim is largely homebound and requires assistance to leave the home. This allows elder abuse to go on for extended periods of time without anyone noticing or intervening.

For this reason, individuals who have an opportunity to interact with elderly people should remain on high alert for any potential signs of elder abuse and neglect – and those who work closely with the elderly should undergo more extensive training in how to spot these signs of abuse and how to appropriately respond to them. This includes people who work in doctors’ offices and hospitals, banks and other financial institutions, and law firms that practice elder law and estate planning. Since professionals in these settings may be some of the only people to come in contact with an elderly person, remaining up-to-date on training aimed at detecting and reporting elder abuse and neglect can be what makes a difference in protecting victims of elder abuse and neglect, while missing these signs, or failing to act once they are detected, could have catastrophic and tragic consequences.

NOTE: This Elder Abuse Awareness series is published in honor of World Elder Abuse Awareness Day, recognized on June 15th each year to raise awareness about the abuse, neglect, and financial exploitation of older adults.  If you suspect that a loved one is being abused, neglected, or exploited, do not wait for the situation to escalate.   The Elder Law Practice Group at Falcon Rappaport & Berkman helps families across New York protect older adults, hold wrongdoers accountable, and put long-term safeguards in place. Contact us today to schedule a confidential consultation and take the first step toward protecting the older adult you love.  Please visit our blog to read the other articles in this series:

PART 1: Why Older Adults are Vulnerable to Abuse – and Why it Often Goes Undetected

PART 2: What are the “Warning Signs” of Elder Abuse?

PART 3: “If You See Something, Say Something” – Immediate Steps to Take If You Suspect Elder Abuse or Neglect

PART 4: Understanding Legal Options and Protections Available for Victims of Elder Abuse  

PART 5: How an Elder Law Attorney Can Help Protect Victims of Elder Abuse or Neglect (And Why We Do This Work)

DISCLAIMER: This summary is not legal advice and does not create any attorney-client relationship. This summary does not provide a definitive legal opinion for any factual situation. Before the firm can provide legal advice or opinion to any person or entity, the specific facts at issue must be reviewed by the firm. Before an attorney-client relationship is formed, the firm must have a signed engagement letter with a client setting forth the Firm’s scope and terms of representation. The information contained herein is based upon the law at the time of publication.