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June 3, 2024

Elder Abuse Awareness for the Healthcare Workforce

Part 1 in a series of articles to support World Elder Abuse Awareness   


Please feel free to repost, print and make available to your workforce members.

Detecting elder abuse can be difficult.  AIHC is publishing a series of articles to help providers and workforce members detect potential abusive situations in support of World Elder Abuse Awareness Day which is recognized on June 15th.

  • Please feel free to repost, print and make available to your workforce members.  This information can be useful when completing a Social Determinants of Health (SDOH) risk assessment and any time a health care professional determines it is necessary to gain a deeper understanding of presenting problems which are warning signs of elder physical, sexual, psychological abuse, abandonment, neglect and financial extortion.

Time to Stand Up for the Elderly

Victimization and abuse of older adults is an important subset of crime. People age 65 and older experience the same crimes as the rest of the population, including financial victimization, neglect, and physical, sexual, or emotional abuse. However, older adults may be less likely to recover from their victimization and are often sought out because of their age and decreased likelihood of reporting.

Researchers estimate that approximately 10% of older adults over age 60 experienced some form of elder

abuse in the past year. However, studies have also shown that crimes against older adults are highly underestimated.

People with degenerative diseases or cognitive disabilities, which include dementia, Alzheimer’s, and Parkinson’s, or those living in institutional settings such as nursing homes, are often not included in surveys. Additionally, while studies demonstrate that older adults are most commonly maltreated by family members or acquaintances, roughly half of violent victimizations are perpetrated by strangers.

Maltreatment is not always a criminal offense, but the intimate nature of many of these victimizations means that older victims are less likely to report offenses committed by someone they know.

Elder abuse can have several physical and emotional effects on an older adult. Victims are fearful and anxious. They may have problems with trust and be wary of others. Many victims suffer physical injuries. Some are minor, like cuts, scratches, bruises, and welts. Others are more serious and can cause lasting disabilities. These include head injuries, broken bones, constant physical pain, and soreness. Physical injuries can also lead to premature death and make existing health problems worse.

When an elderly person is mistreated, they may hesitate to admit the incident due to the desire to have autonomy and control.  The victim may fear that admitting the mistreatment could remove what little autonomy they have left.  Therefore, it is important for health care providers and loved ones to be aware of signs that a patient or loved one has been abused or exploited.

What It Is

Elder abuse is an intentional act or failure to act that causes or creates a risk of harm to an older adult. An older adult is someone age 60 or older. The abuse occurs at the hands of a caregiver or a person the elder trusts. Common types of elder abuse include:

  • Physical abuse is when an elder experiences illness, pain, injury, functional impairment, distress, or death as a result of the intentional use of physical force and includes acts such as hitting, kicking, pushing, slapping, and burning.
  • Sexual abuse involves forced or unwanted sexual interaction of any kind with an older adult. This may include unwanted sexual contact or penetration or non-contact acts such as sexual harassment.
  • Emotional or Psychological Abuse refers to verbal or nonverbal behaviors that inflict anguish, mental pain, fear, or distress on an older adult. Examples include humiliation or disrespect, verbal and non-verbal threats, harassment, and geographic or interpersonal isolation.
  • Neglect is the failure to meet an older adult’s basic needs. These needs include food, water, shelter, clothing, hygiene, and essential medical care.
  • Financial Abuse is the illegal, unauthorized, or improper use of an elder’s money, benefits, belongings, property, or assets for the benefit of someone other than the older adult.

Elder Abuse is a Serious Problem

According to the Centers for Disease Control (CDC) and other government agencies (DOJ, FBI), elder abuse is a serious problem in the United States. The available information is an underestimate of the problem because the number of nonfatal injuries is limited to older adults who are treated in emergency departments.  

  • The information doesn’t include those treated by other providers or those that do not need or do not seek treatment. Additionally, many cases are not reported because elders are afraid or unable to tell police, friends, or family about the violence.
  • Victims have to decide whether to tell someone they are being hurt or continue being abused by someone they depend upon or care for deeply.

The CDC reports that elder abuse is common. Abuse, including neglect and exploitation, is experienced by about 1 in 10 people aged 60 and older who live at home. From 2002 to 2016, more than 643,000 older adults were treated in the emergency department for nonfatal assaults and over 19,000 homicides occurred.

Some groups have higher rates of abuse than others.

  • Compared with women, men had higher rates of both nonfatal assaults and homicides.
  • The rate of nonfatal assaults increased by more than 75% among men (2002–2016) and more than 35% among women (2007–2016).
  • The estimated homicide rate for men increased by 7% from 2010 to 2016.
  • Compared to non-Hispanic Whites, non-Hispanic Black or African American persons, non-Hispanic American Indian/Alaskan Natives, and Hispanic or Latino persons have higher homicide rates (2002–2016).

Overall firearm-specific older adult homicide rates increased between 2014 and 2017.

  • Of the 6,188 victims, 62% were male.
  • The perpetrator was an intimate partner in 39% of firearm homicides and 12% of non-firearm homicides.
  • Common contexts of firearm homicides were familial/intimate partner problems, robbery/burglary, argument, and illness-related (e.g. the homicide was perpetrated to end the suffering of an ill victim, both victim and perpetrator had an illness, or the perpetrator had a mental illness).

An article was published on April 30, 2024 by CBS News entitled Criminal schemes targeting U.S. seniors account for $3.4 billion in reported losses, FBI says.  The article states that Americans over 60 years of age fell victim to so-called elder fraud crimes more frequently last year than during any other year and accounted for an estimated $3.4 billion in total reported losses.

Be Part of the Solution

If you see something, say something to your Compliance Officer, Manager or someone in authority.  Ignoring a potentially harmful situation is to neglect our duty of care to our patients. 

Duty of care is a requirement that a person act toward others and the public with the watchfulness, attention, caution and prudence that a reasonable person in the circumstances would use. If a person's actions do not meet this standard of care, then the acts are considered negligent, and any damages resulting may be claimed in a lawsuit for negligence.

This article is sponsored by the American Institute of Healthcare Compliance (AIHC), a non-profit healthcare compliance training organization. Please re-post this article or print and distribute to your workforce for educational purposes.  Locate more information from your State, local law enforcement, medical society, the Department of Justice as well as the FBI. For more information to obtain online training in corporate compliance, click here.

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