Signs of Elder Abuse

Recently I wrote about under-appreciated caregivers who “can’t get any respect.”  However that observation is not true about all elder “caregivers.”  Sometimes the “caregiver” is abusing the elder. What are the signs of elder abuse?

Let’s describe the scene for both categories.  First in both cases we typically have a sole child who is living with the parent. Second we have siblings who are too busy to be much involved except for weekend visits. Third, sometimes but not always, the elder parent does not want to leave the home or have “too much excitement.” This latter case usually involves a parent who is in the mid-stages of a form of dementia and has difficulty processing unfamiliar stimulation. Often they would prefer the familiarity of their home rather than venturing outside.  In both categories the parent is reliant on the caregiver for daily needs.

So, what are the signs of elder abuse?  The National Institute on Aging, a division of the National Institute of Health has a handy page with a downloadable graphic:

Here are the signs to be aware of:

1. Isolated from family and friends.  This isolation is caused by the caregiver, not as a result of the parent refusing to socialize. A familiar example is “Don’t come over to visit mom today, she’s not feeling well.” Such caregiver behavior may be a manifestation of intentional control of the parent so that he or she does not complain to others. Control is sometimes exercised by threats of going to a nursing home with words such as “Nobody else has time to care for you. If you don’t behave I will have to put you in a nursing home.” We have seen cases where this kind of control was used so that the child could “party on Mom’s money.”
2. Unusual purchases made: The child may make purchases the parent never would. These items might be items such as a well-stocked liquor cabinet, entertainment center with expensive streaming services.  The parent’s savings account will show substantial cash outlays as well.
3. Seems depressed, fearful or withdrawn.  This symptom is most notable where the parent was outgoing and energetic. even where that is not the case the change in relating to other children.  It is evidence of physical or psychological abuse used to control the parent into submission.
4. Has unexplained burns or scars.  From my experience the most common symptom is bruising from physical violence.  Sometimes the bruises are in places unlikely to be the result of a fall.
5. Appears dirty and unkempt. Here the hair may be stringy and evidencing of a lack of bathing. Odorous. Clothing may be well worn, wrinkled and have food stains.
6. Underfed or dehydrated. This is obvious evidence of a lack of proper nutrition.

What looks like elder abuse, but maybe it isn’t.

Any one of the above signs may or may not indicate abuse. Alzheimer’s Disease is infamous for its “difficult behaviors” phase.  For example many dementia patients will not take a shower because water in their face causes agitation. Similarly they may fight having their clothes taken off for bathing or bedtime.  A weary and overstressed caregiver may just cope with “good enough.”  But when more than one symptom occurs there may be trouble. 

In the financial arena questions get much more complicated. Are purchases made to benefit the caregiver abusive? Are those “gifts” manipulated  with threats such as “I will have to put you in a nursing home unless . . . ”  Are they true recognition of the value of the caregiver’s benefits and personal financial sacrifice?  These financial decisions that benefit the caregiver should be with awareness of the whole family.  If there is unreasonable disagreement elder mediation may be the answer. 

In any event questions regarding possible elder abuse should be dealt with immediately lest the family irrevocably split after spending thousands of dollars in legal bills.

Moral: See potential problem? Resolve it as soon as possible before matters get worse.  See an elder law attorney or a geriatric nurse or social worker consultant.