What is elder abuse? Spotting the signs & helping those at risk

Female doctor and senior man

One in 6 people over age 60 has experienced elder abuse, yet few of us know much about the issue. One reason for that: elder abuse is an underreported crime.

“Elder abuse is underreported for many reasons,” says Laura Bertrand, a licensed professional counselor and mental health expert at BlueCross BlueShield of Tennessee.

  1. When it’s children taking care of elderly parents, the parents don’t want to get their kids in trouble. Yet, nearly 60% of elder abuse happens at the hands of a family member.
  2. If there’s abuse going on in elder-care facilities, the people being abused may have illnesses that keep them from communicating effectively.
  3. In one-on-one situations, the person being abused may fear retaliation from the abuser if they talk to someone.

“In general, elder abuse is a complex issue, which is exactly why we need to talk more about it.”

What is elder abuse?

Bertrand: Elder abuse is:

An intentional act


Failure to act

By any person trusted to care for an adult aged 60+ That causes harm


Increases the risk of harm to the older person

Common forms of elder abuse 

  • Physical
  • Psychological/emotional
  • Verbal
  • Sexual
  • Financial
  • Neglect
  • Abandonment
  • Exploitation

Bertrand: Elder abuse comes in many forms.

  • Neglect is very common. And from a brain-health standpoint, it’s as damaging as physical or emotional abuse. It’s also much harder to prove.
  • Financial abuse is also very common. It can range from forging checks or using a person’s credit cards to changing names on a will, life insurance policy or house title.

In care facilities, elder abuse could include:

  • Forcing patients to use the bathroom by themselves when they’re not capable of doing that safely or in a sanitary way.
  • It could also be as extreme as forcing a patient to withdraw and hand over their social security money.
  • Also, elderly women are also at a high risk of being sexually assaulted, with more than 3% of all the women who are raped each year being over age 60.

What are the signs of elder abuse?

Bertrand: It can be difficult to differentiate the signs of elder abuse from the signs of aging. For example, older people bruise easily. So a bruise on the arm could be a sign of abuse or it could be from someone helping them into the shower. Look for changes over time, or for one or more signs of abuse occurring in combination. Most of all, try to create a relationship with your loved one where you can ask when you have concerns.

Signs of elder abuse

The National Institute on Aging says to take note if your loved one:

  • Stops taking part in activities they enjoy
  • Routinely has unwashed hair or dirty clothes
  • Has trouble sleeping
  • Loses weight for no reason
  • Becomes withdrawn
  • Acts agitated or violent
  • Isn’t being given their medications as directed
  • Displays signs of trauma, like rocking back and forth
  • Has unexplained bruises, burns, scars or cuts
  • Shows physical signs of punishment or being restrained
  • Has broken eyeglasses/frames
  • Develops bed sores
  • Lacks medical aids (glasses, walker, hearing aid, dentures)
  • Receives an eviction notice
  • Is living in unsafe or unclean conditions
  • Has unpaid bills despite having adequate financial resources

Bertrand: If your loved one is in a facility, check in with the staff regularly to ensure they’re being given medications correctly and at appropriate times. If someone walks in and your loved one stops talking quickly, that can be a warning sign. Take note of smells: Has your loved one been bathed lately? Is the adult diaper being changed? Are their sheets clean? Is clean clothing available?

Try to come in regularly to check on them, and call or Facetime them daily or every other day if possible. It’s much harder to abuse or neglect someone who has regular attention from their family. And if you can keep a baseline of what’s normal, you’re much more likely to notice if something is going on.

Are any elders more at risk of abuse?

Bertrand: Elder abuse happens across all demographics, but it may be more common for people who:

  • Have ongoing illnesses
  • Have disabilities
  • Are declining in physical strength
  • Have a deteriorating mental condition or live with someone who has a mental condition

Dementia, for example, can cause people to be violent or aggressive. Caretakers and/or victims don’t always ask for help in those situations because they don’t want to direct blame at their impaired loved one. That’s another reason it’s so important to keep the lines of communication open.

What can you do to help someone who may be at risk?

Bertrand: If your family member is in a facility, do your due diligence. Get to know the staff, and make sure that you’re in contact with your family member as much as you can be, even if that’s challenging due to Alzheimer’s or dementia. Look for staff turnover. Abused people abuse people. So if everyone at the facility is working long hours for little pay and they’re understaffed, it’s hard to take care of patients properly.

If active abuse is going on, contact the police if it’s safe to do so. But know that contacting the authorities is not a safe thing to do in every abuse situation. This can be difficult to understand if you haven’t experienced it firsthand. Adult protective services (APS) may also be a good option.

The one thing we know for sure is that elder abuse won’t stop on its own. Tennessee is a mandatory reporting state. This means that if you see or suspect that an adult is being abused, neglected, or exploited — you must report it.


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Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).

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Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.

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Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).