A recent survey by the Ontario Network for the Prevention of Elder Abuse reported that approximately one in 25 people over the age of 65 suffer some form of abuse. Elder abuse can include physical, psychological or financial abuse or neglect, and can be perpetrated by caregivers, friends, family or even strangers. 

Elder abuse often remains hidden because many older adults feel too uncomfortable or ashamed to report it. Some are reluctant to report it because the abuser is a family member, friend or caregiver. Others may not be able to articulate the abuse they experience. 

What is Elder Abuse?

Any act that harms or threatens the health or welfare of an elderly person constitutes elder abuse. This can include physical, psychological or financial abuse, and neglect. Elder abuse can happen at home, in hospitals or long-term care facilities. It can happen to anyone, regardless of class, gender, race or culture. 

Friends, neighbours or family members are the most likely abusers. In fact, unrelated caregivers are reported to be responsible for less than a quarter of elder abuse cases. 

Physical abuse. Health Canada lists the following types of physical elder abuse:

• Assault
• Rough physical treatment
• Sexual exploitation
• Failure to provide food
• Failure to provide appropriate personal, hygienic or medical care

Since they cannot defend themselves, those who are frail or mentally challenged are at higher risk for physical assault. Those living in residential settings who require care for hygiene, dressing, eating and other basic functions often experience rough treatment, which can be physically harmful and degrading. The use and abuse of restraints (physical, such as geri-chairs; or pharmaceutical, such as sedatives) can also be a gateway to abuse of older adults in institutions. 

Psychological abuse. Health Canada identifies various forms of psychological abuse, including:

• Verbal abuse
• Social isolation
• Failure to provide affection
• Denial of opportunity to make or take part in decisions concerning one's own life

Psychological abuse can range from unintentional insensitivity to outright emotional assault. Examples of overt psychological abuse include ignoring calls for help, placing call bells out of reach, or humiliation in front of peers or family.

Neglect. Benign neglect can include poor care due to staff shortages or misunderstanding of patient needs. It is not unusual for elders living alone, far from their children or other family, to suffer such benign neglect. They may seem to be coping well, but can become malnourished or "shut-in," and unable to handle basic household or hygiene tasks over a relatively short period.

Emotional neglect can be caused by feelings that caregivers don't care about them, are always in a hurry and simply "doing a job." This can make elderly people feel unimportant, devalued and even hopeless. 

Financial abuse. When older adults are frail or suffer from poor memory or cognitive problems, they can become victims of financial abuse. Abusers can be caregivers who take advantage by charging inflated rates or stealing. There are also swindlers who prey on seniors by selling them non-existent products or asking for deposits to provide services that are never completed. 

What to Do if You Suspect Elder Abuse

Talk and listen. If you suspect abuse is occurring, broach the subject and assure the elderly person that you will support them in reporting abuse. Watch for signs of abuse that they may be reluctant to share:

• Poor hygiene or bed sores
• Isolation from family or peers
• Unexplained bruises, injuries or physical complaints
• Uncaring attitudes of caregivers
• Signs of anxiety, fear, depression or hopelessness
• Apparent depletion of income

At home. Elder abuse by family members is often caused by stress and frustration related to family issues or caregiving. Encouraging friends and family to seek counselling support can help. Always report physical assaults to the police.

Be sure to research organizations that provide in-home caregivers and find out their policies on suspected abuse. Check in frequently with the caregiver and the elder to make sure the relationship hasn’t become a potentially abusive situation.

In institutional settings. If an elder friend or relative is in a nursing home, report any suspected abuse to the facility’s management. Write down facts, medical issues, etc. and take photos of injuries. Find out what procedures the institution will follow in taking action. 

Ensure you follow up to see that the alleged perpetrator has been removed from your elder's caregiving team and that the elder is not suffering any repercussions. Research the rules regarding mandatory reporting in your province through your Ministry of Health.

Fraud. Report suspected or known financial scams to the police. Be sure to document this with copies of any written material such as brochures, estimates, etc., and times, dates and names of those involved. 

By being aware, watching for signs of abuse and helping older adults avoid situations that could be dangerous, you can reduce the incidence of elder abuse. Talk to your elder loved ones and give them the information they would need should this shameful treatment befall them.

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