Abuse, neglect and exploitation of the elderly

It is very difficult to believe elderly people are at times abused, neglected and exploited. Adventists abhore such behaviour and are committed to do all we can to prevent it. We believe it is important to educate service and care providers and other people about indicators of abuse.

There are various signs that may indicate abuse, neglect and exploitation of the elderly. These can include the following, although on its own one sign is not an indicator of abuse:

Physical appearance

  • Burns, especially located in unusual sites
  • Bilateral bruises on upper arms (from shaking)
  • Clustered bruises on trunk (from repeated striking)
  • Bruises resembling an object
  • Old and new bruises (injury repeated)
  • Bone fractures or signs of fracture
  • Lacerations, welts, black eye
  • Bedsores
  • Unhealed sores, untreated injuries
  • Tremors
  • Broken glasses or frames
  • Lack of prosthetic devices
  • Clothing inappropriate for weather, filthy, torn, too big, rags
  • Lack of clothing
  • Same clothing all the time
  • Shoes on wrong feet
  • Odorous
  • Fleas, lice
  • Rash, impetigo, eczema
  • Malnutrition
  • Wheezing, persistent cough
  • Unintentionally uncommunicative
  • Untreated medical conditions
  • Decayed teeth
  • Swollen eyes
  • Severe or constant pain
  • Swelling of legs
  • Coldness in parts of body
  • Red, painful eyes (glaucoma)
  • Swelling of joints accompanied by weakness or fever
  • Vomiting
  • Shortness of breath
  • Sudden weight loss or gain
  • Blood in excretions
  • Loss of sight or hearing
  • Heat exhaustion
  • Incontinence
  • Dehydration
  • Intentional or unintentional overmedication by caregiver
  • Hair thin as though pulled out
  • Scars
  • Dilated pupils

Behaviour of the person being abused

  • Recent or sudden changes in behaviour
  • Unjustified fear or unwarranted suspicion
  • Refusal to discuss situation or communicate need for help
  • Unwillingness to talk
  • Unreasonable excuses
  • Denial of problems
  • Unaware of how much money they receive and regular monthly expenses
  • Changes in will or in representative payee or in power of attorney
  • Payment of exorbitant prices for services, repairs, rent
  • Depleted bank account with nothing to show for it
  • Large amount of purchases on time-payment plan
  • Chronic failure to pay bills
  • Frequent requests at end of month for supplemental income

Environment

Hazardous condition, such as poor wiring, rotten porch, unventilated gas, broken glass, no locks, roof leaks

  • Many outdated medications from different doctors
  • Medicines not clearly marked
  • Faecal/urine smell
  • Soiled bedding or furniture
  • Evidence of restraints
  • Food is not present, inadequate or spoiled
  • Empty bottles of liquor
  • Lack of electricity, water, heat, toilet and/or cooking facilities, refrigeration
  • House infected with fleas, lice, roaches, rats
  • Burst water pipes
  • Frequent moving
  • Disappearance of personal property or household items
  • Home too cold or too hot
  • Overcrowding

Behaviour of family or caregiver

  • Marital or family problems
  • Continuous friction
  • Striking, shoving, beating, name-calling, scapegoating
  • Conflicts with others in community
  • Hostile, secretive, frustrated, shows little concern, poor self-control, blaming elderly client
  • Denial of problems
  • Arguments within extended family on care provided to client
  • Manipulates client into paying bills, loaning money
  • Alcohol or drug use by family
  • Family has other ill members
  • Resentment by caregiver
  • Caregiver lacks knowledge of client's condition and needed care
  • History of mental illness in the family
  • Client left alone for extended periods of time
  • Excessive payments for care
  • Unusual household composition
  • Caregiver does not provide needed personal care
  • Withholds food, medication
  • Client locked away
  • Caregiver does not allow visitors, and/or family does not interact with client
  • Resentment, jealousy
  • Unrealistic expectations of client
  • Someone other than caregiver brings client for treatment
  • Prolong interval between injury and treatment
  • Doctor-hopping
  • Explanation of injury not feasible or consistent
  • Other unreported injuries found
  • Sudden appearance of previously uncaring relatives
  • Transfer of property, savings, insurance, wills
  • Unexplained cash flow