Elder abuse is defined as
[1]:
Intentional actions that cause harm or a serious risk of harm to a vulnerable elder by a caregiver or person who stands in a trust relationship with the elder, or failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.
According to the National Center for Elder Abuse (
NCEA), elders who experience abuse have a 300% increased risk of death, as well as worse physical and mental health. Elder abuse and neglect lead to about $5.3 billion in annual health care expenditures in the U.S., and financial exploitation is estimated to cost elders $2.9 billion annually.
We often think of abuse as physical violence. However, in older patients the primary forms of abuse are intentional neglect, followed by financial exploitation and emotional abuse.
The different forms of abuse are as follows (adapted from:
[1],
NCEA, and Tintinalli’s textbook of EM)
- Neglect - Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable elder
- Exploitation - Illegal taking, misuse, or concealment of funds, property, or assets of a vulnerable elder
- Physical Abuse - Inflicting, or threatening to inflict, physical pain or injury on a vulnerable elder, or depriving them of a basic need
- Emotional Abuse - Inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts, including threats, intimidation, and harassment
- Sexual Abuse - Non-consensual sexual contact of any kind, coercing an elder to witness sexual behaviors
- Abandonment – Desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person
Some sources also include self-neglect:
- Self-Neglect – failure or inability to provide oneself with sufficient food, clothing, shelter, medical, or hygiene, or inability to perform self-care tasks
In a study
by the DHHS and the NCEA of 71,000 substantiated claims of abuse (many of which involved multiple types of abuse), neglect occurred in almost half of cases, psychological and financial abuse in 35% and 30% respectively, and physical abuse in 25% of cases.
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