Elder Abuse

Elder abuse can occur anywhere, including at home and in care settings. People living with dementia are especially vulnerable because the disease may prevent them from reporting the abuse or recognizing it. They also may fall prey to strangers who take advantage of their cognitive impairment.

Elder abuse is the intentional or negligent act by any person that causes serious harm to an older adult. This harm may be physical, mental, emotional, sexual, and/or financial. Older adults with dementia are especially susceptible to abuse — as many as 62% of them experience psychological abuse and as many as one-fourth have been physically abused.

Additionally, one study found that 60% of elderly victims of sexual abuse have cognitive impairment. Nearly one-third (31%) of adults with dementia have experienced more than one form of abuse.

“People living with Alzheimer’s and other dementia are particularly vulnerable to elder abuse, including verbal, physical, psychological and financial,” said Monica Moreno, senior director of care and support at the Alzheimer’s Association. “As the disease progresses, these individuals are dependent on others for their care and that alone makes them vulnerable. The fact that these individuals may also struggle to communicate abuse or do anything about it only adds to the problem.”

Many people living with Alzheimer’s and other dementia — especially those in the middle and late stages of the disease — may have limited exposure to others, making identifying and helping abused individuals more challenging. These challenges are further exacerbated by the fact that caregivers — both family and professionals — are most often the abusers of older people. In many cases, stress and frustration may unintentionally provoke violent feelings. Common signs of elder abuse include:

• Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.
• Unexplained withdrawal from normal activities, a sudden change in alertness, or unexpected depression may be an indicator of emotional abuse.
• Bruises around the breasts or genital area may be a sign of sexual abuse.
• Sudden changes in financial situations may be the result of exploitation.
• Bedsores, unattended medical needs, poor hygiene, and unusual weight loss may indicate neglect.
• Belittling, threats, or other uses of power by spouses, family members or others may indicate verbal or emotional abuse.
• Strained or tense relationships and frequent arguments between the caregiver and person with disease may be a sign of abuse.

It should be noted that abuse can also originate from the person living with dementia. A person with dementia may exhibit more aggressive behaviors as the disease progresses and cognitive function and the ability to reason decline. The Alzheimer’s Association offers guidance for caregivers to address challenging disease-related behaviors, including anger and aggression. The Association also offers a 24-7 Helpline (1.800.272.3900) to help caregivers and families on various disease-related issues and challenges.

“Caregiving can be incredibly stressful,” Moreno said. “It’s really important to build a support network and reach out for help when you need it. One of the most common themes of abuse we’ve identified through our 24-7 Helpline are situations in which caregivers are overwhelmed to the point that a family member living with Alzheimer's or dementia is not getting the care they need.”

Financial Abuse

One growing area of abuse for seniors is financial abuse or fraud. Studies show that financial exploitation is the most common form of elder abuse, robbing America’s seniors of $2.9 billion each year, according to the U.S. Senate Special Committee on Aging.

Seniors living with dementia can be particularly vulnerable to financial abuse. As memory and other thinking skills decline, many of these individuals struggle to make good financial decisions. Signs that may indicate a person is having problems with money or potentially being taken advantage of include:

• Piles of unopened bills.
• Electricity, gas, or other utilities that get shut off because bills were not paid.
• Unusual or large purchases.
• Buying the same thing more than once, or buying things they don’t need (like dog food when the person doesn’t have pets).
• Giving money to every telemarketer who calls, or sending money in the mail to every company who asks.
• They might give money to the same person or company multiple times.
• Missing money or unexplained withdrawals from the person’s bank account.

Protecting Vulnerable Seniors from Financial Abuse and Fraud

Awareness and education are the best defense to prevent financial abuse. Educating yourself on common scams and sharing this information with older relatives is a good first step. The Consumer Financial Protection Bureau offers a comprehensive list of common financial scams on its website. In addition, make vulnerable relatives aware that scammers often will impersonate family members, government agencies, tech support professionals, and others to steal their money and information.

“If your family member has been diagnosed with dementia or is showing early warning signs, it’s really important to have conversations about managing finances sooner rather than later,” Moreno said. “In the early stages of Alzheimer's disease, people are more likely to understand the importance of these issues and suspicious activities to avoid. If you wait, these concepts will be more difficult to comprehend as your relatives' memories and other executive functioning skills decline.”

Conversations, however, may not always be enough. As Alzheimer’s or dementia progresses, family members may need to take a more hands-on approach to protecting loved ones. The Alzheimer's Association offers these suggestions:

• Discuss how a trusted family member or friend can help either with paying bills or setting up automatic billing to avoid late payments.
• Create a separate account where you can keep a small, agreed-upon amount of money that the person can use for recreational activities, meals with friends, etc..
• Sign up to receive automatic notifications for withdrawals from bank accounts or large charges to credit cards. If you set a charge or spending limit and if the person spends more than that, the bank or credit card company will let you know.
• Request electronic bank and credit card statements and watch for unusual purchases or changes in how the person typically spends money.
• Sign up for the “Do Not Call” list at donotcall.gov to protect against telemarketing calls and potential phone scams.  

To help dementia caregivers with wide-ranging financial issues, the Alzheimer’s Association offers a free online education program -  Managing Money. The program is aimed at helping caregivers learn about the costs of caregiving and the benefits of early planning, and teach how to avoid financial abuse and fraud, start a conversation about finances, assess financial and legal needs, and find support.

If your loved one does become the victim of an online scam, you should report the crime as soon as possible. The Federal Trade Commission, the FBI’s Internet Crime Complaint Center, and the AARP Fraud Watch Network Hotline (1-877-908-3360), offer dedicated staff and resources to help those victimized by financial fraud.

Protecting Vulnerable Seniors from Elder Abuse

There are currently more than 6 million Americans living with Alzheimer’s disease and more than 11 million family and friends providing their care. By 2050, the number of Americans living with Alzheimer’s is expected to reach nearly 13 million.

“Ensuring individuals living with Alzheimer’s and other dementia receive the competent and compassionate care they deserve is something all Americans can support,” Moreno said. “The most basic thing each of us can do is to simply listen to older adults and their caregivers to understand their challenges and provide support in any way you can.”

If you think a vulnerable senior is being abused — physically, emotionally, or financially — report it. If the person is in immediate, life-threatening danger, call 911. In addition, the National Center on Elder Abuse offers a state-by-state directory of local investigating agencies and resources.