Warning Signs That May Suggest Elder Abuse
Elder abuse, neglect and exploitation are complex issues with multidimensional symptoms and ramifications and many types of warning signs.
Be alert to a change in any matter, but particularly to any health, wellness or financial issue, and/or the introduction of a new accountant, lawyer, physician, or any other professional caring for a senior citizen thereby separating the elder from established histories and relationships.
Elder exploitation is often subtle and lost in interpersonal nuances.
Any suspicion requires intervention by a trained, licensed professional physician, psychologist or social worker immediately.
Sudden friendships form and/or intensify and cross healthy personal boundaries, for example, the elder can no longer see their own mail.
New medications, vitamin supplements, or other substances are added without the elder being able to explain how, why, when, and who recommended or prescribed it.
Geriatric care is a highly specialized field, and any change to a senior’s care (even if made by another physician) must be reported and/or cleared with the primary care physician.
Medications, especially controlled substances, are missing from or added to a senior citizen’s care regimen.
A relative, friend, neighbor, or any care-giver gives unlikely explanations about finances, medications, and/or changes, and the elder is unaware of, or is unable to explain what arrangements have been made.
If you feel there is any reason to be suspicious, investigate it immediately.
Report it to a professional.
A recent acquaintance communicates an interest or a desire to become involved in an aspect of an elder’s life, especially finances, care-giving, transportation, or companionship, and/or offers or promises to provide care, friendship, or ingratiates him or herself to a senior citizen.
Don’t expect coping and/or other skills to improve.
An elder is unlikely to develop skills, abilities and cognitive ability not present during earlier phases of their lives.
Any appearance to the contrary may indicate that someone else is actively involved.
A relative or care-giver separates and/or isolates the elder from any long established contact, makes excuses when friends or family call or visit, and does not give the elder messages.
Photographs of family members, memorabilia, etc. are missing from an elder’s home.
A Power of Attorney, Will, or any other legal document is drafted, but the senior does not understand it, cannot explain the need for it, and cannot explain or understand what its implications are.
A relative, neighbor or care-giver with no visible means of support or income appears on the scene and/or becomes overly interested in the elder's financial, health or domestic affairs.
Bills are not being paid.
The elder's placement, care, possessions, and “would be” decisions are inconsistent with the amount of his/her assets and/or income and/or previously stated and long established wishes, history, etc.
Checking accounts, credit card statements, financial statements, etc. are sent to a relative, care-giver, or friend and are not accessible to the elder.
At any physician’s office, bank, attorney’s office, insurance company, investment firm, etc., the elder is accompanied by someone who refuses to allow the senior citizen to speak for him/herself, and/or the elder appears nervous, apprehensive, edgy,
or seems uneasy about or fearful of the person accompanying him or her.
The elder is concerned or confused about any valuable including medication, jewelry, money, and/or any other item the elder needs to maintain wellbeing such as glasses, dentures, hearing aids, walkers, etc.
Pay attention to handwriting changes in signatures of a senior citizen on checks, or any other document.
Pay particular attention if the elder signs checks and someone else and/or another style of handwriting fills in the payee and amount sections.
Pay very close attention to checks made out to cash.
The amount of banking activity or spending habits increases, especially after joint accounts are set up and/or someone new starts helping out in any other aspect of a senior citizen’s care.
Family members as caregivers:
Please remember: it’s a misconception that mistreatment in nursing homes is the primary source of elder abuse, neglect and exploitation.
The statistics say otherwise with about 90% of elder abuse and neglect incidents happening within families.
Multigenerational dysfunctional families, greed, ignorance, mental health issues, substance abuse issues, etc. may be at the root cause with many complex issues adding further cloud the dynamics.
Experts link substance abuse issues (particularly alcohol) as a major factor in dysfunctional families.
If anyone in your family is suffering from any substance abuse issue, the risk factors for the elderly climb.
Outsiders as caregivers:
Home healthcare aides offer valuable assistance to seniors who require help to remain independent.
However, those care-givers may be the source of abuse, neglect, or exploitation.
Cost is often a factor in determining who is hired.
Caregivers hired outside of agencies will be more affordable, but they require much more supervision.
The questions listed below will be the responsibility of the person doing the hiring.
Before hiring any aide from an agency, research your state’s licensing procedures and find out:
What’s the track record of the referring agency?
Is there litigation pending against the agency?
What are the agency’s criteria for hiring?
Does the agency do arrest and/or criminal background checks?
Is drug screening mandatory prior to and after hiring?
Are employees bonded, fingerprinted, etc?
Have you checked with the Better Business Bureau about complaints?
Others with hidden agendas:
This group can include a litany of others, such as neighbors, friends, bank tellers, lawyers, real estate agents, handymen, investment advisors, salespeople, telemarketers, etc., and the motive is the same:
manipulating financial aspects of the elder’s life for the perpetrator’s own benefit.
Unscrupulous telemarketers often canvass during the day seeking those who are at home (ex: retired persons with disposable income) to exploit through various scams.
Bear in mind that in California alone, $20 million a day is pilfered from the elderly.
Please place every one of your elderly relatives and neighbors on the "do not call" list to reduce this possibility as a community service.
Agreements, contracts and legal documents:
Any document, contact or agreement that requires a senior citizen’s signature must be understood by the elder.
He or she must understand the reason for the document, what the resulting consequences of the document will be, and be able to explain it.
In other words, if a senior citizen states "yes," they understand the need for any document, i.e., a Power of Attorney, they must also be able to explain the requirement for it.
"Yes" is not an appropriate reply without the elder being able to give an accurate explanation of "what" or "why" or "who" needs that document.
Red flag tactics utilized by elder exploiters or abusers including some identified personality traits:
Seniors with diminishing functional skills, such as memory, mathematical calculation, and information-processing.
Sufferers of particular illnesses like Alzheimer’s, dementia, etc., i.e., those affecting cognitive capacity.
Nutritional deficiencies and/or malnourishment.
Depression and/or social withdrawal.
Those taking certain types of medications (call the prescribing physician and/or a pharmacist for more information).
Those having sensory infirmities like hearing or vision loss.
Not having access to a healthy nuclear family and/or support group.
Those giving consent while not understanding legal and medical ramifications or consequences.
Those appearing to be susceptible to undue influence by anyone.
Elders who have a lack of spending money.
Seniors who never accept invitations to spend time away from their family or a care-giver.
Elders who put off going to the doctor or those not following doctor’s orders.
Those tending to act impulsively on time deadlines to "act now" for any discounted service or care.
Those who have overly difficult, compliant or gullible personalities.
Those with unresolved behavioral issues.
Isolation by choice and/or imposed by others.
Those especially vulnerable to domination, intimidation and threats.
Those with alcohol or any substance related issues.
Elders forming questionable alliances with outsiders and/or family members.
Seniors who are fearful in making their own decisions or those with no capacity to make decisions.
Those hiding something about a care-giver or keeping secrets in general.
Those with mental health issues.
Seniors with any degree of vulnerability to coercion, trickery or deceit.
Senior citizens who are people pleasers or enablers.
Those having a history of domestic violence or who have been victims of it.
Seniors whose care-givers are stressed or ill.
Those who are dependent on others for care, nourishment, housing, etc.
Elders displaying any physical impairment.
The above is a partial list.
Elder abuse, neglect and exploitation are often lost in inter-personal dynamics and nuances and complicated by failing memories, physical impairments and a multitude of other factors.
When in doubt immediately contact a licensed professional specializing in these issues.
No education, intelligence, sophistication level, social or professional standing in a victim and/or perpetrator are exempt or immune from being a victim or a perpetrator of elder abuse, exploitation or neglect.
Elder abuse, like any other form of violence, is NEVER a satisfactory or appropriate response to any situation no matter how desperate, stressed or frustrated any care-giver feels.
Crisis intervention can prevent or stop elder abuse by offering many types of solutions through the supervision of licensed and trained professionals.
Elder abuse, neglect, and exploitation are crimes.
If you suspect elder abuse, neglect or exploitation, please call your local Adult Protective Services and Police Department immediately and follow up with a complaint in writing via certified mail to agencies, physicians, attorneys, newspapers, etc.
Thank you Irene Masiello for writing this book!