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What is elder abuse?

Interview with Stephanie Marquise

How do states define elder abuse?

There’s a general definition provided by the National Center on Elder Abuse. They define it as any knowing, intentional or negligent act by a caregiver or person that actually causes harm to a vulnerable adult. That includes physical abuse; emotional abuse; sexual abuse; financial exploitation; neglect or abandonment. A lot of states tend to follow that definition.

What is the most common form of elder abuse?

The most common is self-neglect. You may have somebody who is alone in their home and just isn’t necessarily taking care of themselves, or perhaps they may have a problem with their declining health, or they’re isolated, or they have Alzheimer’s or some other form of dementia. In these cases, the elderly person may not be taking their medications or seeking medical treatment for serious illness. Perhaps they have poor hygiene, or are not wearing the type of clothing that they need to be wearing, meaning that they’re overdressed in the summertime or underdressed when its cold. He or she may not be getting enough water and therefore becoming dehydrated or may not be taking care of their home.

The fastest growing type of abuse case is exploitation. The older adults in these cases aren’t necessarily people who are overly wealthy but maybe just aren’t in the best position to make determinations about their finances and they have family members or others in a trusted relationship who take advantage of them.

Do states have mandatory reporting laws? Does this keep the abuse rates down?

Most states do have mandatory reporting laws and about 25% of the reports in those states come from mandated reporters such as physicians. It’s difficult to say if mandatory reporting keeps the abuse rate down because you may people that aren’t reporting abuse so it’s difficult to make that correlation.

How often persons who are being abused or neglected report it themselves?

Eight percent of abuse cases are reported by a family member, the largest portion of that actually split between a spouse or an adult child of the elder. There’s a pretty small number of self-reports of abuse. A lot of the time there is shame associated with it, or not wanting to report a family member. There is also the lack of knowledge about who should they turn to, where should they go. Wisconsin has a program where we are trying to make sure that we are getting more information out to the general public, physicians, or people who have some sort of regular contact with caregivers. We really want to educate them to be aware of the signs of abuse.

Can caregivers in nursing homes be the abusers?

We have a Bureau of Quality Assurance in our State Department of Health and Family Services that goes out and investigates nursing home complaints. If somebody suspects that someone is having problems in a nursing home we would want them to call our department and report it.

What should someone do if they suspect abuse?

If someone suspects elder abuse they should call their local abuse helpline. They can remain anonymous but they need to be prepared to report what happening, when and where it happened, and who they think the suspected abuser might be. In Wisconsin, when a report is received, the local investigating agency will attempt to determine whether the abuse or neglect has occurred, and offer whatever services, resources, information or referrals that they can to stop the abuse or neglect and prevent it from happening again

Can the person who reported the abuse find out the result of their report?

In Wisconsin, for instance, if we have someone who calls in to report abuse or neglect, the person who makes the referral will remain anonymous; their name will be kept confidential. We don’t go out and say “So and so, your son called and he thinks your husband is abusing you.” We don’t tell them that. The results have to remain confidential as well and that is to also help protect the person who is being abused.

How can you determine if an individual with dementia is being abused if they can’t come right out and say it?

One warning sign you want to look for is if they have a vague explanation about how they received any bruises or burns or welts or even breaks. Or if they can’t explain why they are losing money or what’s happening to their finances. A physical signs of abuse is the appearance of malnourishment; does the elder person look dehydrated with dry lips? When you enter their home is there excessive dirt or odors. If an elder person is being abused, they may be somewhat agitated or anxious or will have panic attacks. All of these things are warning signs.

Is there a way to research a long-term care facility’s record of abuse if they have one?

Absolutely, I would certainly encourage people to go out look at the nursing home, take a tour, talk to staff, look at the care of other residents when they are out there, see if they notice strange odors, if they see people that seem like they are alone for a long time, or isolated. And then, certainly, call the State regulating agency for Nursing Homes and they can give you the background of a nursing home if they have seen serious concerns there. But they can certainly give people the background on a nursing home.

What is
elder abuse?

Essay: Major types of abuse

»Interview with Stephanie Marquise


Additional resources

Frequently asked questions from the National Center on Elder Abuse

Facts about elder abuse and neglect including how to report it

Recognize the signs and symptoms of elder abuse and find out how you can help

An elder abuse fact sheet from the Administration on Aging

The nursing home abuse and neglect resource center for the elderly and their families

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