Identifying the ‘Red Flags’ of Elder Abuse

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Photo by Chris Marchant via Flickr

Too many health, justice and social service professionals lack the training to “effectively” identify and assess elder abuse, according to a study in the Journal of Criminal Justice and Law Review.

The study, originally completed in 2008 and reposted this month, concluded that “most elder abuse occurs at the hands of those the victim most trusts–their friends and family.”

Because of this startling and unsettling finding, the researchers outlined abuse indicators, and recommendations for addressing the issue to help the victims.

The authors of the study say the typical victim of elder abuse is someone 60 years or older who is “being abused physically or sexually, exploited financially, neglected, or has been abandoned by a caretaker.” They also mention that the victims typically have mental impairments or other forms of handicaps.

According to recent figures, the problem of elder abuse is increasing.

A 2019 New York-based study conducted by the National Center on Elder Abuse (NCEA) estimated that “260,000 (1 in 13) older adults in the state of New York had been victims of at least one form of elder abuse in the preceding year, and that “…for every case [of elder abuse] known to programs and agencies, 24 were unknown.”

Many of the “red flags” for elder abuse are not physically identifiable, making them difficult to spot. The authors argue that “too many professionals lack the training to effectively assess and detect elder abuse,” so there is a real need for education for prevention and intervention.

Some of the hard-to-identify warning signs outlined in the study include:

      • Caregivers don’t converse with the elderly patient;
      • The elderly are regularly left in unsafe environmental conditions;
      • Appropriate hygiene and/or sanitary conditions are lacking.

Additional signs of trouble are caregivers who are quick to lose their patience with the elderly individual, and the caretaker fails to provide proper attention throughout all interactions.

These signs, the authors say, could be indicative of more sinister behaviors occurring behind closed doors.

Other, more outward signs of abuse outlined by the study are when a caretaker subjects the elderly patient to physical punishment, or “unreasonably” confines or restrains her.

Troubled caregivers themselves present another “primary characteristic” of a lapse in care.

“It has been found that caregivers with clinical depression are much more likely to engage in mistreatment of their elderly dependents than those that are not so afflicted,” the study said.

Spouses are a potential source of abuse, researchers suggested, noting that a spouse who may have been abusive during an earlier point in the relationship might resume that treatment under the added stress of taking care of the more acute needs of seniors unable to fend for themselves.

Victims of elderly abuse are also more likely to be handicapped, recipients of Medicaid, live in a “fewer people household,” and have experienced abuse or trauma in the past.


Once a case of abuse is identified, the authors recommend talking with and including the victim in every new step towards healing, so they’re a part of the decision-making.

Examples of helping the victim heal from trauma-inducing treatment include “support group referral, arranging for assistance from other family members and/or friends, or having volunteers and/or formal service-providers provide assistance.”

“There is clear need for clinical tools that can help identify caregivers at risk for providing poor-quality care,” the study said.

This kind of preemptive emotional and behavioral screening is important to make sure that elderly individuals get quality care, added the researchers.

In situations where a family member takes care of the elderly person for most of the day, health care professionals must assess the older person’s family relationships.

“It is important that professionals probe behind the reason that a relative or friend is living with the elderly person and…it is important that the professional interviews the elderly person to get their perception of the relationship that exists with that relative or friend,” the authors wrote.

Other recommendations include helping the elderly maintain social networks that can reduce their sense of isolation.

The authors of the study were Penny A. Hanser and Robert Hanser, both of the University of Louisiana at Monroe; Scott M. Mire, of the University of Louisiana at Lafayette; and Howard M. Henderson II, of the Sam Houston State University.

Additional reading:

Elder Abuse: When Victims Balk, Should Prosecutors Press Charges?

‘Help Guide’ to Elder Abuse

Elder Abuse (National Institute on Aging)

A Guide to Spotting and Preventing Elder Abuse

The full study can be accessed here.

This summary was prepared by TCR staff writer Andrea Cipriano

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