What Is Elder Abuse and How Can We Prevent It?

July 9th, 2025

According to the National Institute on Aging, elder abuse is the physical, emotional, financial, or sexual abuse of a person over 60. It also includes abandonment, neglect and healthcare fraud. Although anyone can be a victim of abuse, the elderly are especially vulnerable due to physical frailty and mental impairment, such as dementia or Alzheimer’s disease. The elderly are also more prone to social isolation than other adults, which places them at even greater risk. 

Perpetrators of elder abuse may be family, friends, caregivers, or any person who is in a position of power over an elderly person. It can happen in any setting: in the elder’s home, in a nursing home, or in the home of a friend or relative. In the case of financial abuse and fraud, there may not be any contact between the victim and the perpetrator at all. Some of the most egregious cases of financial abuse of the elderly occur when an individual misappropriates money, property or other assets through deceit or fraud. The elderly person may not even be aware of the abuse until it is far too late. 

The Scope of Elder Abuse

Elder abuse is a national crisis in the United States. According to the National Council on Aging, as many as one in 10, or 5 million elderly persons, suffer from some form of abuse or neglect each year, much of which is never reported. Additionally, the organization estimates that elders lose $36.5 billion to financial abuse and fraud each year. Sadly, the majority of the abusers — about 60% — are a family member or spouse. 

Types of Elder Abuse

There are many ways in which the elderly can be abused, neglected or deprived of their rights and dignity. These include:

Physical Abuse

Physical abuse may involve hitting, punching, slapping or using other means to cause physical harm to a vulnerable person. Physically restraining an elderly person by tying them to a piece of furniture, locking them in a room or preventing them from leaving the home, may also constitute physical abuse. The use of “chemical restraints,” e.g.medications whose sole purpose is to prevent an elderly person from acting in a way that disturbs caregivers or staff, is also a form of physical abuse. Chemical restraints are also illegal under federal law, although their use remains widespread.

Elder Emotional Abuse

Emotional abuse includes verbal threats and intimidation, consistent use of ridicule, or minimization of the elderly person’s rights and needs. The abuser may resort to insults, derogatory comments or behavior that discounts the elder’s right to privacy, independence or autonomous decision making. Preventing an elderly person from visiting friends, failing to convey phone messages or withholding mail also constitutes emotional abuse. 

Other forms of emotional abuse, according to Psychology Today, include:

• Threatening a person’s safety, property or loved ones. 
• Extremely jealous, controlling behavior
• Monitoring a person’s every move; refusing to allow them time to themselves
• Gaslighting — a pattern of behavior aimed at causing a person to doubt themselves, their memory or their mental capabilities. 

According to numerous sources, emotional abuse is the most common form of elder abuse, especially in care homes. According to the Nursing Home Abuse Center,  the World Health Organization reports that one in three nursing home staff members admit to psychologically abusing those in their care. 

Elder Sexual Abuse

Sexual abuse is defined as unwanted touching, forced intimate contact or penetrative sex with a person without their consent. Like children, the elderly are especially vulnerable to sexual abuse because they are too weak to fight back and, due to cognitive limitations, may be unable to clearly describe the assault. They are also more likely not to report abuse because they feel embarrassed or ashamed or don’t think they will be believed. 

In addition to sexual contact, elder sexual abuse can involve forcing an elderly person to watch or view pornography or to watch other people perform sexual acts. Forcing an elderly person to disrobe against their will may also be an act of sexual abuse.. 

Additionally, any sexual contact with an elderly person who lacks the capacity to give consent due to dementia, Alzheimer’s or another form of cognitive impairment is abuse and a crime. 

Elder Financial Abuse & Exploitation

Financial abuse and financial exploitation are growing concerns among the elderly. Whereas financial abuse was historically perpetrated by those with access to an elderly person’s assets and funds, today more and more elderly persons are being exploited by fraudsters running elaborate scams. According to FBI Crime Statistics, scams targeting individuals aged 60 and older resulted in the loss of over $3.4 billion in 2023—an increase of approximately 11% from 2022. 

Traditional financial abuse or exploitation typically involves a family member or caregiver with access to the elderly person’s bank accounts, credit cards and other personal financial documents. A perpetrator of such abuse may:

• Forge checks
• Steal retirement of Social Security benefits
• Steal jewelry, cash or household goods
• Steal the elder’s identity and use it to open credit cards or take out loans.
• Use the elderly person’s credit cards or debit card without their consent
• Change names or beneficiaries on a will or life insurance policies
• Change the name on a title to real property such as a house, boat or car
• Use threats or intimidation to force an elderly person to turn over assets against their will
• Fail to pay bills such as rent and utilities in an effort to create hardship for the elderly person

Financial fraud, on the other hand, is typically perpetrated by those who don’t know the victim and defraud them using trickery and deceit..Scams targeting the elderly are one of the fastest-growing and most devastating forms of elder financial abuse. According to the FBI, elderly persons are often targeted due to their lack of sophistication with modern technology; over 101,000 scams involving people over 60 were reported to the FBI in 2022 alone. While these scams and those who perpetrate them are always evolving, in 2023, the most common financial scams  involving the elderly were:

• Tech support scams
• Personal data breaches
• Confidence and romance scams
• Nonpayment or failed delivery scams
• Investment scams 

The priciest of these scams were investment scams, which cost seniors nearly $1.2 billion in 2023. 

Healthcare Fraud

Healthcare fraud is a growing concern in the United States, particularly among the elderly. People over the age of 60 tend to have multiple health issues and multiple providers, so they may not notice questionable financial practices when they occur. 

Healthcare fraud can occur in a number of ways. For example, a provider may:

• Bill for a service that was never provided 
• Bill more than the service provided should cost (upcoding)
• Bill more than once for the same service (unbundling)
• Overcharge for medical care or equipment
• Get kickbacks for providing unnecessary referrals to specialists or prescribing unnecessary medications
• Sell worthless remedies and supplements for a hefty out-of-pocket cost

Additionally, scammers may contact an elderly person claiming to be their provider or insurance company and ask to “verify” the information they have on file. When the victim provides the information, the scammer can submit fraudulent claims using the victim’s identity or steal their identity entirely using the information provided.  

Elder Neglect

Elder neglect is an overarching term that includes any action or inaction that causes an elderly person’s basic needs to go unmet. It can be intentional or unintentional and may be perpetrated by a designated caregiver or by the elderly person themselves. 

In most cases, elder neglect is unintentional, and in many cases is carried out by the elderly person themselves. (This is known as self-neglect). For example, an elderly person may suffer from a physical or mental impairment that prevents them from performing basic self-care. They may miss meals, eat an unhealthy diet, or fail to take medications as prescribed. They may also miss medical appointments due to lack of transportation, let prescriptions run out, or forget to pay rent, mortgage or utility bills. These individuals often appear malnourished or underweight, live in squalid conditions, and may lack basic services such as running water or heat. Yet, whether due to shame or fear of losing their independence, they very often refuse outside help. 

Less often, a caregiver is actually the perpetrator of neglect. A relative or spouse may intentionally fail to provide adequate food or obtain prescribed medication for an elderly person. They may refuse to drive them to medical appointments, cut off access to the internet or telephone, and isolate the elderly person so they cannot ask for help. Some caregivers will actually abandon an elderly person, leaving them alone for long periods of time, despite knowing they cannot care for themselves. Fortunately, these cases are relatively rare.

Signs of Elder Abuse or Neglect

All too often, friends and neighbors of victims of elder abuse are stunned when they learn that the person has been victimized. This happens in large part because signs of abuse can be subtle and often mimic other health conditions, such as depression or dementia. It is also difficult for many people to believe that a caregiver would abuse an elderly person, and abusers are often very good at fabricating explanations for noticeable warning signs. Nevertheless, if you are a friend, relative or neighbor of an elderly person and are concerned about their welfare, it is important to be cognizant of these early warning signs of elder abuse.

Signs of Elder Physical Abuse

• Unexplained bruising, cuts, scrapes, welts or scars
• Broken bones, sprains or frequent trips to the emergency room for injuries
• Signs of having been physically restrained, such as rope burns or marks around the wrists or ankles
• Poor physical condition or disheveled appearance
• Broken eyeglasses or missing hearing aids
• Caregiver prevents you from speaking with the elder person alone
• Overprescribing of sedating drugs 

Signs of Emotional Elder Abuse

• Observed behavior by caregivers that is insulting, belittling, controlling or confrontational
• Signs that the elderly person is traumatized, such as rocking, thumb sucking, refusal to make eye contact, severe withdrawal
• Significant changes in mood

Signs of Elder Sexual Abuse

• Bruising on the thighs or external genitalia
• Vaginal or anal bleeding 
• Blood in urine or stool 
• Torn clothing
• Unexplained sexually transmitted disease
• Extreme mood changes and fearful behavior

Signs of Financial Abuse or Exploitation

• Unexplained withdrawals from the elder’s financial accounts
• Unexplained credit card purchases
• Money missing from bank accounts, IRA or 401k
• Bills not being paid 
• Sudden changes to the elderly person’s insurance policies, will or trust
• Missing cash, jewelry or other items of value
• Evidence of identity theft, e.g. new accounts opened in the elder’s name

Signs of Healthcare Fraud

• Duplicate bills for the same service
• Service dates and office visits don’t match
• Bills from unknown providers
• If the elderly person is in a nursing home or assisted living facility, signs of inadequate provision of care, such as bedsores, poor nutrition, weight loss, poor personal hygiene, frequent infections, etc.

Signs of Elder Neglect

• Poor physical condition, unusual weight loss, bedsores
• Very little food in the pantry or refrigerator
• Unsanitary or squalid living conditions
• Dirty, poorly fitting clothing
• Clothing that is unsuitable to weather conditions (e.g., no warm clothes in the winter)
• Hoarding
• Disheveled, unwashed appearance
• Physical injuries, scrapes, cuts, bruises or signs of frequent falls

Risk Factors in Elder Abuse

As mentioned earlier, social isolation and cognitive difficulties are one of the main contributors to elder abuse. Socially isolated elders who live alone often lack the knowledge or resources to reach out for help if they are being mistreated by someone charged with their care. They may also neglect their own needs due to a lack of money, transportation or community support. 

Additionally, caring for an elderly person can be mentally and physically challenging, especially if the caregiver is also elderly or in less than optimal health. Typically, the needs of the elderly person increase over time, while the capacity of the caregiver to provide care diminishes as physical and emotional stress take their toll. The result can be caregiver burnout, which may predispose the caregiver to lash out in anger, fail to meet the elderly person’s needs or leave them alone for long periods of time. 

Other factors that may increase the likelihood of elder abuse occurring in the elder’s home include:

• Depression or other mental health conditions in the caregiver, including substance misuse
• Lack of support from extended family or the community
• Pre-existing family dysfunction, including prior verbal or physical aggression by the elder or caregiver
• A history of domestic violence or spousal/parental abuse
• A contentious relationship between the caregiver and the elderly person 
• The caregiver’s perception that the caregiving role is burdensome or unfair

In a nursing home or assisted living facility, issues such as inadequate staffing, lack of adequate training, overburdened caregivers and a culture of disrespect for the elderly can also encourage elder abuse.

Where to Find Help for Elder Abuse

If you suspect an elderly family member or someone you know is being abused in some way, the best way to intervene initially is to speak with the elderly person when they are alone. Doing so may be somewhat challenging; many abusers will try to prevent the elderly person from speaking to others when the abuser is not there. If possible, ask the elder out to lunch or offer to take them shopping. If they are homebound, offer to stay with them for a short time while the caregiver runs errands or takes a break. If the caregiver refuses, this is a strong indication that something is amiss. 

When speaking to an elderly person about potential abuse, it’s best to be direct. Ask them if someone is hurting them or if they feel unsafe. If you suspect neglect, ask them if they feel that they have enough food and if they’re taking their medications as prescribed. Most importantly, tell them that you are there for them and can arrange for them to get the help they need. 

In most cases of suspected abuse or neglect, it is not advisable to confront the caregiver directly. This may trigger further aggression against the elderly person, which is exactly the opposite of the result you want. Instead, report your suspicions to Adult Protective Services. If you are located in the U.S., you can find contact information for the authorities in your area by entering the state where the elderly person lives into this search bar on the website of the National Adult Protective Services Association. Be prepared to discuss the objective signs you have witnessed as well as any information the elderly person provided you when you file the report. 

If the elderly person is living in a long-term care facility, you may also report suspected abuse to the National Long Term Care Ombudsman Program office in your state. 

Lastly, if you feel the elder is in imminent danger, take steps to remove them from the environment immediately. If they are injured, take them to the closest emergency room and report your suspicions about the abuse to someone there. Doctors and nurses are mandated reporters, which means the law requires them to report the abuse to Adult Protective Services and, in some cases, the police. If the elderly person is uninjured but you believe they will be injured if you leave them alone, call the police and ask them to assist you in removing the person to a safe location until APS can intervene. 

Preventing Elder Abuse

Preventing elder abuse is of paramount importance in our efforts to protect our elders from violence, exploitation and neglect. The National Institute on Aging estimates that fewer than one in 14 cases of elder abuse are ever reported, so prevention is the surest way to keep vulnerable elderly persons safe. 

According to the Social Security Administration, education is key to preventing elder abuse. The agency recommends the following practices 

• Know the signs of elder abuse
• Stay in touch. Isolation is a strong risk factor for elder abuse and neglect. Visit elderly friends and family often, and ask them how they are faring and if they need any help from you.
• Know what resources are available in your community and share them with friends, neighbors and others who are in contact with a vulnerable elderly person.
• Spread the word. Talk to people in your community about the scope of elder abuse and educate others about how to spot it and when to report it. 

Additionally, if you are a caregiver for an elderly person, the National Council on Aging suggests that doing the following can decrease the risk that you will become abusive to someone in your care:

• Take care of your physical and mental health. Keep medical appointments; eat a balanced diet, and enlist help from other family members and friends so you can take a break.
• Seek professional help for depression, burnout or drug and alcohol concerns.
• Stay connected to friends and family. Isolation puts both you and the person you are caring for at risk.
• Attend a support group for caregivers either in person or online. 
• If you have engaged in abusive behavior in the past or have the urge to do so at any time, contact the National Domestic Violence Hotline 24/7 to speak with a counselor.  Call 1-800-799-SAFE (7233) or text Start to 88788. 

Summary

In summary, elder abuse is extremely common in the U.S. and globally, with as many as one in 10 elderly persons suffering from abuse or neglect each year. Elder abuse can happen anywhere, but the majority of abuse occurs at the hands of a family member or spouse in the victim’s home. Knowing the signs of abuse; reporting suspected abuse promptly, and educating others about prevalence and prevention are all essential to keeping our elderly safe. 

Sources

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“Elder Abuse”. National Institute on Aging. https://www.nia.nih.gov/health/elder-abuse/elder-abuse#

“2021 Elder Fraud Brochure”. US Department of Justice. https://www.justice.gov/d9/2023-12/elder_fraud_brochure_-_2021.pdf

“Elder Fraud in Focus”. FBI. https://www.fbi.gov/news/stories/elder-fraud-in-focus#:~

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“Sexual Battery: Laws and Penalties”. Criminal Defense Lawyer. https://www.criminaldefenselawyer.com/crime-penalties/federal/sexual-battery.htm

“Self-neglect in Older Adults: a Primer for Clinicians”. Journal of General Internal Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC2585676/

“Caregiver Burnout”. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9225-caregiver-burnout

“Get Help: Help in Your Area”. National Adult Protective Services Association. https://www.napsa-now.org/help-in-your-area/

“Get Help”. The National Consumer Voice for Quality Long-Term Care. https://theconsumervoice.org/get-help/

“What Are Mandated Reporting Laws for Elder Abuse?” Nursing Home Abuse Center. https://www.nursinghomeabusecenter.com/blog/elder-abuse-reporting-laws/