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* This is the Consumer Version. *

Preventing and Responding to Elder Abuse

By Daniel B. Kaplan, PhD, LICSW, Assistant Professor, Adelphi University School of Social Work ; Barbara J. Berkman, DSW, PhD, Helen Rehr/Ruth Fitzdale Professor Emerita, Columbia University School of Social Work

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Many older people who are abused do not seek help for various reasons. They may feel ashamed and be reluctant to tell others about the abuse. They may be unable to tell others because the perpetrator limits phone calls or access to visitors and health care practitioners. If the perpetrator is the caregiver, older people may feel too dependent on or want to protect the perpetrator, who may also be their adult child. They may be afraid of being harmed further, of being abandoned, or of being forced into a nursing home.

Older people should never think that abuse is part of being old or dependent. Being mistreated threatens their personal dignity and sense of well-being and can even cost people their life. Family members and friends can help by maintaining close ties with an older person.

Older people who are worried about abuse can take steps to make it less likely to happen, such as the following:

  • Not living with someone who has a history of violent behavior or substance abuse

  • Keeping in touch with friends and former neighbors, especially if they have to move to a caregiver’s house

  • Staying connected with social and community organizations (increasing the chances that abuse, if it occurs, is noticed)

  • Insisting on legal advice before signing any documents related to where they will live or who controls their finances (the local Area Agency on Aging can refer people for legal help)

The National Center on Elder Abuse provides a resource titled Preventing Elder Abuse by In-Home Helpers for older people and their families considering hiring in-home help.

If older people believe they are in danger, they can call an elder abuse hotline for immediate help. Such hotlines are listed in the local phone book, usually in the Blue Pages, or can be provided by a phone operator. A list of all state laws about elder abuse and telephone numbers to call to report abuse are available at the National Center on Elder Abuse (855-500-3537 or www.ncea.acl.gov). The National Association of Area Agencies on Aging (202-872-0888 or www.n4a.org) is another good source of information and referral. If older people do not feel endangered but still want help, they can try talking about it with their doctor, social worker, or other health care practitioner.

Relatives, friends, and acquaintances have a responsibility to help if they know of or strongly suspect abuse, as do health care practitioners. Directly confronting the perpetrator is not recommended because it can worsen abuse. Instead, the situation should be reported. Reporting suspected or confirmed abuse or neglect is mandatory in all states if the abuse occurs in an institution and in most states if it occurs in a home. Every state has laws that protect and provide services for vulnerable, incapacitated, or disabled people. Every state also has laws protecting people who report suspected abuse from being sued for doing so. To report abuse, people can contact the following:

  • In most states: The state social service department (Adult Protective Services)

  • In a few states: The state unit on aging

  • For abuse within an institution: The local long-term care ombudsman's office or the state department of health

Telephone numbers for these agencies and offices in any part of the United States can be found by calling the Eldercare Locator (800-677-1116 or www.eldercare.gov) or the National Center on Elder Abuse (855-500-3537 or www.ncea.acl.gov) and giving the person's county and city of residence or zip code.

Because abuse and its effects can vary greatly, interventions need to be tailored to each person’s situation. Interventions may include the following:

  • Medical assistance

  • Education, such as information about abuse and available options, as well as help with devising safety plans

  • Psychologic support, such as psychotherapy and support groups

  • Law enforcement and legal intervention, such as arrest of the perpetrator, orders of protection, and legal advocacy

  • Arrangement for alternative housing, such as housing that provides safe shelter with protection from the perpetrator

* This is the Consumer Version. *