Elder Abuse Prevention Series
HealthLink BC File #93a, June 2011

Preventing Abuse and Neglect in Later Life

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• What types of abuse or neglect can older adults experience?
• Why does abuse or neglect happen?
• Health effects of abuse and neglect
• Emotional effects of abuse and neglect
• Abuse and neglect can be prevented
• For more information

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Abuse and neglect in later life can affect an adult’s health, happiness and safety. Older adults can experience different kinds of harm from people they rely on or trust. Abuse of older adults can occur at home, in the community, or in institutional settings. Those who abuse are most often family members such as a person’s spouse or children, but they can also include friends and caregivers.

What types of abuse or neglect can older adults experience?

Abuse and neglect can take many forms including physical, emotional, financial, sexual, social, spiritual, or withholding the necessities of life. Some types of abuse and neglect violate an older adult's basic rights, and several types are crimes.

• Physical abuse includes violence or rough treatment, even if it does not leave an injury.

• Emotional abuse includes name calling, intimidation, threats or any treatment that offends an older person’s sense of dignity and self-worth. Emotional abuse is often a way that people try to control an older person.

• Financial abuse is the most common form of abuse reported by older adults. Examples of financial abuse include pressuring an older adult with requests for money, using an older adult’s property or money without his or her full knowledge and consent, or improperly using one’s authority as a power of attorney.

• Sexual abuse occurs when a person pressures an older adult for intimacy or sexually harasses or sexually assaults him or her. Sexual abuse can also include making sexual comments or jokes, and unwanted touching or leering.

• Violations of rights mean ignoring older adults’ rights to privacy, information or community supports.

• Neglect refers to situations where a person has a duty to provide care or assistance to an older adult, but that person does not provide such care or assistance. For example, the caregiver might stop paying the bills or providing food, medication or other assistance to the older adult.

Why does abuse or neglect happen?

Some people learn to abuse or use violence and control in their relationships, and some do not treat older adults with respect. Some people experience personal problems or stresses, increasing their risk of harming or neglecting others. These factors may increase the risk of abuse.

Living together with older adults may create family tensions. In some cases, family pride can keep abuse hidden. However, caring communities can help protect people from abuse and neglect.

Health effects of abuse and neglect

Abuse and neglect can have long-term adverse effects on the health and well-being of older adults. These effects may be lessened by emotional support from family and friends, and by the older adult’s perception of having some control of the situation. Health effects do not occur the same way for everyone.

In general, older adults have less physical strength and they are less able to defend themselves from physical abuse. The most obvious signs of physical abuse are falls, bruises, broken bones, burns, head injuries or injuries to the mouth.

Other health effects of abuse or neglect are less obvious, and these may include sleeping difficulties, stomach problems, or breathing problems. An older adult who is neglected may be severely dehydrated or suffering from malnutrition. Some signs of abuse, such as frequent falls or confusion, may be mistaken as a part of aging. Some signs may look like health concerns common in later life. Older adults who experience abuse or neglect may also lose interest in life, change their habits such as eating, drinking or taking medications, or have suicidal thoughts. People may not recognize or identify these as abuse.

Living with abuse and neglect can significantly increase a person's chances of becoming ill or dying early. The stress of living with abuse or neglect may also worsen other health concerns.

Emotional effects of abuse and neglect

Individuals who cause abuse and neglect to older adults often threaten, harass, or intimidate them. They may cause fears in older adults by threatening to not let them see their grandchildren or threatening to leave them alone or place them in a residential care facility.

Older adults often experience stress, worry, anxiety or depression as a result of abuse and neglect. They may feel shame, guilt, or embarrassment that someone in the family or someone close has harmed them. An older adult who feels abused or neglected usually loses trust in the person who causes the harm.

Some older adults who have experienced abuse earlier or throughout their lives may use alcohol or prescription drugs to help them with sleep, anxiety, or other concerns.

Today, older adults are more willing to seek counselling or join a support group to help them.

Abuse and neglect can be prevented

There is no law in British Columbia that requires people to report abuse and neglect of older adults. If you experience abuse or neglect, you can get help and prevent the situation from becoming worse. There are several ways you can help an older adult who may be or feel abused or neglected:

• Believe the older adult if he or she confides in you about a difficult situation.
• Listen to the older adult in a non-judgmental manner.
• Recognize abuse and neglect and speak up about it.
• Encourage the older adult to ask a professional for confidential help.
• Know where to call to get help or information.
• Respect the person's choices.

If you are a service provider working with older adults, you can help as follows:

• Help older adults and families learn more about their rights and responsibilities.
• Help older adults build or regain their confidence and skills.
• Help reduce the person's social isolation.
• Have appropriate resources to help older adults and families.

Health professionals and other service providers are trained to recognize the common signs and screen for abuse and neglect, and they know how to help. They can help an older adult assess his or her own personal safety, and they can help develop a safety plan.

For more information

If you see a crime or harmful situation occurring to an older adult, call the police or 9-1-1 immediately. You can also call 8-1-1 for information and advice, and speak to a registered nurse available 24/7 about non-emergency health concerns or questions. Translation services are available in over 130 languages on request.

For information and services, you can also contact:

• Home and Community Care Office in your local health authority whose staff has a responsibility to investigate more serious reports of suspected abuse or neglect.
• B.C. Centre for Elder Advocacy and Support plus the Seniors Advocacy and Information Line (SAIL) at 1-866- 437-1940 or visit www.bcceas.ca
• Office of the Public Guardian and Trustee at 604-660-4444 or www.trustee.bc.ca
• Legal Services Society at 604-408-2172 or toll-free at 1-866-577-2525 or visit www.lss.bc.ca
• Call Victim Link toll-free in B.C. at 1-800-563-0808 for information for victims of family and sexual violence or crime.

For more information, see other topics in the HealthLink BC Files Elder Abuse Prevention Series.

#93b Abuse and Neglect of Older Adults: Information for Family Caregivers

#93c Abuse and Neglect of Older Adults: Understanding Gender Differences

#93d Financial Abuse of Older Adults

For more HealthLinkBC File topics, visit www.HealthLinkBC.ca/healthfiles/ or your local public health unit. Click on www.HealthLinkBC.ca or call 8-1-1 for non-emergency health information and services in B.C. For deaf and hearing-impaired assistance, call 7-1-1 in B.C. Translation services are available in more than 130 languages on request.