1. ELDER ABUSE

2. Categories of Elder Abuse Domestic Elder Abuse Institutional Elder Abuse Self-neglect or Self- abuse

3. Domestic and Institutional Abuse Physical abuse Sexual abuse Emotional or psychological abuse Neglect Self-neglect Exploitation

4. Physical Abuse The use of physical force that may result in bodily injury, physical pain, or impairment. Includes: striking (with or without object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, burning. Also included: inappropriate use of drugs and physical restraints, force-feeding, and physical punishment

5. Sexual Abuse Non-consensual sexual contact of any kind with an elderly or disabled person or with any person incapable of giving consent. Including: unwanted touching, all types of sexual assault or battery – rape, sodomy, coerced nudity, and sexually explicit photography.

6. Emotional or Psychological Abuse Infliction of anguish, pain, or distress through verbal or nonverbal acts. Including: verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition: treating an older person like an infant, isolating elderly person from his/her family, friends or regular activities, giving an older person the “silent treatment” and enforced social isolation.

7. Neglect The refusal or failure to fulfill any part of a person’s obligations or duties to an elder (including failure to pay in-home service fees or home care services). Typically means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, etc.

8. Self-neglect Characterized as the behavior of an elderly that threatens his/her own health or safety. Self-neglect manifests itself in an older person as a refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions

9. Exploitation Misusing the resources of an elderly or monetary benefit. Including: taking Social Security or SSI (Supplemental Security Income) checks, abusing a joint checking account, and taking property and other resources.

11. Possible Indicators of Abuse, Neglect, or Exploitation

12. Physical Signs Injury that has not been cared for properly Injury that is inconsistent with explanation for its cause Pain from touching Cuts, puncture wounds, burns, bruises, welts Dehydration or malnutrition

13. Physical Signs, cont’d. Poor coloration Sunken eyes or cheeks Inappropriate administration of medication Soiled clothing or bed Frequent use of hospital or health care/doctor-shopping Lack of necessities

14. Behavioral Signs Fear Anxiety, agitation Anger Isolation, withdrawal Depression Non-responsiveness, resignation, ambivalence

15. Behavioral Signs, cont’d. Contradictory statements, implausible stories Hesitation to talk openly Confusion or disorientation

16. Signs by Caregiver Prevents elder from speaking to or seeing visitors Anger, indifference, aggressive behavior toward elder History of substance abuse, mental illness, criminal behavior, or family violence Lack of affection toward elder

17. Signs by Caregiver, cont’d. Flirtation or coyness as possible indicator of inappropriate sexual relationships Conflicting accounts of incidents Withholds affection

18. Signs of Financial Abuse Frequent expensive gifts from elder to caregiver Elder’s personal belongings, papers, credit cards, missing Numerous unpaid bills A recent will when elder seems incapable of writing

19. Signs of Financial Abuse, cont’d. Caregiver’s name added to bank account Elder unaware of monthly income Elder signs on loan Frequent checks made out to “cash” Unusual activity in bank account Irregularities on tax return Caregiver’s refusal to spend money on elder

21. Facts and Figures The U.S. has 44 million persons age 60 or older, & 36 million people with disabilities. Most recent year studied, Adult Protective Services completed 364,512 investigations of abuse, neglect, or exploitation involving persons living at home – 43% confirmed. In the last decade, abuse reports by APS has increased 150%

23. The National Center on Elder Abuse (NCEA) Serves as a national resource for elder rights advocates, adult protection services, law enforcement and legal professionals, medical and mental health providers, public policy leaders, educators, researchers, and concerned citizens. Mission is to promote understanding, knowledge sharing, and action on elder abuse, neglect, and exploitation.

24. Resources National Association of Adult Protective Services Administrators National Center on Elder Abuse