- First, if an older person is being abused, reporting will result in them receiving help. They can receive treatment for physical injuries or harm, for example. The situation they are in should change for the better.
- Second, if the abuse is taking place because of a specific individual, the individual can be identified and removed. If legal charges are appropriate, the person can be charged.
- Third, if the abuse is taking place in an institution such as an assisted living facility or nursing home, that institution can take steps to ensure it doesn't happen again. Some abuse may take place because of unclear policies or insufficient training or oversight. The institution can develop better policies.
- Fourth, the older person can receive justice. Legal suits can be filed so the elderly person can be compensated for medical bills and other financial harm that resulted from the abuse, for example.
- Fifth, the more reporting that occurs, the better the state and society at large understands the problem of elder abuse. The better our collective understanding, the more that can be done to combat elder abuse.
Steps to Take if You Witness or See Signs of Elder AbuseWhat specific steps should you take if you witness or see signs of elder abuse? It depends on the situation and your relationship to the elderly person.
If They Are a Loved One or FriendIf you find a loved one or friend in a life-threatening or serious situation, it may be prudent to act to remove them from the situation immediately, before reporting. A severely injured, disoriented, or dehydrated individual may suffer further injury or even die if left in the situation. Your first step if the situation concerns their health is to call 911 immediately. Safety first. If they need to be taken away in an ambulance and hospitalized, that needs to occur before reporting. The second step should be documenting the harm you found. If your loved one required medical care, document it. Take pictures of any wounds or injuries. If their living quarters were not properly maintained, take pictures. If they were being looked after improperly in ways that had physical evidence, take pictures of it. (If they were in inappropriate restraints, for example, or dressed in clothing inappropriate for the temperature.) While pictures are excellent evidence of a physical issue, they are not the only documentation available. Take notes of what you found. If the issue resulted in a change of affect, anxiety, or fear, especially if the fear was of a specific person, take notes and include the person's name. And include other specific information, such as the date and time. Similarly, if you witness an instance of abuse, write it down immediately. It could be belittling behavior or a raised voice—or a raised hand. Note the person who did it, the place, the time, and the date. Some abuse isn't physical, but financial. Older people can be defrauded of their assets, have cash or other possessions taken from them, be subject to duress or intimidation that makes them give away assets, and more. The first step you should take if you suspect financial abuse is to call law enforcement. Report the issue just as you would if you had experienced a theft or fraud of your own assets. Get a copy of the police report as evidence, as well. The second step in addressing financial abuse is also documentation. Make a record of the type of financial abuse, what occurred, how much was taken, and dates and times. If a specific person was involved, include their name and relationship to the elderly person. For all forms of abuse, once your loved one is safe, secure, and protected, make an appointment to discuss the case with a personal injury attorney specializing in elder abuse.
Reporting: Who, Where, and WhyOnce you have evidence, whether it's a single instance or a suspected pattern, you need to take steps to report it to the appropriate person(s). The goal of reporting it is justice for the abuse victim and rectification of the situation. If you suspect a family member or friend, speak to the relevant people. This could be other family members or professionals in elder care. If your loved one is receiving in-home care, speak with the caregivers and their supervisors if they work for an agency. Bring your evidence with you. Emphasize that you want the issue to never happen again and seek a resolution. In most cases, they will be concerned and take action. Follow up to ensure that the promised action is taken. If the abuse happened in an institution, report it to the administration of the nursing home or assisted living facility or the nursing staff. Don't be highly emotional or accusatory. Your primary goal should be your loved one's well-being and safety. In all of these discussions, document the time, date, names, and positions of the people you've talked to. Make note of their comments and solutions. Follow up to see if the solutions are implemented, and if they work for your loved one. If you see or suspect that the situation has not changed or resolved, be prepared to move your loved one to different caregivers or a different facility.
If You Don't Know the PersonThere are times that you may witness elder abuse and not be personally involved in the elderly person's life at all. Florida takes all elder abuse very seriously. As a result, anyone who sees elder abuse in the state is required to report it. Incidents can be reported online at a state website. Note that the report refers to abused children and vulnerable adults. The reporting instructions are given in English, Spanish, and Creole. You can also report via telephone by calling the Florida Abuse Hotline at 1-800-96-ABUSE (1-800-962-2873) or TTY (Telephone Device for the Deaf): 1-800-955-8771. The Hotline is available 24/7. If you want to report via fax, access the state's fax reporting form, fill it out and fax it to 1-800-914-0004.
Required Reporting by a Medical ProfessionalCitizens are not the only people urged to report elder abuse. Medical professionals are legally required to report abuse. Nurses, who see patients frequently, may be best-positioned to provide reports. Medical professionals who see abuse and do not report it may face criminal charges and civil lawsuits. Nursing homes should report abuse cases to the U.S. Centers for Medicare and Medicaid Services. However, nursing home abuse is tremendously underreported. Reports can affect the publicly available documents on a particular nursing home's quality of care, so some nursing homes may be incentivized not to report, as poor reports can affect people's willingness to use their facilities. Other facilities may be poorly organized and thus simply not have adequate reporting procedures in place. Unfortunately, medical personnel may also fail to report abuse. This can happen for many reasons. Many nursing homes are understaffed. A great deal of abuse may happen that no one sees or sees very intermittently. Neglect, one of the most common forms of abuse, may be viewed primarily as the unavoidable consequence of insufficient staff, not as a reportable offense. Abuse can also happen because of inadequately qualified, experienced, or trained staff. Medical personnel may focus on rectifying these deficiencies rather than reporting abuse. Finally, sadly, medical personnel and other caregivers may be concerned that the administration of the institutions where abuse happens will retaliate against them. They may lose their employment or their contracts or receive poorer assignments. As a result, it's not a good idea to assume that caregivers will report any abuse. Everyone needs to remain vigilant.
Knowing the Symptoms and SignsWhile you may see or hear elder abuse, or an older person may confide in you, it's far more common to suspect it by seeing its symptoms and signs. The U.S. Centers for Disease Control and Prevention defines elder abuse as an “intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult.” That sounds, and is, very straightforward. But the effects of elder abuse can be far more diffuse than simply seeing a black eye and suspecting that someone has hit the older person. The symptoms and signs might not be visible or even related to the abuse suffered. Depression and withdrawal, for instance, can be signs that the older person is being physically abused or feels unsafe. Many older people may feel afraid to say anything about abuse. They often depend on the caregivers who abuse them. They may fear retaliation or loss of care if the person leaves. Other older people may not be able to recognize abuse or let anyone know. Senior citizens with dementia or Alzheimer's, for example, may not remember abuse. Some medications may make them unaware of it. Many older people lack social or other support networks that would provide them with someone to tell. The CDC recognizes several different kinds of abuse, all with different symptoms.
Physical AbusePhysical elder abuse encompasses any action (or lack of action) that causes the person injury, pain, or physical harm. Signs and symptoms include:
- Injuries that can't be explained;
- Broken bones;
- Contusions (bruises);
- Cuts or scars;
- Fresh or unhealed wounds;
- Scars or signs of old wounds that have healed;
- Symptoms that result from inadequate or no medication;
- Symptoms of overmedication;
- Fear on the part of the older person, especially of a specific person;
- Lack of personal hygiene and care;
- Sudden personality or behavioral changes; and
- Refusal to see visitors.
Sexual AbuseElder sexual abuse is any kind of sexual behavior or contact with an older person that is nonconsensual and unwanted. Signs and symptoms include:
- STIs or genital infections;
- Genital bruises or bleeding;
- Torn or stained clothing, including underwear;
- Sudden personality or behavior changes; and
- Refusal to see visitors.
Emotional AbuseEmotional abuse can result from a wide array of actions (or inactions), including causing psychological distress or pain by words, actions, threats, insults, humiliation, belittling, screaming, or becoming angry. It can also encompass depriving the older person of social contact or needed care, such as food and sleep. Signs and symptoms include:
- Unusual behavior or statements;
- Sudden changes in personality or behavior;
- Agitation, anxiety, or upset behavior;
- Lack of communication or unresponsiveness;
- Refusal to have visitors;
- Fear of caregiver; and/or
- Weight loss.
NeglectNeglect consists of denying care that a person needs to live comfortably or not providing sufficient care. It can be a deliberate act or the result of poor choices or lack of training. Neglect can range from not washing the older person's hair for a month to failing to prepare and serve adequate food. Signs of neglect can include:
- Signs of poor nutrition;
- Weight loss;
- Complaints of hunger;
- Unsanitary living conditions;
- Lack of personal hygiene (if a caregiver provides help bathing and washing);
- Unwashed or soiled clothing;
- Inappropriate environmental temperature;
- Lack of water;
- Lack of necessary items for comfort;
- Lack of needed assistive devices (hearing aid, cane);
- Unsafe environment (insufficient lighting, pests, etc.);
- Untreated or unattended health issues; and/or
- Health issues worsening or not improving as they should.
Financial AbuseElder financial abuse consists of using an older person's assets improperly or illegally, or gaining access to them in an unauthorized way. Assets include money, property (homes, items in the house), bank and other accounts, credit and debit cards, cars, and so on. Signs and symptoms can include:
- Missing cash or checkbooks;
- The older person not having access to their own accounts;
- Missing funds from bank and other accounts;
- Missing items and property;
- Missing debit, credit, or ATM cards;
- Signatures on documents looking forged (i.e., not in older person's handwriting);
- Financial documents in the caregiver's name;
- Credit and bank cards or checks in caregiver's name;
- Sudden changes to the elderly person's will;
- Misleading fees or services; and/or
- Decisions about finances reached as a result of deception or coercion.