What’s Caregiver Abuse? And What Can You Do About It?

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

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Caregiver abuse has become a significant and growing problem, as more adults age and look to others for caregiving. You may think of caregiver abuse as being a problem associated with professional caregivers, but family members are also guilty of abuse. The vast majority of caregivers are caring, loving people, but the bad apples can inflict severe and lasting harm to the people they abuse. 

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According to the National Council on Aging, one in ten Americans over the age of 60 have suffered some form of abuse. However, this can be a significant underestimation as most cases of abuse go unreported. Even more stunning is that over 60 to 90 percent of abusers are family members. It must be said that everyone has a responsibility to look for, recognize, and report abuse.

Reporting abuse from a family member can be complicated. If you are unsure what constitutes caregiver abuse and how to report it, this article can help you get started.

What is Caregiver Abuse?

First, let’s identify who a caregiver is. A caregiver is anyone who has the responsibility for the physical and emotional care of another person. This could be a professional caregiver, a family member, or the staff of assisted living or nursing homes.

Caregiver abuse falls into these general categories, and it is common for more than one of these abuses to happen simultaneously. 

  • Physical. Physical abuse is the inflicting of pain or injury to another person and is intentional. Hitting, pulling, or pushing are all forms of physical abuse.
  • Emotional. Emotional abuse is intended to intimidate or humiliate through threats, demeaning, disrespectful, and belittling comments. The ultimate goal is to instill fear and to gain control.
  • Sexual. Sexual contact between consenting adults is legal and normal. Abuse is when the person does not have the capacity to consent or is threatened in some way to get agreement to sexual contact. 
  • Financial Exploitation. Estimates suggest that financial exploitation is more frequent than all other forms of abuse and, like the other types of abuse, vastly underreported. Much of the time, instilling fear through emotional abuse is connected to an effort to gain control of finances.
  • Neglect. Neglect is when a caregiver fails to provide for the basic needs of a vulnerable adult. This includes food, water, shelter, clothing, assistance with necessary daily activities, and medical help.
  • Abandonment. Abandonment is the willful desertion of a person that someone has been providing care for. People can be abandoned in nursing homes, senior living communities, or in their homes. 
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What Are Some Signs of Caregiver Abuse?

The importance of recognizing caregiver abuse cannot be overstated. An abusive caregiver must be stopped. When vulnerable adults are abused, they can lose their livelihoods, suffer mental health problems, and have increased mortality. 

When family members are involved, awareness and intervention can be complicated by your relationship. Don’t allow that to dissuade or distract you. Caregiver abuse is criminal no matter who the perpetrator is. Well established signs of caregiver abuse can be described as the following:

Signs of financial exploitation

When looking for signs of financial exploitation, you may see examples of unexplained missing funds, either cash, from a bank account, or unauthorized credit card use. A common method of getting money is for a caregiver to take a person to the bank to withdraw money. 

In addition, some bills may not be paid, and instead an aging adult may transfer significant assets to their caregiver, or even give them expensive gifts or large amounts of cash. It is also important to note that sometimes a vulnerable adult can be pressured to change their will, naming a family member or caregiver as the beneficiary of the estate. Finally, an elder tells you that they want to marry their caregiver, which has happened before.

Signs of physical abuse

Your loved one may have some unexplained bruises, marks, abrasions, or have recurring broken bones or other debilitating “accidents.” A physically abused person may also be very fearful and anxious, and try to downplay their pain.

Signs of emotional abuse

There are many signs of emotional abuse, such as seeing your loved one withdraw from social activities or family, and have depression and/or anxiety. You may also witness conflicts between them and their caregiver, sometimes with threatening, disrespectful, and belittling language. Make it a point to see how your loved one responds to their caregiver. If they are timid or fearful around them, it can be cause for concern.

Signs of neglect

Neglect can sometimes be tricky to see, but some blatant signs include unexplained weight loss, poor hygiene, the appearance of bedsores, unattended medical problems, and dehydration. All of these can be signs that caregiver duties are not being completed and someone is not getting assistance with their activities of daily living, enough physical activity, eating enough, or staying hydrated.

Signs of abandonment

Abandonment can be seen when a family member deserts and refuses to care for their parent or grandparent, and does not provide an explanation. A caregiver could also quit without giving notice, endangering your loved one. In addition to these situations, a person who has been abandoned by a caregiver will be depressed and show signs of neglect.

What Can You Do If You or a Loved One Experience Caregiver Abuse?

Some cases of caregiver abuse will be blatant and obvious. Others will be more difficult to sort out and may take time to figure out, but don’t leave anyone in danger. Take these steps to protect yourself or a loved one.

1. Report the abuse

If you suspect professional caregiver abuse, you must report it to Adult Protective Services after notifying the company the caregiver works for. If the company says they will make the report, don’t rely on their word, we recommend making the report yourself.

For a family member, things can get tricky. Many families have ended up in court over allegations of neglect, abuse and exploitation, with relationships permanently damaged. No abuse should be tolerated, but talking about it first might be the best approach depending upon the circumstance. If you don’t get reasonable explanations, then make your report. 

2. Stop financial exploitation

If you suspect a caregiver is financially exploiting a loved one, you might have to get an attorney. For a family member who does not have the capacity to stop the abuse, guardianship might be the next step. With guardianship or a conservatorship, you have the authority to take over finances and stop the financial exploitation. 

In the case of a professional caregiver, make a call to Adult Protective Services and to the agency where the caregiver is employed. If the caregiver is not employed through an agency, your task will be more difficult to manage. Banks and other financial institutions may not be cooperative if you don’t have the legal authority to stop the financial exploitation.

3. Talk to your loved one

Talk to the older adult that you are concerned about. Since caregiver abuse tends to go underreported, someone may be very reluctant to divulge information for fear of reprisal. Providing support and comfort is critical. Let the person know that you want to protect them and that you will handle the situation.

If the person becomes angry and says they don’t want your help, you still have an obligation to report suspected caregiver abuse to the authorities. 

4. Proof is not required

Your job is to report, not prove. The authorities will investigate and take appropriate action. Be aware that a staff person from Adult Protective Services will visit your loved one during their investigation. It is not unusual for an abused person to deny that there is any problem. 

Have as much information available as you can when making a report. Reports to Adult Protective Services are anonymous. If Adult Protective Services declines to take action, continue to be vigilant and don’t hesitate to make additional reports if necessary.

5. Head off caregiver abuse by recognizing caregiver burnout

Caregiver burnout is no excuse for caregiver abuse, but sometimes people lose control. If you see that a family member is caring for a loved one and seems overwhelmed, offer to help. Suggest to hire a caregiver to take some of the load off. If you can’t be a caregiver yourself, offer to do the things you can, like coordinate medical care, arrange for prescriptions, shop, and bring some meals over.

If it appears that the situation is critical, talk as a family about other options for care like assisted living, respite care, or adult daycare. Offer to arrange for alternative care to give the primary caregiver a break.

6. Call 911 in an emergency

If the situation is critical or life-threatening, call 911. A person’s safety and well-being are your responsibility if you see that they are in danger. It is better to err on the side of caution. An emergency room visit can sometimes be the catalyst for identifying and addressing caregiver abuse. Emergency departments also have social workers trained to deal with elder abuse issues.

7. Protect yourself

Protecting yourself entails making decisions while you are physically and mentally able. Start by doing long-term care planning that includes advance directives. Consider having an attorney on your team that you can trust. If you find yourself in an unsafe or confusing situation, you have a legal authority on your side.

Stay socially connected. Social isolation is a risk factor for caregiver abuse. No one thinks abuse will happen to them until it does. Know your rights and reach out for help if you need it. If you think you might have depression, seek the services of a therapist who can help you with strategies to feel better.

Handling Caregiver Abuse is Important and Necessary

Thinking about and dealing with caregiver abuse is difficult and heartbreaking. No matter who the person is, caregiver abuse is not to be tolerated and must be reported. Knowing what to look for and how to handle the situation will give you the confidence to help someone in need, even if that person is you.


Sources

  1. “Elder Abuse Facts.” National Council on Aging. www.ncoa.org/public-policy-action/elder-justice/elder-abuse-facts/#intraPageNav2
  2. “What is Elder Abuse?” Centers for Disease Control and Prevention. www.cdc.gov/violenceprevention/elderabuse/fastfact.html
  3. “Insights on Adverse Effects of Elder Abuse.” National Institute of Justice.  nij.ojp.gov/topics/articles/insights-adverse-effects-elder-abuse 

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