Caregivers Patients

How to Detect and Prevent Abuse From Caregivers

Written by Anthony Emecheta

Abuse of seniors can come in different forms and from anyone. While it is rarely expected that abuse of a senior should come from a family member, studies have shown that is where it often comes from. Therefore, it is important to know the signs of abuse and nip them in the bud. This is particularly important in Black communities where caregiving is often done by overstressed family members who may not possess the requisite training.

The Centers for Disease Control and Prevention describes 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”. What this means is that abuse can be physical or psychological. Senior abuse is mostly grouped into five forms which also helps to distinguish them from other forms of harm. Below are the types of caregiver abuse and their percentage prevalence.

  • Caregiver neglect (5.1%): failure to meet the basic needs of the elderly person including food, water, and shelter
  • Physical abuse (1.6%): the use of physical force like kicking, hitting, slapping, or pushing, that leads to injury, pain, illness, or death
  • Financial exploitation (5.2%): unauthorized or illegal use of a senior’s money or belongings for a purpose that benefits someone other than the senior
  • Psychological abuse (4.6%): verbal or nonverbal behaviors that cause mental pain, distress, or fear to the senior
  • Sexual abuse (<1.0%): forceful or nonconsensual sexual interaction with a senior including sexual harassment or penetration

The prevalence of caregiver abuse can be higher than the stipulated numbers because of underreporting. Looking at the broad picture, a review report published in the Journal of the National Medical Association suggested that elder abuse by caregivers across the African Diaspora community ranges from 24.9% to 81.1%. The authors highlighted the risk factors to include widowhood, lack of resources, social isolation, and cognitive and physical impairment.

Another study published by the US Department of Justice added that the tendency of Black people to be in poorer health than their White counterparts can significantly increase their risk of being abused. It takes more time and resources to care for a senior with poor health than a healthy one.

The lack of money to get professional or additional help means caregivers (mostly family members in Black communities) are often stressed physically and financially. This strain can make them to become unintentionally abusive.

How to detect senior abuse

Signs of senior abuse are always there, even if the seniors are cognitively impaired or too physically frail to speak up. The signs that you should look for will depend on the type of abuse that you suspect. The easiest to detect are physical and sexual abuse.

Lacerations, bruises, fractures, swellings, or skin discoloration can be a sign that a senior is physically abused. Other signs that may suggest physical or sexual abuse include cigarette burns, black eye, unexplained injuries (including on the breast), scalp wounds, bleeding in the genital area, unexplained sexually transmitted diseases, and torn underwear.

Neglect is also another form of abuse that leaves physical signs. Poor personal hygiene is one of the first signs of neglect. Others are signs of dehydration and malnutrition, bedsores, and sudden weight loss that is not due to an illness.

The abuses that are harder to detect are those that don’t leave physical scars. However, you can also tell when a senior is going through psychological abuse by observing a change in their behavior. Withdrawal, depression, anxiety around people, and unusual mood changes can all be a sign of psychological abuse.

Financial exploitation is the easiest to go unnoticed. However, unusual banking activity and sudden changes to the senior’s legal arrangements (like powers of attorney, titles to property, etc.) can be a sign that a senior is being exploited financially.

How to prevent caregiver abuse

There is no denying the fact that some caregivers are guilty of one or more of these types of senior abuses without even knowing it. In some cases, the abuse is strictly from a place of ignorance. Therefore, education and caregiver training are important steps towards stamping out the menace of elder abuse in Black communities—and elsewhere.

Community-based programs that make use of unique social networks involving Black seniors can provide a platform to improve caregiver support and training. Such a platform will help to reinforce traditional filial and informal caregiving practices as well as encourage caregivers and families with aging seniors to use available government institutions.

Also, the prevention of senior abuse in Black communities requires fundamental changes to the social conditions of Black communities. The provision of low-cost national health insurance, guaranteed annual income, tax incentives for caregivers, federal assistance to frail seniors, and other targeted measures will go a long way to eliminate senior abuse.

Many of the current approaches to preventing senior abuse typically hinge on experimental service programs or mandatory reporting laws. However, these interventions rarely tackle the root of the problem which is usually poverty and caregiver burnout. Always report elderly abuse rather than looking the other way when you encounter one. Remember, elderly abuse is a crime that is punishable by law. To report elder abuse or find services for older adults and their families, visit The Eldercare Locator. You can also access the Locator by calling 1-800-677-1116 .The Eldercare Locator is a public service of the U.S. Administration on Aging.

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About the author

Anthony Emecheta

Anthony Emecheta holds a master’s degree in microbiology. He is a passionate educator and particularly an advocate of racial equality. He strongly believes the world will be a better place if we all see ourselves as humans first before anything else.

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