The term ‘elder abuse’ applies to a wide range of crimes and contexts. Simply put, anyone who intentionally causes harm or risk of harm to an elderly person they have power over has committed elder abuse.

Unfortunately, nursing homes are one of the most common settings for elder abuse. Profit-driven facilities often fail to provide acceptable minimum standards of care to their vulnerable residents.

Let’s take a look at some of the most common forms of abuse found in nursing homes and assisted living facilities.

Neglect/Abandonment

Inaction in the form of neglect is elder abuse — particularly when there is a duty of care involved, as with caregivers such as nursing home staff.

Neglect takes many different forms, including failure to provide food, water, medical care, or medication. It can also involve leaving an elderly person alone or unsupervised for extended periods of time, or failing to address basic hygiene or cleanliness needs. In nursing homes, neglect often arises as a result of understaffing, inadequate training, or lack of resources.

Abandonment occurs when a resident is discharged from a facility without proper notice or support, or when a caregiver fails to return to a facility to provide care.

Physical abuse

Physical abuse is usually the most visible, easily recognizable form of elder abuse. It involves the use of physical force causing pain, injury, or impairment.

Physical abuse takes many different forms, including hitting, slapping, pushing, shaking, and using physical and pharmacological restraints. Signs of physical elder abuse include:

• Cuts and scrapes
• Broken bones
• Bruises
• Burns
• Dislocated joints
• Emergency room treatment
• Head injuries
• Sprains

According to a 2017 study analyzed by the World Health Organization, 9.3% of nursing home staff members admitted physically abusing elderly residents. The Department of Justice estimates that only 1 in 20 cases of physical abuse are reported to authorities.

These stark figures illustrate the need for family members to remain vigilant to the possibility that their loved one is experiencing physical abuse.

Emotional abuse

Emotional or psychological abuse is the intentional infliction of mental pain, fear, anguish, or distress.

Often difficult to detect, emotional abuse frequently involves the use of tactics such as gaslighting and intimidation to control or manipulate an elderly person, causing them to feel frightened or humiliated. Emotional abuse takes many different forms, including shouting at, insulting, belittling, or ignoring an elderly person.

Signs of emotional elder abuse include:

• A withdrawn or depressed disposition
• Low self-esteem
• Mood swings or personality/behavioral changes

Financial abuse

Financial – or fiduciary – elder abuse refers to financial exploitation by people who have a duty to act in the elderly person’s best interests. This may include caregivers, financial advisors, and other professionals entrusted with managing the individual’s finances.

Financial abuse includes theft, embezzlement, fraud, or coercion. A caregiver who has access to an elderly person’s bank account may take advantage of their vulnerability or cognitive impairment, and use their position of trust to steal money or make unauthorized purchases.

There are several warning signs that may indicate fiduciary elder abuse, including sudden, unexplained withdrawals from their bank account, missing personal property or valuables, or changes in estate planning documents that they did not initiate.

Sexual abuse

Sexual abuse involves any unwanted sexual contact or activity, including sexual assault, rape, or coerced sexual activity.

In nursing homes, sexual abuse may be perpetrated by caregivers taking advantage of a resident’s vulnerability, cognitive impairment, or physical limitations. Sexual abuse can also occur between residents. Disabilities like dementia and Alzheimer’s make older people particularly vulnerable to sexual abuse.

For more information on the various manifestations of elder abuse in nursing homes, visit the National Center on Elder Abuse.