Understanding and Preventing Elder Abuse

In this important episode, host Lisa Skinner explores a deeply concerning issue that affects millions of older adults worldwide — elder abuse. With compassion and clarity, Lisa explains the many forms this abuse can take, how to recognize the warning signs, and what steps can be taken to prevent or report it.

Every person, regardless of age, deserves to live free from harm, neglect, and exploitation. Yet, according to the Centers for Disease Control and Prevention, approximately one in ten people over age 60 experience some form of abuse each year. This episode sheds light on the silent suffering many elders face — and provides listeners with the tools to recognize, respond, and advocate for those who may be at risk.

Listeners will learn:

• The different forms of elder abuse — physical, emotional, financial, sexual, neglect, and self-neglect.
• Who is most at risk, including individuals living with dementia, those dependent on caregivers, and socially isolated adults.
• The warning signs that may indicate abuse is occurring.
• Barriers to reporting and why so many cases go unreported.
• Practical steps to take if you suspect elder abuse — from ensuring immediate safety to reporting and seeking support.
• Prevention strategies to protect loved ones, including caregiver support, open communication, financial safeguards, and community connection.

Lisa also debunks common myths surrounding elder abuse and discusses the legal and ethical considerations for mandated reporters and caregivers. This episode serves as both an educational guide and a compassionate call to action — reminding listeners that vigilance, empathy, and awareness can make all the difference in keeping our elders safe.

Resources Mentioned:

• National Center on Elder Abuse (NCEA): https://ncea.acl.gov
• Adult Protective Services (APS) Directory by State: https://ncea.acl.gov/Resources/State.aspx
• National Domestic Violence Hotline: https://www.thehotline.org/ — for confidential support
• Truth, Lies, and Alzheimer’s Book by Lisa Skinner: https://www.truthliesalzheimers.com

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to...

Episode Transcript

Lisa Skinner (00:01):
Welcome back, everybody. Today, we're going to
be diving into a somewhatsensitive topic, but a necessary
one to be aware of. It's thetopic of elder abuse, and I'm
going to cover many aspects ofit, including what constitutes

(00:21):
elder abuse, how to spot warningsigns, how to report
mistreatment, and much, muchmore. Why? Because every person,
no matter how old, deserves tobe safe from harm by those who
live with them care for them, orhave daily contact with them.

(00:45):
Yet, approximately one in 10people, age 60 and older who
live at home experience abuse,including mistreatment and
exploitation, and this isaccording to the Centers for
Disease Control and Preventionover time, elder abuse can harm

(01:07):
an individual's physical andpsychological health. It can
destroy social and family tiesand cause devastating financial
loss. Research also suggeststhat older people who have been
abused tend to die earlier thanthose who have not been abused,

(01:29):
even in the absence of havingchronic conditions or life
threatening diseases. And that'saccording to The JAMA Network
article 184, 342, 342, so whatdoes elder abuse actually look
like? Well, there's no singlepattern of elder abuse. It's a

(01:51):
complex problem that can stemfrom multiple causes, such as a
history of violent interactionswithin the family, lifestyle
adjustments and tensions thatcan arise as a result of new
living arrangements or acaregiver's personal problems,

(02:11):
for example, caregiver stress,mental or emotional illness,
addiction to alcohol or otherdrugs, job loss, or other
personal crises can lead to theabuse of an older person. Then
there are certain societalattitudes that may also

(02:32):
contribute to violence againstolder people and make it easier
for abuse to continue withoutdetection or intervention. For
example, older people are oftenregarded as being insignificant,
leading society to fail torecognize the importance of

(02:53):
assuring dignified, supportiveand non abusive life
circumstances for every olderperson. These factors include
the devaluation of and lack ofrespect for older adults, and
society's belief that what goeson in the home is a private

(03:15):
quote, unquote family matter.Who is most affected by Elder
Abuse, like other forms ofabuse, elder abuse, again, is a
complex problem, and it's easyfor people to have
misconceptions about it. Thetruth is that most elder abuse

(03:39):
and neglect does take place inthe home. The majority of older
adults live in the community,either on their own or with
their spouses, children,siblings or other relatives,
rather than living ininstitutional settings. And as a
result of these statistics, thehome is obviously where most

(04:05):
abuse happens. Family memberscommit elder abuse in nearly six
out of 10 cases. That'sstartling, according to the
National Council on Aging,anyone can be vulnerable. Older

(04:26):
individuals who are frail, whoare alone or depressed, as well
as those with a physicaldisability or mental illness,
are vulnerable to abuse.However, even those who are not
affected by these visible risks,can find themselves in abusive
situations and relationships.Elder abuse affects people

(04:49):
across all socioeconomic groups,cultures, races and ethnicities.
Elder Abuse takes many forms.Forms in many different ways.
Sometimes the signs of abuse aresilent or hard to detect, giving

(05:10):
the perception that everythingis okay. So here are some of the
warning signs that a person maybe experiencing abuse, there's
physical abuse, and it involvesincluding, but not limited to
inflicting physical pain orinjury or inappropriate use of

(05:34):
restraint, unexplained injuriessuch as bruises, sprains, burns
burns and or welts, especiallyif you're noticing that these
things are recurring, thenthere's emotional and
psychological abuse, and thisincludes, but not limited to

(05:55):
insults, threats, humiliatingthe elder, isolating the elder,
or intimidating the elder,you'll see sudden or frequent
withdrawal from socialactivities. They're scared, or
they exhibit anxiety around aspecific person. They become

(06:22):
more depressed, or you seesudden extreme mood changes or
deterioration in their moods orsleep patterns. Also look for
changes in appetite self blameor expressions of helplessness,

(06:43):
there's neglect, and what fallsinto this category are failing
to provide food, shelter,medicine, hygiene or medical
care. Those are just a fewexamples isolation that includes
limiting the elder from contactwith friends and family or

(07:04):
monitoring their communications.Then, of course, there's
financial abuse. This can rangefrom theft, misuse of an older
adult's funds, exploitation oftheir assets, forging their
signature, sudden changes in abanking institution. Bills are

(07:30):
go unpaid, yet funds aredisappearing, or new, unfamiliar
accounts also unexplainedchanges to wills or a power of
attorney or a beneficiarysignature you notice large
withdrawals, cash advances orpurchases that are not aligned

(07:52):
with needs or preferences,insistence that the elder's
finances be managed by thecaregiver and or missing
valuable or inconsistentreceipts from shopping or
services provided there's sexualabuse. This includes

(08:14):
inappropriate touching,photographing the elder in
suggestive poses, forcing theelder to look at pornography or
any unwanted sexualizedbehavior, as well as non
consensual sexual contact orcoercion by another person. Self

(08:36):
neglect is also abuse when anolder adult is unable to care
for themselves, they canendanger their own health and
safety, potentially due tocognitive impairment, depression
or physical Disability,abandonment falls into the abuse

(08:59):
category, like deserting,desertion of an older adult by
someone responsible for theircare. So how do we recognize
elder abuse? Well, recognitioncan be extremely challenging,
especially when the abuse ishidden or the elder is reluctant

(09:22):
to report it. So here are someideas. Look for a pattern of
concerning signs across multipledomains. So here's one
classification, social andenvironmental signs to look for
isolation from friends or otherfamily members, conflicting or

(09:46):
implausible explanations aboutinjuries or their needs, unsafe
living conditions that includesno heat, unsafe housing or.
Threats of eviction,
untreated medical or dentalneeds, caregiver, elder

(10:08):
interactions. This look mightlook like the caregiver refuses
to leave the elder alone, or theelder is fearful of the
caregiver. The elderconsistently defers to the
caregiver or avoids questionsabout their care, apparent
caregiver stress and blaming theelder for their problems. Again,

(10:35):
self neglect indicators youmight notice, poor hygiene, poor
personal hygiene. They're alwaysin soiled clothing, and they're
living in dirty living spaces,their inability to obtain or
manage food or their medicationsor even essential services and

(11:02):
severe, untreated medicalconditions due to intentional
neglect, and some of the otherindicators would be poor
hygiene, malnutrition anddehydration, or you notice that
all of a sudden, their denturesare missing, their eyeglasses

(11:24):
have disappeared, their hearingaids cannot be found, or some of
their other personal belongings.Now I just want to say that some
signs may actually have amedical explanation or result
from the fact that they livewith cognitive impairment or
dementia, so keep that in mindbefore maybe jumping to a rushed

(11:51):
decision about what's going on,Who is at the highest risk. So
the list of elders who are atthe highest risk of abuse
include Older Adults withCognitive Impairment and or
dementia, dependence on othersfor daily needs, physically or

(12:16):
financially, living with acaregiver who is under stress
has a history of abuse, or theylack training, social isolation
or lack of supportive networks,a previous history of abuse

(12:37):
within their own family andfinancial dependence on their
caregiver. What are the barriersto reporting and disclosing
abuse? Well, the most obviousone would be fear of retaliation

(12:58):
or losing essential caregiversupport, losing their
independence, having cognitiveimpairment or communication
difficulties could hinder theirmemory and ability to
communicate with others, feelingshame, guilt, embarrassment or a

(13:20):
believing that abuse is a normalpart of living, or it's a
cultural belief dependency onthe abuser for care, and you
always have to factor in familydynamics or fear of
institutionalization. What doyou do if you suspect elder

(13:49):
abuse? Step one, the first thingyou want to do, make sure the
elder is safe. If there is anyimmediate danger or acute harm
you want to contact emergencyservices in the US. Dial 911,
elsewhere, use the localemergency numbers. Number two,

(14:13):
document what you are observing,record dates, times and
descriptions of your concerns,note physical signs, statements
from the elder or changes thatyou've noticed in their
behavior, and preserve anyphysical evidence. So in other

(14:35):
words, don't wash or moveinjured belongings unless
necessary to prevent harm. Stepthree, try talking with the
elder, if safe and appropriate,choose a private, calm setting,
use respectful, non judgmentallanguage. Express concern for

(14:57):
them and ask open endedquestions. For example, I'm
worried about your safety. Canyou tell me what's been
happening? Avoid pressuring orarguing with them, and respect
their autonomy and decisions,and then, of course, report it

(15:19):
what you discover to the rightauthorities. Reports are often
confidential and protected bylaw in the US, you can report to
adult protective services inyour state, your local police or
sheriff department, a long termcare ombudsman if abuse occurs

(15:42):
in a facility, a state agencyoverseeing elder care or social
services, and then in othercountries, you can contact a
social services or Department ofAging and Elder Affairs police
for criminal abuse, nationalhelplines or elder abuse

(16:04):
hotlines. If you're uncertain,start with Adult Protective
Services or local socialservices, and they can guide you
seeking additional supportmedical evaluation for injuries
or health care concerns by amedical provider or social

(16:27):
services are available forcounseling, respite care and or
caregiver support. Legal Adviceis available. Elder Care
attorneys on guardianship powersof attorney and or protective
orders, and then financialprotection resources that

(16:48):
include credit monitoring andfraud protection. And then
finally, create a safety planidentify trusted individuals who
can help with daily oversight,arrange for safer housing,
access to transportation andregular check ins, and then

(17:13):
consider temporary or permanentchanges in caregiving
arrangements, if you feel thatis necessary. Now I'm going to
talk a little bit about howdifferent settings affect
reporting and resources, becausethat varies. So if the abuse is

(17:37):
occurring and we it's in a homebased environment, this often
requires coordination with adultprotective services, social
workers and primary careproviders if the abuse is
occurring in a nursing home,assisted living memory care

(17:59):
facility or long term carefacility, you want to file
complaints with state regulatoryagencies, the facilities,
ombuds, person Long Term Careregulators and notice patterns
of neglect or abuse if the abuseis occurring in a hospital

(18:23):
setting, the medical teams candocument injuries, coordinate
with social work involvement andreport concerns to adult
protective services if abuse issuspected. So here are some
prevention strategies for you tobe aware of, regular open

(18:46):
communication with older adultsand caregivers. Provide
caregiver support that includesrespite services, training in
caregiving techniques and instress management, safeguard
their finances, monitor theiraccounts, set up alert

(19:09):
notifications and Use trustedfinancial professionals do some
proactive legal planning
by creating advanced directivesor durable power of attorney
guardianship arrangements andliving wills and trusts ensure

(19:34):
safe living environment byMonitoring home safety
assessments and assistivedevices to prevent falls. Then
there are community connections,social groups, senior centers
and routine check ins. Welfarechecks is one of them. And of

(19:54):
course, always stay on top ofeducating yourself. Of recognize
signs of abuse, how to reportand how to access the resources
available in your area orcommunity. Legal and ethical
considerations to be aware of.Elder abuse is a crime in many

(20:21):
jurisdictions, the legaldefinitions, however and
penalties do vary. There aremandated reporters, many
professionals, your doctors,your nurses, your social
workers, teachers, lawenforcement, these people are

(20:43):
legally required to reportsuspected abuse. It's mandatory
now, privacy versus safety,balancing elder autonomy with
protective interventions. AdultProtective Services focus on the
elders, safety while respectingtheir rights, capacity and

(21:08):
consent determine their decisionmaking capacity. Are they
confused? Are they beingcoerced? Because all these
things can definitely andobviously complicate them giving
consent to anything. So I wantto finish by debunking some

(21:32):
common myths to elder abuse. Sothe myth, this is one myth, that
Elder abuse is only aboutphysical harm, the reality it
comes in a lot of differentshapes and forms, including
emotional, financial neglect,self neglect, among others,

(21:55):
another myth. Well, the elderwill just tell someone if
something's wrong, the realityof that is that many elders,
again, their number one fear isretaliation. They feel ashamed
sometimes, or depend on theabuser for care, making
disclosures rare. That's the sadtruth of this, another myth, if

(22:22):
there are injuries, it must bedue to an accident. But the
reality to that myth isinconsistent injuries repeated
incidents, or injuries notmatching the elder's activity
level can certainly indicateabuse. One more myth, reporting

(22:45):
abuse will ruin the family.Reality, protective services
prioritize safety and canprovide supportive services.
Reporting can prevent furtherharm. So hopefully you will
benefit from being aware ofeverything that I've shared with

(23:06):
you today, and this recording,of course, is available for you
to access when it airs and thenanytime in the future. So that
concludes today's episode of thetruth lies in Alzheimer's show.
And once again, I'm LisaSkinner, your host, and I
certainly appreciate you takingthe time to spend part of your

(23:29):
day with us here, and I lookforward to bringing you another
brand new episode next week.Have a great rest of your week,
and please try to stay happy andhealthy. Bye for now.