News Room

Understanding Elder Abuse

A growing crisis in the care of older adults

By Brian Kabateck

Elder abuse is a widespread problem that often hides in plain sight.

Data from the National Council on Aging (NCOA) shows that approximately 10% of Americans aged 60 years or over have experienced some elder abuse in the last year—between five and six million older adults annually—and many researchers believe the actual number is considerably higher than recorded. Yet only one in 24 cases is reported to authorities. In the United States, an older adult is abused every five seconds.

Tragically, senior citizens are most often mistreated by people they trust and depend on, such as family members or nursing home staff.

“Elder Abuse: The Hidden Epidemic,” an article published last month by the National Institutes of Health (NIH), calls the mistreatment of older adults “a major public health problem.” “Prior to the pandemic, approximately 1 in 10 older adults in the United States experienced elder mistreatment. In 2020, this number doubled to 1 in 5, a nearly 84% increase (Liu, 2022). More distressing is that in almost 60% of elder abuse and neglect cases, a family member is the offender, and two-thirds of the perpetrators are adult children or spouses (Nursing Home Justice Team, 2021).”

Abuse also often happens in the very institutions we rely on to care for our aging loved ones—hospitals, nursing homes, and long-term care facilities. One in six older adults living in a community setting is mistreated; a whopping 66% of staff in these facilities report that they have committed abuse or neglect within the last year.

What is elder abuse?

Elder abuse can take many different forms:

Physical: Recklessly or intentionally causing bodily injury or pain to an older adult. Unnecessary or excessive use of force in tasks such as feeding or restraining.

Emotional/psychological: Causing an older adult distress, fear, or anguish through harassment, verbal or nonverbal threats, intimidation, humiliation, or disrespect.

Sexual: Unwanted sexual interaction of any kind, imposed through force, manipulation, threats, or when the elder is incapable of giving consent. May include intimate touching or fondling, rape, forced nudity, taking explicit photos or videos, administering medically unnecessary exams or treatment of private parts, and forcing an elder to look at sexual images, videos, or pornography.

Confinement: Isolating or restraining an older adult when not medically necessary.

Passive neglect: Failure to provide for an older adult’s essential needs, such as shelter, food, clothing, hygiene, and medical care.

Abandonment: Leaving a dependent older adult alone without planning for care or assistance.

Deprivation: Putting an elder in harm’s way (physically, mentally, emotionally) by ignoring their needs or denying them essential care such as medical treatment, medication, therapeutic devices, physical aid, food, shelter, and so forth—except in cases where the competent older adult has expressed a wish to go without such care.

Financial exploitation: Improper, illegal, or unauthorized use or withholding of an older adult’s resources.

Abuse has grave consequences for the victim. Abused older adults may suffer physical injury or illness, more frequent hospitalizations, deteriorating mental health (depression, anxiety, suicide), severe loss of dignity, diminished quality of life, and increased mortality.

Numerous common factors can increase an older adult’s vulnerability. Seniors with dementia, mental illness, or physical disabilities, those impaired by medication, individuals who have suffered past trauma, and low-income older adults are at heightened risk of abuse. Women are about 35% more likely to suffer abuse than men.

According to the National Center on Elder Abuse (NCEA), psychological abuse is the most common form of elder abuse; however, as the NCOA explains, “elders are more likely to self-report financial exploitation than emotional abuse, physical abuse, sexual abuse, or neglect.”

Why don’t abused elders come forward?

Seniors who experience abuse may have physical or cognitive limitations that inhibit their ability to speak out. They are often dependent on their abuser for care and basic necessities; they may fear retaliation; they may have been manipulated or threatened; they may feel shame or even worry about getting their abuser in trouble; in some cases, the victim cannot fully comprehend that they have been neglected or abused.

Elder Abuse in California

Unfortunately, despite rigorous state and federal regulation, California has a staggeringly poor track record on elder abuse. Data from the California Senate Office of Oversight and Outcomes shows that California has more than twice the national average of elder abuse reports—well over 200,000 each year. Eleven percent of all reported cases of elder abuse in the U.S. happen in our home state—the highest in the nation. In Orange County, reports of elder abuse nearly doubled between 2002 and 2012.

Watch for these signs of elder abuse:


  • Behavioral changes such as mood swings, becoming withdrawn or agitated, avoiding eye contact, unexplained changes in eating or sleeping habits
  • Symptoms of trauma
  • Unexplained injuries and marks such as bruises, cuts, scars, burns, broken bones (or given explanation is inconsistent / doesn’t make sense)
  • Unsafe or unsanitary living conditions
  • Development of preventable conditions such as bedsores
  • Poor hygiene (dirty clothes, unwashed hair, dental issues)
  • Individual seems lost, confused, afraid, frail, malnourished, dehydrated
  • Evidence of sexual abuse such as bruising or bleeding in intimate areas, STDs, pain in genitals
  • Lack of crucial personal health care items and medical devices (hearing aids, eyeglasses, dentures, walker)
  • Sudden, unexplained financial troubles despite adequate resources (pattern of missing belongings or assets, evidence of unpaid bills, changes to accounts or POA, someone showing strange interest in elder’s financial matters)


The World Health Organization affirms that any abuse of an older adult, whether a single act or a repetitive pattern, is a severe violation of human rights.

If you suspect that an older adult you love is the victim of abuse, carelessness, or exploitation at home or in a long-term care facility, do not hesitate—contact the experienced and compassionate elder abuse and nursing home abuse attorneys at Kabateck LLP for a free and confidential case evaluation. We are committed to protecting elders and gaining justice for survivors.