Recognizing and Preventing Abuse, Neglect and Exploitation of Individuals with Disabilities and Older Adults

By Roxanne J. Chang, JD, MS LLP

Individuals who have disabilities or who are older are at higher risk of abuse, neglect and exploitation. According to the National Center on Elder Abuse, approximately 30 percent of individuals with disabilities who need assistance with daily care, maintaining health and safety, and accessing the community have experienced some form of mistreatment. The National Council on Aging estimates that one in 10 Americans who are 60 years or older have experienced some form of elder abuse. Unfortunately, it is suspected that actual occurrences may be even greater than what is reported, for various reasons.

The definitions of abuse and exploitation vary from state to state, but they are defined by the National Council on Aging as follows:

  • Physical Abuse—Inflicting, or threatening to inflict, physical pain or injury on a vulnerable person, or depriving them of a basic need.
  • Emotional Abuse—Inflicting mental pain, anguish, or distress on a vulnerable person through verbal or nonverbal acts.
  • Sexual Abuse—Non-consensual sexual contact of any kind, coercing a vulnerable person to witness sexual behaviors.
  • Exploitation—Illegal taking, misuse, or concealment of funds, property or assets of a vulnerable person. Identity theft is also considered a form of exploitation.
  • Neglect—Refusal or failure by those responsible to provide food, shelter, health care or protection for a vulnerable person.
  • Abandonment—The desertion of a vulnerable person by anyone who has assumed the responsibility for care or custody of that person.

Warning Signs

Abusers can be anyone: a family member, a friend, a stranger, a service provider or a neighbor. It is important, therefore, to be informed and on the lookout for the warning signs of abuse, neglect and exploitation.

Warning signs of abuse include:

  • Changes in behavior (for example, refusing to go places or see people they typically like to go or see);
  • Changes in emotional states (for example, the person is more withdrawn, nervous, fearful, sad or anxious);
  • Unexplained cuts, bruises, bleeding;
  • Broken bones;
  • Burns;
  • Overmedication;
  • Isolation;

Warning signs of neglect include:

  • Dehydrated or malnourished;
  • Poor hygiene (for example, dirty hair, skin, clothing) or strong body odor;
  • Isolation;
  • Lack of food and other amenities in the home;
  • Unexplained weight loss;
  • Pressure sores;
  • Unpaid bills;
  • Lack of proper medical care or treatment;
  • Animal or insect infestation in the home;

Warning signs of exploitation include:

  • Withdrawals of significant amounts of cash from banks unexplained or in the presence of others;
  • Forged checks;
  • Unexplained/unknown credit card or other charges;
  • Unpaid bills;
  • Limited or no access information about finances;
  • Unknown/unfamiliar creditors, such as credit card companies;
  • Reliance on caregivers who have a history of substance abuse or other mental health issues;
  • Significant dependency for care or assistance on caregivers or others who do not have much prior history with the individual (for example, a person’s new “best friend” or neighbor who was never really involved before);
  • Isolation;
  • Multiple phone or in-person requests for money, or promises of a big “win” or “prize”;
  • Solicitations for money for goods and services that seem “too good to be true.”

Preventing and Addressing Abuse, Neglect and Exploitation

  • There are some steps that can be taken to prevent abuse, exploitation or neglect: Knowing the warning signs.
  • Asking lots of questions.
  • Developing and increasing the individual’s circle of support
  • Referring the individual to community resources, health care and social service professionals for more assistance. If you suspect that a person may be experiencing abuse, exploitation or neglect:
  • Listen, affirm and reassure the person that it is never his or her fault and that this is nothing to be embarrassed about.
  • Make a report to the school, social services or health care professionals
  • Contact the police or an attorney.
  • Make a report to the state or local child or adult protective services agency. Some states require certain professionals, such as health care providers, school workers, public employees and law enforcement, to make a report to the protective services agency whenever there is a suspicion of abuse, neglect or exploitation.
  • Call the local long-term care ombudsman if the person lives in a residential facility such as a nursing facility.
  • Refer the person to, or contact, professionals or organizations that have experience in assisting and supporting victims of abuse, neglect or exploitation.

Abuse, neglect and exploitation can happen to anyone. We can more effectively prevent and address them by educating ourselves and others, and building a stronger community of support to promote the health, well-being and independence of older adults and individuals with disabilities. After all, “It takes a village!”