Protecting Your Loved One From Abuse

Unfortunately, unless you are able to be with your loved one 24-hours a day, you need to be aware of the dangers of possible care-recipient abuse.

While most caregivers—both professional and “informal” or “family” caregivers—truly want to help those that they care for, there are times when care recipients become victims of abuse. Abuse comes in different forms, but the general definition includes: “the infliction of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm or pain or mental anguish; sexual exploitation; or the willful deprivation of essential needs.”

Some forms of abuse, such as physical abuse, are fairly easy to detect. In contrast, types of abuse like intimidation and mental anguish may be more difficult to recognize. Regardless, care recipients who are cursed at, ridiculed, or threatened are usually hesitant to speak up, so it’s important that you watch for signs that your loved one is being abused—especially if he or she resides in a care facility, makes use of home health or other home care services, or participates in adult day care or similar programs.

Physical Abuse

Physical abuse indicators include cruel discipline, physical assaults, excessive use of restraint (chemical or physical), and wrong or unnecessary medication. Physical abuse is visible in many ways, including broken bones, burns, cuts, internal physical injuries, marks/ bruises, and scars. Signs include:

  • Broken bones, including the inability to move a limb, spiral fractures, or fractures of the skull, nose, or facial structure resulting from incidents including the mishandling of an elderly patient with osteoporosis
  • Burns or blistering of the skin resulting from incidents including scaling bath water, cigarette burns, or rope burns on areas including the arms, legs, neck, or torso
  • Cuts or scratches resulting from fingernail scrapes or being jabbed with a sharp object
  • Internal injuries often indicated by bleeding, bloody stools, pain, stuporous states, or vomiting which can be caused by incidents including overmedication or a blow to the stomach or head
  • Marks, bruises, or scars in areas such as the face, neck, inner arms, inner thighs, and the upper arm

Sexual Abuse

Sexual abuse may be defined as “contact or interaction of a sexual nature involving an incapacitated or dependent adult without that adult’s consent.” The following incidents may indicate sexual abuse:

  • Affectionate gestures that are too lingering and/or seductive or that are centered on the sex organs, anus, or breasts
  • Injury to an individual’s genitals, anus, breasts, or mouth
  • Exposure by another of his/ her genitals to the care recipient
  • Nude pictures or photographs taken of the resident or shown to the resident
  • Difficulty walking or sitting, pain or itching in the genital area, torn or bloody underwear, and venereal disease are also sometimes signs of sexual abuse


Neglect is another form of abuse that means a threat to an adult’s health or welfare by physical or mental injury or impairment, deprivation or essential needs, or lack of protection from these. Incidents that sometimes indicate neglect include:

  • The care recipient being left alone or ignored by staff members
  • A group of residents with aggressive tendencies being left alone
  • An intoxicated or sleeping staff member
  • Failure by any member of the staff to notify a care recipient’s doctor, dentist, or family about medical problems immediately after they occur, or a prolonged lapse in time before treatment is given for these problems

Emotional Abuse

Finally, emotional abuse, which is often the hardest form of abuse to detect, includes verbal abuse meant to injure the care recipient’s self-esteem or feelings of self-worth. Signs of emotional abuse include:

  • Threats, insults, or scolding by a caretaker or other resident
  • A caretaker not allowing the care recipient talk for him/ herself
  • A dramatic change in the care recipient’s behavior, which often leaves the individual withdrawn or depressed

Guarding Against Abuse

As a caregiver it is important that you keep your eyes open for signs of abuse, which can occur in institutional environments, as well as in a home-based caregiving situation. Regardless of where your loved one receives care, be aware of the following risk factors, which can indicate abusive tendencies in professional caregivers or other staff members:

  • Alcohol/drug abuse
  • Chronic physical illness
  • Excessive absenteeism
  • Expecting the care recipient to fulfill his/her needs
  • Family problems, or a history of family violence
  • Financial problems
  • Insubordination or a need for control
  • Mental illness
  • Multiple past disciplinary actions taken against the prospective caregiver
  • Social isolation
  • Tardiness or unexplained absences

In the event that you need to report a case of abuse, contact the Adult Protective Services office, Department of Aging, or Long-Term Care Ombudsman’s office in your loved one’s area.

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