Many members of our community are elderly or disabled, and elect to have an in-home caregiver rather than move to a full-time care facility.  Unfortunately, these caregivers can sometimes be unscrupulous, actively taking advantage of a situation for financial gain or just being in it for the paycheck and neglecting their patient.

If you or someone you know is elderly or disabled, download our tip-sheet Elder & Dependent Abuse [PDF, 176Kb] to learn and be able to recognize the signs of abuse.  Nearly a quarter of a million Californians become victims of elder or dependent adult abuse each year, and this number is expected to climb as our population grows and ages.

Physical abuse
Physical abuse is just like it sounds.  Whether a spouse, relative, or outside person, the caregiver inficts physical pain and causes injuries to their charge.  Signs include:
• Injuries that don't match the explanations given (such as a black eye or broken jaw from a minor fall, or chafing and abrasions on the wrists from an adhesive bandage, for example)
• Bruises, scratches, or other injuries, especially when frequent or in different stages of healing
• Inappropriate use of restraints or medication

Neglect
Neglect is a little bit more subtle than physical abuse, but it is still fairly easy to spot.  In this case the cargiver simply doesn't care and ignores their charge.  Signs include:
• Poor hygiene (for example, unbathed for an unreasonable amount of time, bedpans or adult diaper unchanged, etc.)
• Dirty or torn clothing
• Medical conditions that go untreated; bedsores
• Malnourished or dehydrated (signs include unexplained weight loss, "sunken" appearance to the face, severely chapped lips or hands, etc.)

Psychological abuse
More difficult to detect than physical abuse or neglect is psychological abuse, in which the caregiver isolates their charge or makes them feel worthless or scared (similar to domestic violence).  Signs include:
• The elderly or dependent person becomes withdrawn, secretive, or hesitant to talk freely around the caregiver
• The caregiver isolates the charge, restricting when and with whom contact can be made (for example, the charge is not allowed to visit friends or family, or even seek non-emergent medical care)
• The elder or dependent adult becomes confused or extremely forgetful, in the absence of another reason for such confusion or forgetfulness

Financial abuse
While not the most common form of elder or dependent abuse, financial abuse (also called fiduciary abuse) is probably the most well-known.  Signs include:
• Unusual bank activity (large withdrawals or fund transfers, increased frequency or types of transactions with no plausible explanation, etc.); transactions conducted in manners "out-of-habit" (such as debit transactions when the elder or dependent adult normally writes checks or pays cash)
• Unpaid bills, utilities shut off, eviction notices, sudden pattern of bounced checks
• Changes in spending patterns, often accompanied by the appearance of a new "best friend"
• Implausible explanations given by a relative or caregiver about an elder or dependent adult's finances

Types of abusers
There are three types of abusers:
• Plotting abusers deliberately plot and scheme to take advantage of a situation; these are typically financial abusers
• Happenstance abusers don't plan to abuse when taking on caregiving roles, but are presented with opportunities to that cause them to undertake abusive behavior
• Overwhelmed abusers are generally good-intentioned, but simply can't manage the responsibility whether due to it being greater than they can handle or due to other stressors in their personal life

When you suspect abuse
Many cases of elder and dependent abuse involve more than one type of abuse; an example is the coupling of psychological and financial abuse (the caregiver makes the elder or dependent adult feel as though they are incapable of managing their own finances), or an emotionally abusive caregiver becoming neglectful or even physically abusive.

If you suspect that an elder or dependent adult is being abused, report it.  Los Angeles is a County agency that investigates reports of suspected abuse, and will follow-up on each reported case with an in-person visit to the reported victim.  APS social workers will investigate and assess the situation, and will work with the victim to get them the help they need.  In cases of criminal abuse, APS will also work with law enforcement to file charges. http://css.lacounty.gov/aps.aspx 

Sometimes it can be difficult to acknowledge that potential abuse is occuring, particularly when the abuser is a relative ("Johnny would never do that!") or a caregiver from a supposedly reputable agency ("They're the professionals; they must know what they're doing").  However, the longer the abuse is allowed to continue, the worse it will get - so it is critical to report any suspected abuse right away.

Pay attention to what the elder or dependent person tells you, such as "My showers are always cold," or "I can't go outside anymore, it's not safe; they tell me it's not a good idea."  While it is possible that the person is confused or forgetful (such as in the case of Alzheimer's patients), these sorts of verbal cues can also be signs of neglect or physical abuse.

To report suspected elder or dependent adult abuse, call one of the following hotlines:

California Attorney General's Elder Abuse Hotline
(800) 436-3600

Los Angeles County Adult Protective Services
(877) 4-R-SENIORS (477-3646)
(213) 351-5401 (if calling from outside of Los Angeles County)

To report suspected elder or dependent adult abuse at a long-term care facility (nursing home, residential care facility, or assisted living facility), call one of the above hotlines or call:

California Long Term Care Ombudsman's Hotline
(800) 231-4024

If you have reason to suspect criminal abuse that has the elder or dependent adult's life or safety in immediate jeopardy, contact the Sheriff's station or law enforcement agency in the victim's area (for Lancaster, (661) 948-8466; for Palmdale, (661) 272-2400).

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