Sunday, October 24, 2021

Elder abuse, red flag warning signs



by Paula Robinson

This is the last installment in this series about Elder Abuse and Neglect which is a widespread problem in societies in the 21st century.

As was noted in this column on Nov. 19, experts estimate that only one in six cases of Adult Abuse and Neglect or fewer are reported, which means that very few seniors who have been abused get the help that they need, so what should we be looking for to help keep our older adults free from harm? Please read on and if you suspect someone you care about is being abused or neglected – you have the power to help prevent further abuse. You do not need absolute proof to report suspected abuse or give your name, and all calls are handled confidentially.

Red Flags – Indicators

Physical: Unexplained reason or explanation in consistent with bruises or welts in various stages of healing; swelling, lacerations, punctures, repeated falls, restricted movement of an individual perhaps due to internal injuries, or bilateral injuries indicating possible grabbing or restraint; grip marks, malnourishment, dehydration, patches of hair missing, twisting injuries or spiral fractures, pinch marks, swollen eyes or ankles, broken eyeglasses, skin tears, or and an untreated medical condition. Often times, elders may have torn or bloody clothing or injuries reflecting an outline of objects used to cause the injury such as: belt buckles, rings, hands etc. More serious and obvious signs may be rope or cigarette burns, blisters, hyperthermia and or hypothermia.

Neglect: Observe for elders who appear to be: emaciated, malnourished or dehydrated with sunken eyes and poor skin turgor, confusion without a known cause, being inappropriately dressed, under-or over-medicated; they may have open sores, poor hygiene or live in unsanitary conditions including improper heating or air conditioning, and even more caustic could be the smell of urine or feces in the home with a lack of required safety measures. Health and safety measures may include doors with no locks, rodents or insects, repairs that are needed to the roof, stairs or railings, poor lighting, or fire hazards. You may note pressure sores or ulcers if you can observe the senior closely. Other concerns are the senior is being left alone without supervision or assistance when needed; medical appointments are being cancelled on a regular basis, or the senior is not showing up for scheduled appointments.

Sexual Abuse: Of all, this might be one of the most difficult signs to report unless you are close to the individual; however, you may observe unwanted touching, coerced nudity or sexually or explicit photography. You may hear the senior talk of frequent pain, see bruising, or bleeding in the genital area. Other issues may be inappropriate sexual comments from others (families and or caregivers), or any other signs of physical restraint which may have you suspect that something may have been done against a seniors will. A healthcare professional may suspect sexual abuse when there is unexplained sexually transmitted disease or repeated genital infections.

Emotional Abuse/Behavioral: Have you noticed any unexplained changes in alertness, withdrawal from normal activities, or other depressive issues? Look for low self-esteem, greater agitation, difficulty sleeping or needs for excessive sleep, passivity, and feelings of hopelessness, (may talk about suicide), and they may doubt their sanity. There may be periods when the senior goes without visitors or outings for long periods and is resigned and tearful. When there is isolation, or one is given the “silent” treatment it should be immediate cause for concern including intimidation and humiliation. Other signs: the senior has no opportunity to speak for themselves, may become reluctant to talk about their home life, and is fearful when approached by their caregiver to the extent that they may even flinch or withdraw even when approached by others for fear of being harmed.

Financial Abuse: Even more so now in tough economic times watch for large sums of money being taken from a bank account, signatures on checks or other papers that look suspicious; the senior is now in debt and does not know why; bank statements are no longer being sent to the individual’s home; they cannot pay their bills or buy personal care items; personal belongings, such as clothes or jewelry are missing from their home or room in an institution, they are asked to sign legal papers (Power of Attorney, a will, or a joint deed to a house), without being able to understand what they mean, and they cannot remember signing papers or making certain money transfers. Often checks may be written as” loans” or gifs” and there could even be a loss of property. The older adult is suddenly not allowed to decide or speak for himself or herself.

The key to helping our seniors get help is to report the suspicion(s) promptly. Talk with your older friends, neighbors and relatives because maintaining communication decreases isolation and it may give the senior a chance to talk about any troubles they are having. Generally, be aware of the possibility of abuse in its many forms by looking around and taking note of what is happening with your senior neighbors. Are you seeing nervousness, withdrawal or anxiety around certain people, when they have not seemed so in the past? Experts know that abusers may be spouses, family members or personal acquaintances, or they could be professionals in positions of trust; and or opportunistic strangers who prey on the vulnerable.

You can report suspected mistreatment to our local law enforcement agency or to the Florida Abuse Hotline at 1-800- 962-ABUSE (1-800-962-2873). Florida law (Chapter 475) requires that persons who know or have reasonable cause to suspect that an adult has been neglected or abused report such knowledge. Again, you can remain anonymous but please help to prevent elder abuse!

Paula Camposano Robinson, RN, is co-founder and owner of Sanitasole Senior Health Services. This is an information-only column and is not intended to replace medical advice from a physician. Email or visit, for more information. Phone: 239.394.9931.

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