Elder Abuse

By Richard P. Holm MD​

Caring for the elderly my whole clinical life has been an honor and a pleasure, but some experiences have been terribly heartbreaking. Elder abuse is one of the saddest, and it can come in the form of physical harm and neglect, emotional cruelty, or financial exploitation.

A couple of years ago a frail, confused, elderly person arrived in the emergency room with a fractured bone, bruises, sores, and was quite unclean. His family described that the patient had fallen multiple times recently, and I could see his needs were overwhelming his care providers. If there hadn't been physical abuse, there was at least neglect. After surgery and hospital care, we were able to send the patient to a nursing home. We all need to be aware when there might be possible physical abuse, and call for help when we see it.

Another case was one of emotional abuse with much blaming, shouting, and anger put upon an incapacitated elder. It was by a visiting, emotionally-ill family member who had arrived from afar and was unloading his own emotional baggage upon their frail and defenseless parent. The patient had been admitted for a medical issue, and the nurses were the first to recognize the emotional abuse. Police were notified and the visitor was banished from visiting the patient in the hospital during their stay or at their home after they were discharged.

On instance of financial abuse was evident in another case, when a son informed me that his 80-plus-year-old mother and her new boyfriend had recently been going to the bank and removing large sums from the mother’s savings account. The son believed his mother was “losing it”, and informed me that she had been spending thousands of dollars for herbal and supplemental cures for her memory problems She had several unpaid bills and was now was being manipulated by an opportunist. He asked me how to protect his mother’s money.

I saw the patient in my office; obviously the mother was demented and incapacitated. A judge confirmed her incompetence and determined the son was to have power of attorney. Problems could have been avoided had the son been more watchful, had the mother made financial plans before her mental health problems, and had a bank’s trust department or a bookkeeping business been asked to pay bills.

None of us are safe from abuse. When people become frail or lose their mental capacity, then bad people can take advantage of them. Elder abuse can come in the form of physical harm and neglect, emotional cruelty, or financial exploitation, and is more common than you would expect.

Be aware, and take precautions.