Elder Abuse

There are five principal domains of elder abuse: physical abuse, psychological abuse, sexual abuse, neglect, and financial abuse. This chapter discusses the prevalence, prediction, and assessment of elder abuse as well as other factors related to abuse. The incidence of elder abuse is 24 times greater than the number of cases referred to social service, law enforcement, or other legal authorities. Caregiver factors, rather than risk factors associated with the abused elder, may be more important in predicting abuse. Lack of compliance with medical regimens, delay in seeking medical care, disparity in explanations given for injuries, unexplained injuries, and implausible or vague explanations may be warning signs. Elder financial victimization can be classified as door-to-door scams, professional swindles, and caregiver abuse. Elder abuse increases mortality, emergency room visits, hospitalizations, and skilled nursing home placement. The psychiatric assessment may raise red flags of suspected elder abuse and may necessitate reporting to adult protective services. Interventions should be tailored to the circumstances and the resources available.