1 October: International Day of Older Persons - signs of elder abuse

Possible indicators of physical abuse

• cuts, lacerations, puncture wounds
• bruises, welts, discolouration
• any injury incompatible with history
• any injury which has not been properly cared for (injuries are sometimes hidden on areas of the body normally covered by clothing
• poor skin condition or poor skin hygiene
• absence of hair and or hemorrhaging below scalp
• dehydration and or malnourished without illness-related cause
• loss of weight
• burns: may be caused by cigarettes, caustics, acids, friction from ropes or chains, or contact with other objects
• soiled clothing or bed

Possible indicators of psychological / emotional abuse

• helplessness
• fear
• hesitation to talk openly
• withdrawal
• implausible stories
• depression
• confusion or disorientation
• denial
• anger
• agitation

Indicators of possible financial abuse

• unusual or inappropriate activity in bank accounts
• signatures of cheques, etc., that do not resemble the older person's signature, or signed when older person cannot write
• power of attorney given, or recent changes or creation of will, when the person is incapable of making such decisions
• unusual concern by caregiver that an excessive amount of money is being expended on the care of the older person
• numerous unpaid bills, overdue rent, when someone is supposed to be paying the bills for a dependent elder
• placement in nursing home or residential care facility which is not commensurate with alleged size of estate
• lack of amenities such as TV, personal grooming items, appropriate clothing, that the estate can well afford
• missing personal belongings such as art, silverware, or jewellery
• deliberate isolation, by a housekeeper, of an older adult from friends and family, resulting in the caregiver alone having total control

Elders may be financially exploited if they are:

• accompanied by a stranger who encourages them to withdraw a large amount of cash
• accompanied by a family member or other person who seems to coerce them into making transactions
• not allowed to speak for themselves or make decisions
• with an acquaintance who appears too interested in their financial status
• nervous or afraid of the person accompanying them
• giving implausible explanations about what they are doing with their money
• concerned or confused about 'missing funds' in their accounts
• unable to remember financial transactions or signing paperwork
• fearful that they will be evicted or institutionalised if money is not given to a caregiver
• neglected or receiving insufficient care for their needs or financial status
• isolated from other family members or supports by a family member of acquaintance

Symptoms of financial exploitation - suspicious banking activity

• unusual volume of banking activity
• frequent account changes from one branch/bank to another
• change in pattern of withdrawals (e.g. several in one day) or unusually large amounts
• large withdrawals or transfers from recently opened joint accounts
• banking activity inconsistent with customer's usual habits
• large withdrawal from previously inactive account or savings account
• frequent withdrawals made through ATMs, especially if elder is physically frail and had not used ATM previously
• regular rent or utility payments by cheque cease abruptly
• stable, single beneficiary trusts are revoked
• distribution provisions are altered to require payments to third parties
• suspicious signatures on cheques or other documents, like credit card applications
• elder's signature appears forged
• cheques /withdrawal slips made out in one handwriting, elder's signature appears correct
• sudden increases in incurred debt when elder appears unaware of transactions
• bank loans obtained
• large credit card or reserve credit debts
• second mortgages obtained
• a fiduciary or other begins handling the elder's affairs, withdrawing funds with no apparent benefit to the elder
• bank statements and cancelled cheques are no longer sent to the elder's home
• implausible reasons for banking activity are given either by the elder or the person accompanying him/her

• dirt, faecal/urine smell, or other health and safety hazards in elder's living environment
• rashes, sores, lice on elder
• elder is inadequately clothed
• elder is malnourished or dehydrated
• elder has an untreated medical condition

Possible indicators of self-neglect

• inability to manage personal finances, e.g. hoarding, squandering, giving money away or failure to pay bills
• inability to manage activities of daily living, including personal care, shopping, meal preparation, housework etc.
• suicidal acts, wanderings, refusing medical attention, isolation, substance abuse
• lack of toilet facilities, utilities or animal infested living quarters (dangerous conditions)
• rashes, sores, fecal/urine smell, inadequate clothing, malnourished, dehydration etc.
• changes in intellectual functioning, e.g. confusion, inappropriate or no response, disorientation to time and place, memory failure, incoherence, etc.
• not keeping medical appointments for serious illness

Possible indicators of abuse from the caregiver

• the elder may not be given the opportunity to speak for him or herself, or see others, without the presence of the caregiver (suspected abuser)
• attitudes of indifference or anger toward the dependent person, or the obvious absence of assistance
• family member or caregiver blames the elder (e.g. accusation that incontinence is a deliberate act)
• aggressive behaviour (threats, insults, harassment) by caregiver toward the elder
• previous history of abuse of others
• problems with alcohol or drugs
• inappropriate display of affection by the caregiver
• flirtations, coyness, etc. as possible indicators of inappropriate sexual relationship
• social isolation of family, or isolation or restriction of activity of the older adult within the family unit by the caregiver
• conflicting accounts of incidents by family, supporters, or victim
• unwillingness or reluctance by the caregiver to comply with caregiver to comply with service providers in planning for care and implementation
• inappropriate or unwarranted defensiveness by caregiver

Get help:

If you are being abused, or suspect someone is abusing an elderly person, contact Careline on 0800 333 231. The tollfree Careline is available for advice on ageing matters or to report abuse of older persons, from a landline, and every effort will be made to address cases as quickly as possible.For more info visit AgeInAction.co.za

Read more:

Depression in the elderly
Post a question to Cybershrink.
The shameful health status of SA's elderly