Identifying Elder Abuse in Missouri

Elder abuse is often referred to as a silent problem; a problem that affects the dignity, security, and safety of some American seniors every day.  Elder abuse includes various forms of abuse such as physical abuse, sexual abuse, neglect, exploitation, emotional abuse, and abandonment.  According to statistics published by the National Council on Aging (NCOA), approximately one in ten Americans aged sixty and older have experienced some form of elder abuse.  Many acts of abuse go unreported.  One study relied upon by the NCOA reports that only one in twenty-four cases of elder abuse are reported to authorities.

In general, elder abuse is a term referring to any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult.  The Administration for Community Living (ACL) defines the most common acts of elder abuse as follows:

• “Physical Abuse – inflicting physical pain or injury on a senior, e.g. slapping, bruising, or restraining by physical or chemical means.
• Sexual Abuse – non-consensual sexual contact of any kind.
• Neglect – the failure by those responsible to provide food, shelter, health care, or protection for a vulnerable elder.
• Exploitation – the illegal taking, misuse, or concealment of funds, property, or assets of a senior for someone else’s benefit.
• Emotional Abuse – inflicting mental pain, anguish, or distress on an elder person through verbal or nonverbal acts, e.g. humiliating, intimidating, or threatening.
• Abandonment – desertion of a vulnerable elder by anyone who has assumed the responsibility for care or custody of that person.”

Elder abuse statistics published by the United States Department of Justice indicate elder abuse occurs by all of the above-described forms with Exploitation, Neglect, and Emotional abuse occurring most often.  In the case of Self-neglect, there is no outside perpetrator to observe or report so statistical evidence of occurrences is very difficult to confirm.

Physical Abuse.  Sometimes it is obvious that physical abuse is taking place. Trauma such as a deterioration in health, hospitalization, cigarette burns, unusual bleeding, hair loss, broken bones, and cuts and bruises are apparent.  Other signs of physical abuse include things like rapid or unexpected weight loss; a sudden decrease in appetite; dehydration; unexpected breathing problems; dirty or inappropriate clothing; lacking personal hygiene; frequent skin abrasions or rashes; untreated injuries or infections; bedsores; expired prescriptions; a lack of assistive medical devices; missing or broken eyeglasses, dentures, or hearing aids; filthy or unsafe living conditions; missing pets or pet neglect; pest or rodent infestations; a lack of general maintenance to homes and tangible personal property; and unusual confusion, despair, social withdrawal, or sleeping problems.  However, in many cases, it is not easy to recognize physical abuse or neglect by others. In those instances, signs and symptoms are often blurred by the victim’s existing medical conditions, or they can be hidden by the efforts of cunning offenders.  If you suspect elder abuse, follow your intuitions and investigate fully.

Sexual Abuse.  Sexual abuse is a type of elder abuse that can remain hidden for a long time, often because of embarrassment, fear of further humiliation, or memory problems caused by dementia.  Additionally, signs of sexual abuse are generally hidden from view unless you examine the older adult regularly as a family member, trusted caregiver, healthcare professional, or intimate partner. Indications of sexual abuse may include groin or inner-thigh bruises; pain, irritation, or unusual bleeding in the buttocks or genital area; scratches or bruises near breasts; unexplained infections such as sexually transmitted diseases (STDs); bloody stools; stained or ripped clothing; and uncharacteristic behavior toward sexual intimacy.

Exploitation.  Exploitation of the elderly can be even more difficult to observe.  Many seniors are suspicious of others and refuse to share their financial status even with their children and loved ones.  But if you suspect financial exploitation of a senior adult, you likely observe signs such as unusual spending amounts, especially for unnecessary products or services; confusing bank transactions, including unexplainable money transfers or withdrawals; a large amount of unopened mail, bills, or sweepstakes offers; unpaid bills or demand letters from creditors; letters to or from a new “friend;” missing property or possessions; suspicious legal documents related to estate planning such as powers of attorney or a new Last Will & Testament with terms inconsistent with previous documents or oral representations; signatures on documents that do not look familiar.

Emotional abuse.  Emotional abuse is often the most challenging type of elder abuse to detect. Signs of emotional abuse can appear as a heightened fear of others, especially when around caregivers or others who provide services to the elder adult; dramatic weight gain or loss; new or worsening depression or anxiety; personality changes; uncharacteristic disorientation or confusion; strange behavior like ticks, murmuring, rocking back and forth, biting fingernails, sucking a thumb, or biting oneself or others.

Abandonment.  Older adult abandonment is generally defined as the purposeful and permanent desertion of a person over age sixty.  Victims are left at a hospital, a nursing home, or in a public location without further care or attention by those dropping them off. In some instances, the act or abandonment is excused by the perpetrator because they feel overburdened or because he or she lacks the resources to care for the victim. Whatever the reason for abandonment, one can only imagine the fear, confusion, and despair that the unwitting adult victim feels.

If you suspect elder abuse, do not delay reporting.  If there is an immediate danger to life, limb, or property, call 911 right away. If no immediate danger exists, call the Missouri Department of Health & Senior Services to explore the services they provide.  If you are a mandated reporter, DHSS encourages you to make your adult abuse and neglect reports online at https://health.mo.gov/safety/abuse/ to keep the hotline open to the public.  If you are a member of the public, call the Adult Abuse and Neglect Hotline at 1-800-392-0210.

Todd Miller is a monthly contributor and regularly writes and speaks on various legal topics including bankruptcy, estate planning, probate, and elder law.  He formed the Law Office of Todd Miller, LLC, 1305 Southwest Blvd., Ste. A, Jefferson City, Missouri in 2006.  He has been awarded the Substantial Contributor Attorney Award by the Missouri Bar and ranked as one of the “Top Attorneys in Missouri” by The Legal Network.  Mr. Miller earned his juris doctorate degree from the University of Missouri School of Law in 1999 and graduated with honors from Lincoln University in 1991.  You may find him at www.toddmillerlaw.com (573) 634-2838 or on Facebook, Instagram, and Twitter.