Abuse in Vulnerable Adults

Overview

Older adults and adults with physical disabilities or mental or emotional conditions are more vulnerable than other adults. This is because they may not be able to defend themselves, protect themselves, or get help for themselves when injured or abused. Vulnerable adults have a higher risk of being abused by others.

There are three types of abuse.

• Domestic abuse. This usually happens in the person's home or in the home of the caregiver. The abuser is often a relative, a close friend, or a paid caregiver.
• Institutional abuse. This happens in a nursing home, foster home, or assisted-living facility. The abuser is usually a person whose job is to help care for the vulnerable adult.
• Self-neglect. A vulnerable adult may not take care of themself very well.

Abuse in vulnerable adults can include:

• Violent acts. These can include hitting, pushing, choking, and burning. Other examples are misuse of medicines or physical restraints and force-feeding.
• Forced sexual contact. This can include rape, forced nudity, and sexual photos.
• Emotional or psychological abuse. This can include insults, threats, and humiliation. Other examples are treating the person like a baby and not letting the person see loved ones.
• Neglect. This can include not providing for basic needs. It can also include financial neglect, such as withholding payment for nursing home care or assisted living.
• Misuse of money, property, or assets. This can include forging the person's signature, stealing money, and stealing valuable things. It also includes tricking the person into signing papers to transfer money, property, or assets.

If you're worried about possible abuse of a vulnerable adult, talk to that person's doctor. You can also talk to your own doctor if you need help knowing what to do.

To report abuse or to get help, call Adult Protective Services (APS) in your state.

What are the signs of abuse in vulnerable adults?

Along with reports from the vulnerable person about abuse, there are other signs to look for. Get treatment right away if the injury is serious.

Here are examples of signs to watch for.

Signs of abuse:

• Bruises, black eyes, welts, and rope marks. They can also include cuts, punctures, burns, or injuries that have not been treated.
• Broken bones, including the skull.
• Sprains, dislocations, or internal injuries.
• Broken glasses or dentures.
• Signs of being restrained.
• Signs of too much or too little medicine.
• A vulnerable adult's sudden change in behavior.
• A caregiver that refuses to let visitors see the person alone.

Signs of possible sexual abuse:

• Bruises around the breasts or genitals.
• A sexually transmitted infection (STI) or other genital infection that can't be explained.
• Bleeding from the vagina or anus that can't be explained.
• Underwear that is torn or stained.

Signs of emotional or psychological abuse:

• Seeming upset or nervous.
• Acting more quiet or paranoid than normal.
• Behaving strangely. This may include sucking, biting, and rocking.

Signs of neglect:

• Dehydration (not enough water or fluids).
• Malnutrition (not enough food).
• Untreated health problems.
• Pressure injuries (pressure sores).
• Unclean clothes, or an unclean body.
• Living conditions that aren't clean or safe.

Signs of financial abuse:

• Sudden banking changes, such as large withdrawals.
• Added names on a vulnerable person's bank card.
• Sudden changes in a will or other legal document.
• Missing money or valuable things.
• Unpaid bills or lack of care, even when money isn't a problem.
• Forging the person's signature.
• Relatives showing up who weren't involved before.
• Paying for services that aren't needed.

What makes abuse more likely?

Things that make abuse more likely include:

• A pattern of domestic violence over time.
• Financial or mental health issues. Abuse can happen if the caregiver relies on financial or other support from the vulnerable person. The mental health of the caregiver can sometimes be a factor.
• Social isolation. A caregiver or family member who is abusive may try to limit contact with others. This can make it easier to keep the abuse a secret.