What is Elder Abuse and Neglect?

This section covers:

What is abuse?
What is neglect?
Who abuses and neglects older people?
Types of elder abuse
Signs of abuse
Resources for more information on elder abuse

1. Abuse

Elder abuse refers to the mistreatment of older people. It includes actions and behaviour, or lack of action or behaviour, that result in physical, mental, emotional, financial, or sexual harm to an older person. Actions that can be abusive include:

Physical assault
Sexual assault
Threats of violence
Harassment and stalking
Intimidation
Humiliation
Over-medication
Withholding of medication
Censoring mail
Invasion or denial of privacy
Denial of access to visitors
Financial abuse
Forcing someone to create or change a legal document

Abuse can occur on a single occasion, or involve a repeated pattern of abusive behaviour. These incidents may start out small and become more serious over time. More than one type of abuse may occur at the same time.

Sometimes elder abuse is a criminal act. Not every form of elder abuse will be a crime.

2. Neglect

Neglect is a failure to provide necessary care, assistance, guidance, or attention that causes, or is likely to cause, serious physical or psychological harm, or substantial financial damage or loss to the older adult.

Neglect can be deliberate. It can also be the result of inattention or lack of knowledge. Neglect can include not providing an older person with:

Food, nutrition, and water;
Shelter or appropriate housing;
Clothing;
Medication or medical care;
Visits from friends and family;
Access to their spiritual community or faith group and its practices;
Required mobility assistance or transportation;
Critical equipment such as mobility devices, hearing aids, and glasses;
Financial assistance to meet basic needs;
Support to maintain safe housing (for example cleaning the home or paying for utilities);
Assistance with activities the older person cannot perform independently, such as eating, dressing, preparing meals, and personal care.

Depending on the impact of neglect and the nature of the relationship between the older person and the person who is neglecting them, neglect might be a criminal act.

3. Who Abuses and Neglects Older People?

Most cases of elder abuse and neglect are perpetrated by someone who is known to the older person, often in the context of an ongoing relationship. Older people are often abused and neglected by people they trust, such as family, friends, spouses, volunteer caregivers, legal guardians, care facility staff, and professionals (such as doctors, nurses, and lawyers).

Sometimes the abuser is dependent on the older person for money, food, or shelter. Other times the older person is dependent on the abuser. Inter-dependency and dependency can create challenges in responding to abuse.

Older people can be abused by strangers, including con artists. Sometimes scammers target older people because they think they will be easier to fool or influence.

Sometimes, elder abuse and neglect is a form of intimate partner violence.

4. Types of Elder Abuse

4.1 Physical Abuse

Physical abuse is any act of violence or rough treatment. Physical abuse does not always cause a physical injury that you can see. It can cause pain or emotional distress. Examples of physical abuse include:

Physical acts such as slapping, shaking, punching, roughness, or shoving
Over-medicating an older person, such as by prescribing a medication which is not needed or administering too much medication
Withholding medication, including refusing to pay for a prescription, rationing a medication, or limiting the dosage of a medication
Unlawful confinement, including locking an older person in their room, restricting them to a building, or restraining them to a bed or chair

4.2 Psychological Abuse

Psychological abuse is also referred to as mental abuse or emotional abuse. Psychological abuse is the intentional infliction of mental harm, anguish, or suffering. Examples of psychological abuse include:

Verbal acts such as yelling, swearing, or insulting an older person
Threatening to physically or psychologically harm an older person, their friends or family, or their pets
Harassment, including intimidation, bullying, or degrading comments
Treating an older person in a demeaning way which harms their dignity
Preventing a capable adult from making their own decisions
Invading an older person’s privacy, including opening their mail, reading their emails, or accessing their personal information without permission
Causing social isolation, such as by restricting visitors or not allowing an older person to attend social gatherings
Not allowing an older person to visit their grandchildren, or threatening to prevent access to grandchildren
Refusing to allow an older person to exercise their faith, including not allowing them to attend religious services, or removing objects associated with the person’s faith

4.3 Financial Abuse

Financial abuse is the illegal or improper use of material possessions, funds, assets, property, or legal documents. Financial abuse is the most commonly reported type of elder abuse. Examples of financial abuse include:

Fraudulently accessing an older person’s money, including theft, stealing personal banking information, or coercing an older person to open a joint bank account
Misusing an older person’s funds, including spending money that belongs to the older person without permission, coercing them to make a financial decision that benefits the abuser, or selling property for the abuser’s financial gain
Misuse of a power of attorney, representation agreement, trust, or guardianship, including spending the older person’s money in a way which does not accord with their wishes, values, or needs
Perpetrating a financial scam against an older person, whether it is in person, over the phone, or over the internet
Misuse of an older person’s property, including stealing property or selling the property without permission
Misuse of an older person’s housing, including forcing an older adult to sell their home, coercing an older adult to take out a mortgage or loan against their home, or sharing an adult’s home without appropriately contributing to the living expenses
Coercing an older person to give them money or property they expect to receive in the older person’s will
Coercing an older person to change their will

4.4 Sexual Abuse

Sexual abuse is any sexual touching, acts, or comments done without an older person’s consent or knowledge. Examples of sexual abuse include:

Touching an older person in a sexual manner without their consent
Forcing an older person to participate in sexual activity
Making inappropriate sexual comments at an older person or in their presence
Forcing an older person to participate in, or view, pornography or sexually explicit material

Sexual abuse can occur in the context of a marriage or other spousal relationship when one of the people does not consent to intimacy.

5. Signs of Elder Abuse

There are many possible indicators of elder abuse and neglect. Older people who are experiencing abuse or neglect may not be able to explain what is happening. Therefore, it is important to know how to identify the potential warning signs. Below is a non-exhaustive list of indicators of abuse:

Behavioural Changes:

Acting passive or compliant
Exhibiting psychological symptoms such as anxiety, fear, depression, or agitation
Appearing withdrawn or non-responsive
Becoming unusually aggressive
Showing changed interest in sexual activity
Exhibiting confusion

Communication:

The older person says they are being abused
The older person demonstrates confusion about legal, financial, or health matters, such as a new will or power of attorney
Another person has started speaking on behalf of the older adult
Someone has restricted the older person’s access to communication methods
The older person’s speech patterns have changed

Social Changes:

Becoming withdrawn or having lowered self-esteem
Stopping making their own decisions
Avoiding usual social interactions or events
Having less or no contact with family and friends
Behaving differently around a specific family member or friend
Taking on caregiving responsibilities when they are not physically able to or are not being compensated for this

Physical Changes:

Frequent or unexplained injuries
Difficulty walking or sitting
Unusual or new occurrences of insomnia
Changes in nutrition or hydration
Changes in the older person’s appearance or grooming
No longer using mobility aids, glasses, or hearing aids

Economic Signs:

A gradual or sudden inability to meet their financial obligations
The cancellation of critical services, such as internet or power
Confusion about their finances
The new participation of a person who would not ordinarily support the older person in their financial matters
Changing living arrangements or living conditions
The disappearance or sale of possessions

6. Resources for More Information on Elder Abuse

British Columbia, “Elder Abuse Reduction Curricular Resource: An Instructor’s Guide for Teaching Core Competencies in Elder Abuse Prevention, Detection and Response in British Columbia” (October 2014) at 26, online: <solr.bccampus.ca:8001/bcc/items/8d5b3363-396e-4749-bf18-0590a75c9e6b/1/>. This publication and its content are licensed under Creative Commons Attribution CC BY-NC-SA 3.0.

British Columbia, “Understanding and Responding to Elder Abuse” (Vancouver: November 2014) at 2-5, online (pdf): <www2.gov.bc.ca/assets/gov/law-crime-and-justice/criminal-justice/victims-of-crime/vs-info-for-professionals/info-resources/elder-abuse.pdf>

Canada, Federal Elder Abuse Initiative, “Elder abuse: It’s Time to Face the Reality”, (Ottawa: 2009) (last modified 26 July 2012), online (archived): Government of Canada: <www.canada.ca/en/public-health/services/health-promotion/stop-family-violence/prevention-resource-centre/prevention-resources-older-adults/elder-abuses-time-face-reality.html>.

National Initiative for the Care of the Elderly (NICE), “Into the Light: National Survey on the Mistreatment of Older Canadians 2015” (March 2015) at 6–7, online: NICE <cnpea.ca/images/canada-report-june-7-2016-pre-study-lynnmcdonald.pdf>

Whaley Estate Litigation Partners, Whaley Estate Litigation Partners on Elder Law (Toronto: Whaley Estate Litigation Partners, 2020) at 1-7, online (pdf): <welpartners.com/resources/WEL-on-elder-law.pdf>