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
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
- 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.
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;
- 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:
- 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
- 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
- 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
- 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
- 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>