Types of Abuse

Physical Abuse

Physical abuse causes or is likely to cause pain or injury. Behaviors associated with physical abuse include hitting, slapping, kicking, pinching, biting, or the nontherapeutic use of drugs, restraints, and confinement.

Indicators

  • Fractures, dislocations, burns
  • Broken eyeglasses, frames
  • Internal injuries
  • Signs of traumatic hair loss or tooth loss
  • Bilateral bruising to the arms
  • Bilateral bruising of the inner thighs
  • Wrap around bruises that may indicate physical restraints

Emotional Abuse

Emotional abuse is repeated or malicious spoken, written, or gestured language and other treatment that would reasonably be considered disparaging, derogatory, humiliating, harassing, or threatening. On the other side of the picture, subjecting a vulnerable adult to the “silent treatment” is a form of emotional abuse. Minnesota law also prohibits the use of any aversive or deprivation procedure, unreasonable confinement, or involuntary seclusion, including the forced separation of the vulnerable adult from other persons against the will of the vulnerable adult or his/her legal representative.

Indicators

  • Victim is cut off from other family members, friends or neighbors
  • Caregiver or others in household are verbally aggressive, belittling, shaming or threatening.
  • Uncharacteristic behavior or changes in customary habits
  • Anxiety and depression
  • Regressive or self-destructive behavior

Sexual Abuse

Sexual abuse includes victimization by criminal sexual conduct, solicitation, inducement or promotion of prostitution, as defined in Minnesota criminal laws. Sexual abuse further includes any sexual contact or penetration by a facility staff person or a person providing services in the facility and a resident, patient, or client of that facility.

Indicators

  • Any of the indicators of physical abuse
  • Genital or anal pain or bleeding
  • Torn, stained, bloody underclothing
  • Sexually transmitted diseases
  • Reports of unnecessary or uncomfortable hygiene practices

 

Financial Exploitation

Exploiters may describe themselves as “family caregivers,” while the truth is that they are dependent on their victims for financial assistance, housing and other support. The risk increases when the exploiter knows where important papers are and has access to personal information (e.g., PIN numbers, Social Security number). Substance abuse and other personal problems may be associated with the behavior.

Financial exploitation happens in many ways. These include when someone who has a legal obligation to manage the money makes unauthorized expenditures of a vulnerable adult’s funds, or fails to use the funds for his/her food, clothing, shelter, health care or supervision. Financial exploitation can also occur when someone uses or disposes of a vulnerable adult’s money or property without any legal authority.

Acquiring possession or control of a vulnerable adult’s funds or property through pressure, deception, or fraud constitutes financial exploitation.

Indicators

  • Signs of neglect despite availability of resources
  • Unpaid bills despite availability of resources
  • Corollaries: pharmacy stops filling prescriptions, threats of eviction or involuntary discharge from residence for unpaid rent
  • Sudden changes in property titles, mortgages, Powers of Attorney documents, wills, trusts
  • Large or frequent gifts to caregivers
  • Caregiver’s excessive interest in elder’s financial records
  • Sudden appearance of previously uninvolved relatives claiming rights to elder’s possessions
  • “Helpful neighbors” paid big sums for chores
  • Elder is repeatedly isolated from callers or visitors (or investigators)

 

Financial Scams

Financial scams are a risk for everyone. They come in a broad array of scenarios, by telephone, by mail, by computer, and at the front door. Older people are attractive targets for scammers because they are likely to have savings and are likely to be more trusting of others. Vulnerable adult victims of financial scams are unlikely ever to be able to make up the lost dollars. And like financial exploitation in general, victims of scams suffer consequences beyond irreplaceable money. Physical health, emotional well-being, care and housing often suffer too.

Indicators

  • The victim receives news about a prize or other windfall that requires payment of fees or taxes up front.
  • The victim is pressured to keep “good” news a secret until a transaction is complete or risk losing out on this one-time opportunity.
  • A caller constantly seeks more information and pressures the victim to comply.
  • A third party claims to be from a government agency, financial institution or other entity and asks for personal information and numbers.
  • A victim receives mail or email for sweepstakes, contests or other sources suggesting that he or she has already been scammed.

The federal Consumer Financial Protection Bureau is a watchdog agency that issues many resources to combat financial exploitation and scams, especially those that target vulnerable populations. The following list of common scams and indicators comes from the Consumer Financial Protection Bureau:

Relative in need
Someone who pretends to be a family member or friend calls or e-mails you to say they are in trouble and need you to wire money right away.
Charity appeals
You get a call or letter from someone asking for money for a fake charity—either the charity does not exist or the charity did not call or write to you.
Lottery or sweepstakes
You get a call or e-mail that you have a chance to win a lot of money through a foreign country’s sweepstakes or lottery. The caller will offer tips about how to win if you pay a fee or buy something. Or the caller or e-mail says you already have won and you must give your bank account information or pay a fee to collect your winnings.
Home improvement
Scammers take money for repairs and then they never return to do the work or they do bad work. Sometimes they break something to create more work or they say that things need work when they don’t.
Free lunch
Scammers invite you to a free lunch and seminar, and then pressure you to give them information about your money, and to invest the money with them. They offer you “tips” or “guaranteed returns.”
Free trip
Scammers say you’ve won a free trip but they ask for a credit card number or advance cash to hold the reservation
Government money
You get a call or letter that seems to be from a government agency. Scammers say that if you give a credit card number or send a money order, you can apply for government help with housing, home repairs, utilities, or taxes.
Drug plans
Scammers pretend they are with Medicare prescription drug plans, and try to sell Medicare discount drug cards that are not valid. Companies with Medicare drug plans are not allowed to send unsolicited mail, emails, or phone calls.
Identity theft
Scammers steal personal information—such as a name, date of birth, Social Security number, account number, and mother’s maiden name—and use the information to open credit cards or get a mortgage in someone else’s name.
Fake “official” mail
Scammers send letters or e-mails that look like they are from a legitimate bank, business, or agency to try to get your personal information or bank account number.

Neglect

Neglect by a caregiver occurs when a person who is responsible for care fails or refuses to provide food, clothing, shelter, health care, or supervision that is reasonably required to maintain the vulnerable adult’s physical and mental well-being.

Self-neglect occurs when an individual is unaware of their deteriorating health or environment, refuses assistance, or fears that assistance will also bring undesired consequences like loss of independence.

Indicators

  • Poor hygiene – soiled clothing, dirty nails and skin, matted or lice-infested hair, odors
  • Unclothed, or improperly clothed for weather
  • Rashes
  • Sunken eyes, area around cheekbones
  • Dehydration, evidence by low urinary output, dry fragile skin, dry sore mouth, apathy, lack of energy, and mental confusion
  • Unusual weight loss
  • Untreated medical conditions – unattended fractures, infections, lack of wound care
  • Absence of needed appliances – dentures, eyeglasses, hearing aids, braces, prostheses, walkers, wheelchairs, commodes
  • No heat, running water, faulty wiring or other hazards
  • Hoarding and garbage