Elder abuse in aged care or nursing homes can happen to any older person. It’s important to learn about the different types of elder abuse, how to recognise the signs, how to protect those who may be vulnerable, and where they can get help.
What is elder abuse?
The abuse of older people is a complex issue. Elder abuse is described as an intentional act resulting in the harm, serious risk of harm, or distress to an older person; it also occurs when there has been a clear case of neglect or a failure in duty of care to act on that neglect.
Elder abuse in aged care can take many forms, and more than one type of abuse could be taking place. The most common include:
- Physical – mistreatment or assault causing injuries (hitting, slapping, pushing, or kicking), or related to quality of care and safety concerns (using restraints).
- Neglect – intentionally failing to provide basic necessities such as adequate food, medication and hygiene products, suitable accommodation or warmth.
- Emotional or Psychological – verbal harassment or threats; pressuring or intimidation; bullying or name-calling; and humiliating or degrading behaviour.
- Financial: taking control of their power of attorney or finances, preventing them from accessing their money, stealing or causing financial losses (including taking money or belongings; forcing them to change their will, transfer property deeds, or sign other documents).
- Social abuse: forcing someone to become isolated by restricting their freedom in their home or involvement in social activities; preventing contact with family or friends; and preventing access to crucial services.
- Sexual abuse – forcing unwanted sexual acts, subjecting them to obscene behaviour or sexually explicit materials without their consent.
Elder abuse is also commonly caused by someone close to them, such as family members or a partner, friends, neighbours, professionals, or paid caregivers; and it could be carried out by multiple people.
The elder abuse could be a one-off or occur repeatedly over time, it can happen in the home or within an aged care setting, and for those who are involved they may not even recognise that what is happening is actually a form of abuse.
Whether it is a family member or a nursing home complaint, any form of abuse is unacceptable and should be stopped. In the aged care sector, it is mandatory to report a nursing home if residents are being abused. This mandatory reporting helps to ensure any incidents of elder abuse are documented and addressed. Some forms of elder abuse are also illegal and must be reported to the police.
Elder abuse risk factors
Known risk factors for elder abuse can include:
- An older person relying on someone else for their care.
- The carer or family member:
- Finding it challenging and stressful to look after the older person.
- Feeling resentful about having to provide care.
- Is dealing with other stressors, such as financial difficulties.
- Lacks adequate support or opportunities for respite.
- A history of family violence.
- Differences in cultural values between the carer or family member and the older person.
- The older person had previously been abusive towards their now adult child.
- Either the carer, the older person, or both, have a mental health condition or behavioural problems.
- Either the carer, the older person, or both, have issues with substance abuse (alcohol or other drugs).
Despite these risk factors, there is never an excuse for abuse. When complaining about an aged care facility, it is important that older people feel that they are supported, and are always able to talk to someone they know and trust.
Signs of elder abuse
Signs that an older person may be experiencing abuse and you should raise a complaint or report a nursing home:
Physical signs
- They appear underfed (weight loss or malnutrition) or dehydration.
- They have bed sores or other preventable conditions.
- They are not receiving necessary care for their medical problems.
- They have unexplained and frequent injuries, such as bruises, black eyes, broken bones, burns, scars, or sexually transmitted infections.
- They are wearing dirty clothes (or during their care you notice torn, stained, or bloody underwear).
- Being left dirty or unbathed, and their personal hygiene has declined or is poor.
Emotional and behavioural signs
- They are exhibiting behaviour that is fearful, anxious, withdrawn, depressed, or confused.
- They have had a sudden change in mood or are experiencing mood swings.
- They have become isolated from friends and family.
Financial signs
- They have had an unexpected or sudden change in their financial condition.
- They have had unusual financial activities such as significant withdrawals or transfers made from their accounts.
- They are missing personal items or money from their home or room.
- There have been suspicious changes in documents such as their will, power of attorney, property tiles, or policies.
- There have been unpaid bills or a lack of medical care even though they have enough money to pay for it.
Environmental signs
- They are wearing unsuitable clothing or aren’t covered properly for the weather conditions.
- They are over- or undermedicated.
- They are living in unsafe or unsanitary conditions (dirt, insects, soiled bedding or clothes, no heat or running water, or other hazardous living conditions).
- They have been deserted in a public place.
Reporting elder abuse
If you are concerned about the welfare of an elderly person, and suspect abuse from from:
- members of their family
- an individual aged care worker
- their aged care service
- from another resident living in a residential care home
- or anyone else, it should be reported immediately.
There are also actions that can be taken if elder abuse is suspected or disclosed
- If complaining about the nursing home care directly to the facility has not already been addressed, refer the older person to a Social Worker for a psychosocial assessment and coordination of interventions.
- Contact the hospital on-call Social Worker for out-of-hours situations, or admit the patient overnight for daytime assessment.
- Do not alert or confront the alleged abuser (this should be handled by professionals).
- Assess the urgency and risk by considering medical needs, danger levels, abuse nature, mental health impact, and relationship dynamics.
- Contact Police or emergency services when required (with the older person’s consent).
- Report to the Police any cases of serious injury, threats involving weapons or when aged care workers are being threatened.
- Avoid investigative questioning; focus on medical questions to provide appropriate intervention, leaving investigations to the Police.
- To report a nursing home for neglect or any abuse in residential aged care facilities to the Police within 24 hours.
- If Police aren’t required, refer to Social Workers for a comprehensive psychosocial assessment and consider other specialist services to ensure their safety while complaining about the aged care facility.
- Be supportive by reassuring the older person that the perpetrator is responsible for the violence, and inform them of their rights to report the crime to the Police.
- Speak with the older person away from family or their carer, but have a Social Worker present. Use familiar words, repeat questions, and allow for extra response time.
- While complaining about nursing home care, document injuries, treatments, and other interventions provided.
How do I report a nursing home?
You can call the national 1800 ELDERHelp (1800 353 374) line (freecall) to talk to someone about potential or actual elder abuse.
Avoiding elder abuse
Elder abuse is often hidden or goes unreported for a range of reasons:
- Victims may be reluctant to report it because they want to protect their abuser.
- They feel shame or guilt about the situation.
- The elderly person and the abuser may depend on each other for care, financial support, housing, or transportation.
That is why when addressing elder abuse, it is crucial that the focus remains on their safety and wellbeing, their need to maintain some of those close relationships (such as family), and that they want to gain control back over their life.
Providing support and resources to address the abuser’s problems can also lead to better outcomes for the older person.
There are also some ways to help an older person avoid an abusive situation:
- Choose a reputable nursing home with a good track record of care.
- Build relationships with dedicated aged care staff to ensure your loved one is well looked after.
- Ensure the older person has access to support services and regular medical check-ups.
- Encourage open and honest communication within the family.
- Be vigilant for signs of abuse and report any concerns immediately.
- Support the older person in maintaining social connections and activities to reduce isolation.
- Provide education and resources to the family and carers about elder abuse and its prevention.
- Give your nursing home feedback when you feel that they aren’t taking your concerns seriously.
More information
With elder abuse, you should never feel ashamed to ask for help (whether for yourself or your loved one).
If you are experiencing elder abuse or think you might be; or your loved one is being abused, mistreated, or neglected, there are a range of support services available.
For an unsafe or life threatening situation – call the Police on triple zero (000).
How to report a nursing home – you can contact the Aged Care Complaints Commissioner directly on 1800 951 822.
For general advice:
- MyAgedCare for Australia wide elder abuse contacts.
- National Disability Abuse and Neglect Hotline Tel. 1800 880 052.
- 1800 RESPECT National Sexual Assault, Domestic Family Violence Counselling Service Tel. 1800 737 732.
- 1800 ELDERHelp Tel. 1800 353 374
Or, if you’d like further information about Aurrum Aged Care, get in touch with our team today.