Dementia in all its forms is devastating enough, robbing a senior of their memories, cognitive function, and ability to live independently over time. It also makes seniors particularly vulnerable to all forms of elder abuse.
Sadly, seniors with dementia are most at risk of being the victim of abuse or neglect. According to the Center of Excellence on Elder Abuse and Neglect, caregiver abuse and neglect of patients with dementia was found in 47% of surveyed cases. A study published in Health Affairs found that anywhere from 28% to 62% of seniors with dementia suffer psychological abuse while 3.5% to 23% suffer physical abuse.
Why are dementia patients so susceptible to abuse? Many factors are to blame including the emotional, physical, and psychological burden caregivers may face. In nursing homes and care facilities, overworked and stressed staff may take out their frustrations on vulnerable residents who may not be able to follow instructions or require intensive assistance. Impaired memory, difficulty communicating, and problems with judgment can also make these vulnerable adults targets.
Elder abuse victims are four times more likely to go into a long-term care facility, twice as likely to be hospitalized, and three times more likely to die sooner, even with modest abuse.
Here is how to recognize the signs of elder abuse in seniors with dementia so you can protect your loved one.
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How to Recognize Dementia in Seniors
In the early stages, dementia can be difficult to recognize and may be written off as simply getting older. You can protect an aging loved one by watching for signs of dementia and taking steps to protect them from abuse, neglect, and fraud.
Signs of early dementia include:
- Difficulty remembering how to perform once familiar tasks like playing a game
- Changes in personality or mood which may cause paranoia, agitation, hallucinations, anxiety, depression, or inappropriate behavior
- Frequently losing things and being unable to track down where they could be
- Difficulty with written or spoken language
- Trouble concentrating, reasoning, solving problems, or planning
- Memory issues that affect everyday life like forgetting the names of family members or conversations
- Trouble with spatial and visual abilities which may make them get lost in familiar areas
- Trouble with motor function and coordination
What Are the Different Types of Dementia?
Up to 50% of people 85 and older have some type of dementia. While Alzheimer’s disease is the most common and well-known type of dementia, the disease comes in other forms. Types of dementia include:
- Alzheimer’s disease affects 10% of adults 65 and older. This progressive disorder affects thinking, memory, and, as it progresses, the ability to perform simple tasks.
- Lewy body dementia (LBD) is a progressive form of dementia that accounts for 5-10% of dementia cases. LBD frequently causes symptoms associated with movements like rigid muscles, a hunched-over posture, and trouble walking.
- Vascular dementia is a decline in cognitive function caused by blocked or reduced blood flow to the brain. This can occur after a stroke or a condition that affects small blood vessels. It’s believed to account for 5-10% of dementia cases.
- Frontotemporal disorders include a number of rare brain disorders that happen due to progressive nerve cell loss.
- Mixed dementia is a combination of at least two types of dementia like vascular dementia and Alzheimer’s.
- Parkinson’s disease dementia is a type of dementia associated with Parkinson’s disease which affects about 2% of people over 65. Between 50% and 80% of people with the disease eventually develop dementia.
- Huntington’s disease is a genetic disorder that causes dementia as it progresses.
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Primary Types of Elder Abuse of Seniors with Dementia
The Elder Abuse Act in California protects seniors against all types of abuse and neglect. This act made California one of the first steps to take comprehensive action to protect vulnerable adults. Elder abuse comes in many forms. You can protect your loved one by understanding the forms of elder abuse and neglect and watching for these warning signs.
Psychological and emotional abuse represents one of the most common forms of elder abuse. It may leave a senior feeling shame, powerless, isolated, humiliated, or frightened. Unfortunately, this type of abuse is particularly hard to recognize in seniors with dementia. Common examples of emotional abuse include:
- Threats to deny basic needs or visits
- Isolating the senior
- Humiliating the senior with name-calling
- Threats of physical harm
- Bullying, harassing or intimidating behavior
- Ridiculing or demeaning behavior
- Screaming or yelling
Physical elder abuse may involve kicking, punching, slapping, burning, or pushing a senior. It can also involve locking them in their room, giving them medication they haven’t been prescribed or over-sedating them, or using restraints.
Signs of physical abuse may include:
- Unexplained bruises, cuts, or burns, especially in multiple stages of healing
- Fractures that occur in a long-term care facility
- Signs of being restrained like marks around the wrists
- Sudden changes in behavior
- A caregiver won’t let you see the senior if they are not present
Financial abuse happens when someone improperly uses your loved one’s property, money, or resources. It can be committed by primary caregivers, family members, in-home care providers, or even staff in a nursing home or long-term care facilities.
You may notice many signs of financial elder abuse such as:
- Strange transactions or ATM withdrawals by a senior who has not used a debit card
- Suspicious transfers between accounts or withdrawals your loved one can’t explain
- Missing possessions
- Large sums of money missing from a senior’s bank accounts
- The senior cannot access their financial accounts
- The senior has provided money or gifts to caregivers or strangers
- Checks written to unfamiliar people
- New credit accounts in the senior’s name
Elders are certainly not immune to sexual abuse. Sadly, some of the most vulnerable adults may be most at risk of this form of abuse in senior living facilities and nursing homes. Warning signs and forms of sexual abuse in seniors with dementia may include:
- Sexually-oriented activities with someone who cannot give consent such as forcing someone to watch sex acts or pornography
- Sexually transmitted diseases
- Bruises, particularly around the genitals or on both sides of the body
- Anal or vaginal bleeding
- Behavioral changes such as becoming withdrawn, especially in the presence of someone specific, depression, anxiety, refusing to communicate, and a fear of being touched
Elder abuse and healthcare fraud can be tied in many ways. It can happen when a nursing home resident is overmedicated or not provided with proper care through their health insurance. It can also occur when Medicaid or Medicare are billed for services that were not delivered, were misrepresented, were unnecessary, or were grossly inadequate. If a healthcare provider falsified information for financial gain or to avoid providing proper medical care, it is considered healthcare fraud.
- Services billed that were not provided
- Inadequate medical care even though your loved one’s bills are paid
- Undermedication or overmedication
- Misrepresenting services that have been provided
- Being charged for more expensive or complex services than your loved one received
- Issues with care in a facility like understaffing or overcrowding
Neglect can happen when the primary caregiver does not fulfill the senior’s needs. This can include emotional, physical, and social needs and access to health care, medication, and food. It may also involve leaving a senior in unsafe or unhygienic conditions. Signs of neglect are:
- Unexplained weight loss
- Unsanitary or dangerous conditions such as soiled bedding or a lack of heating
- Being left in dirty clothing or appearing unbathed
- Missing medication or medical aids such as hearing aids, dentures, glasses, or a walker
- Being left in bed for a long period of time without supervision
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What to Do if You Suspect Elder Abuse or Neglect
If you suspect your loved one has been the victim of neglect, mistreatment, or elder abuse, there are many steps you can take to safeguard them from further harm, protect their rights, and hold the responsible party accountable.
If your loved one’s health or safety is in immediate risk, call 911. Otherwise, proceed with the following steps depending on where your loved one lives and who is providing care.
How to report elder abuse if your loved one lives in a private home
- Contact Adult Protective Services (APS) under the California Department of Social Services. APS responds to reports of abuse or neglect and conducts an investigation. Note that adults can withdraw consent or refuse services offered by APS. With most types of abuse, APS will respond within 10 days.
- Contact law enforcement. In addition to calling APS, you can report elder abuse or neglect to your local law enforcement agency. Police can respond when a loved one’s safety is endangered or you suspect a crime has been committed. They may arrest the person abusing your loved one, perform a well-being check, or help APS conduct an investigation. They can also work with social services and families to protect vulnerable seniors.
How to report elder abuse if your loved one is in a nursing home
- File a complaint with the California Department of Public Health (DPH). An investigator will be assigned to your loved one’s case within 48 hours. You can file a complaint online or call 916-492-8232.
- Report neglect or abuse to the Bureau of Medi-Cal Fraud & Elder Abuse (BMFEA). There are three divisions to investigate and prosecute crimes against seniors committed by care facility employees, healthcare fraud, and the owners and operators of care facilities. You can report abuse by calling 800-722-0432 or submitting a complaint online.
Contact an Elder Abuse and Neglect Lawyer
After reporting the abuse, your next step should be contacting an experienced elder abuse lawyer to protect your loved one’s rights and hold the responsible party accountable. An elder abuse attorney can help you ensure your loved one receives the proper care they need and build a case for compensation from the abusive or negligent provider. This compensation can be used to pay for a new facility for your loved one, medical expenses, and more.
If you suspect your loved one has been mistreated or abused in a nursing home or by a care provider, call Berman & Riedel today to schedule a free consultation. Our law firm has recovered tens of millions for victims in elder abuse cases and we are committed to fighting for your loved one’s rights.