Protecting the Vulnerable: How to Identify & Stop Institutional Elder Abuse


“The sign of a civilised society is how we treat the most vulnerable.” 

– Matt Hancock (British politician)

When a beloved elder is placed in a skilled nursing facility or assisted living community, the last thing any of us want to imagine is that they will suffer mistreatment at the hands of those who are supposed to care for them. Unfortunately, elder abuse in institutional and community settings is a worldwide public health problem, with victims suffering a wide range of mistreatment, including:

  • Psychological Abuse

  • Physical Abuse

  • Financial Abuse

  • Sexual Abuse

  • Neglect

In fact, according to the Worldwide Health Organization (WHO), nearly 1 in 6 people over the age of 60 have suffered some form of abuse in an institutional setting over the last year.  In an alarming confirmation of this trend, the WHO also reports that 2 out of 3 nursing home or long-term care facility staff members admit to having committed abuse in the last year. 

As with most forms of abuse, the actual statistics are likely much higher, due to the shame and fear victims face when reporting the maltreatment. This is especially true in the case of institutionalized elder abuse, given that the victim’s abuser is often also their caretaker. 

Elder abuse can take a serious toll on an individual's physical health and emotional well-being, and can even lead to premature death. If you suspect that your loved one is suffering abuse or neglect at the hands of their caretakers in any setting, call (310) 273-1230 or contact the experienced personal injury lawyers at Carpenter & Zuckerman today. With over 27 years fighting on behalf of vulnerable injury victims, the formidable attorneys at CZ Law are fully equipped to manage your elder abuse case. We won’t stop until justice is served in honor of your loved one.

What is Elder Mistreatment or Neglect?

There are varying definitions of elder abuse utilized by prominent health and advocacy organizations throughout the world. The WHO defines elder abuse as "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person." Most widely accepted definitions of elder abuse share common elements, including:

  • Abusive action, such as physical, psychological, financial or sexual abuse

  • Neglect, such as failing to protect or provide necessary care

  • A relationship of dependence and trust between an older individual and a caregiver

  • A one-time event, or ongoing mistreatment

  • Results in harm and/or distress to the victim 

Common Types of Elder Abuse & How to Identify Warning Signs

Elder abuse and neglect can take many forms, some of them more subtle than others. However, all forms of elder mistreatment have the capacity to cause long term physical harm and emotional trauma to patients. Below are the most common types of abuse suffered by older people in community and institutional settings, as well as information about how to address each type of abuse:

Psychological & Emotional Abuse

According to the National Center on Elder Abuse (NCEA), psychological and emotional abuse are the most common types of abuse in institutional care and community settings. In institutional settings, 33% of residents reported experiencing psychological abuse.

Psychological, emotional, and mental abuse can involve:

  • Shouting, name-calling, bullying, and other insults

  • Threats of violence, physical abuse, or abandonment

  • Intimidation, humiliation, belittling, or harassment

  • Infantilizing seniors and treating them like children

  • Isolating patients from their families, friends, and community

  • Withholding patient needs to force them into submission

Warning Signs of Psychological & Emotional Abuse

When your loved one is a patient in a long term care facility or a resident in an assisted living community, you may not be present to witness the behavior of their caregivers. When you are present, staff and management are likely to display their best behavior. So, how can you tell if your family member is being psychologically abused? Pay careful attention if your loved one displays the following warning signs: 

  • Describes concerning interactions with staff & management

  • Appears stressed, anxious, or uncomfortable with certain staff members

  • Seems quiet, upset, or withdrawn from family, friends, or community

  • Expresses feelings of shame, guilt, hopelessness, or inadequacy

  • Shuts down or refuses to talk about the situation when asked

Physical Abuse & Assault

According to NCEA, physical abuse is defined as “the intentional or reckless use of physical force or physical coercion that may result in bodily injury, physical pain, or impairment.” Specific examples of physical abuse include:

  • Hitting, punching, biting, slapping, pinching, burning, kicking, shoving, or pushing

  • Excessive or unnecessary use of physical or pharmaceutical restraints

  • Force feeding

  • Physical punishment

Warning Signs of Physical Abuse & Assault

Not all physical abuse is obvious. Staff members and management may minimize injuries, lie about how they occurred, or blame them on the patient. Key warning signs of physical abuse of the elderly in institutional care settings include:

  • Bedsores, bite marks, ulcers, bruises, bone fractures, burns, cuts, or welts

  • Dehydration, malnutrition, or dramatic weight loss

  • Sudden behavioral or mood changes

  • Unexplained head injuries or concussions

  • New infections, illnesses, or aggravation of prior injuries

  • Dental injuries as a result of poor dental care

  • Markings on the body that indicate use of physical restraints

Sexual Abuse & Sexual Assault

Any form of nonconsensual sexual conduct or contact is sexual abuse. Sexual abuse may happen by force or threat, or when residents are incapacitated or unconscious.

It is the duty of a care facility’s staff to protect their residents from sexual assault. If your loved one has suffered inappropriate sexual advances, sexual communications, or explicit images or videos from either the staff or other residents, you may pursue holding the institutional care facility liable for failing to maintain a safe environment for their patients. Specific examples of sexual abuse in an institutional or community setting include:

  • Inappropriate touching

  • Sexual assault or battery / Rape

  • Sexual harassment

  • Sexual interaction with those unable to give consent

Warning Signs of Sexual Abuse & Sexual Assault

  • New or unexplained sexually transmitted infections or diseases

  • Cuts or bruises on or near the breasts or genitals

  • Unexplained vaginal or anal bleeding

  • Sudden incontinence

  • Anxiety or depression

  • Insomnia

Financial Abuse & Theft

Unfortunately, caregiving staff may use their power to financially exploit vulnerable elderly patients, either for their own benefit, or on behalf of the facility. The United States Department of Justice defines the financial abuse of the elderly as occurring  “when a person or entity takes [assists, or uses undue influence], secretes, appropriates, obtains, or retains real or personal property of an elder or dependent adult for a wrongful use or with intent to defraud, or both.” 

Examples of financial abuse in long-term care facilities include:

  • Stealing money or property from residents

  • Overcharging residents

  • Coercing residents into signing checks or financial documents

  • Using residents’ credit cards or online accounts to access their assets

Warning Signs of Financial Abuse & Theft

It is important to periodically monitor your older loved one’s financial health, just as you would their physical health. As an older adult ages, and especially if they are experiencing any form of dementia, they may become an easy target for financial abusers, whether in an institutional setting or elsewhere. Key warning signs that an older adult is being financially abused include: 

  • Unexplained or sudden changes in your loved one’s banking practices, such as large withdrawals or the sudden addition of signatories to their accounts

  • Sudden changes to an older person’s will, trust, or other financial documents

  • Abrupt transfers or liquidation of assets

  • Missing personal items, financial documents, or credit cards

  • Unexplained financial charges, or charges for unnecessary services

  • Unpaid bills, notices of collection, or eviction proceedings

  • Sudden anxiety or depression in your loved one

For more information on specific financial scams targeting the elderly, visit the Consumer Financial Protection Bureau’s website

Neglect or Abandonment

Neglecting a resident’s needs can cause them serious harm. Abandoning their care could lead to severe injuries or even death. Neglect can occur in a variety of ways in a care facility setting, including:

  • Failure to provide patients with proper nutrition, hydration, or medications 

  • Failure to reposition immobile patients, causing bedsores

  • Failure to provide cleaning and laundry services in a residential care setting

  • Lack of proper medical or dental care

  • Physical or social isolation of patients

Identifying Neglect or Abandonment

  • Dehydration or evidence of malnutrition

  • Bed sores or other untreated injuries

  • Untreated illnesses

  • Lack of personal hygiene

  • Poor or unsanitary living conditions, i.e. a buildup of laundry & dishes

  • Depression

What Should You Do if You Suspect Elder Abuse? 

When it comes to uncovering harmful treatment of nursing home and long-term care residents, you should not rely solely on the facility’s management to address your concerns. In many cases, staff and management are part of the problem. If you suspect an older adult is being abused in an institutionalized setting, or elsewhere, utilize the following resources to report and address the abuse:

Contact Adult Protective Services

Each of the 58 counties in the State of California has an Adult Protective Services (APS) agency that is charged with investigating and intervening in cases of the suspected abuse of older adults (over age 60) or dependent (disabled) adults (between ages 18 to 59). APS handles cases of suspected elder or dependent adult abuse whether it occurs in a private home, institutional, or community setting. Call 1-833-401-0832 to report elder abuse. Enter your 5-digit zip code to be connected to the Adult Protective Services in your county. Emergency help is available 24/7.

Contact the Office of the State Long-Term Care Ombudsman

The Office of the State Long-Term Care Ombudsman (OSLTCO) is overseen by the California Department of Aging (CDA), and is required to cross-report incidents of alleged elder abuse to the appropriate government and law enforcement agencies. 

Specifically, OSLTCO is responsible for “investigating allegations of abuse in nursing homes, residential care facilities for the elderly, adult residential facilities, intermediate care facilities, adult day health care facilities, and adult day programs.”

Both APS and OSLTCO have a responsibility to cross-report allegations of abuse to the appropriate agencies that have jurisdiction over elder abuse that occurs in specific settings, such as state mental hospitals, adult day care facilities, nursing homes, etc.

Document Incidents of Elder Abuse

If your loved one mentions any specific incidents of abuse or neglect, or you notice any of the signs listed in the sections above, be sure to document those incidents as thoroughly as possible, including:

  • Keep a log of the date, time, and circumstances of any signs of abuse

  • Photograph physical evidence of maltreatment or neglect, such as physical injuries or unsanitary living conditions

  • Preserve evidence of financial abuse by taking screenshots or photos of suspicious charges, or alarming financial notices.

  • Write down or record details of concerning interactions with caregivers or staff, with your loved one’s consent

  • Retain medical records detailing new or worsening injuries, infections, or diseases

  • Report the abuse to the care facility, if it will not compromise your loved one’s safety

  • Contact APS or OSLTCO to report the abuse

  • Contact an experienced elder abuse lawyer to discuss your legal options

Abusers often start by committing small offenses that may initially go unnoticed; however, the abuse typically intensifies over time. By keeping track of any complaints or reports of abuse, you can aid your elder abuse attorney in building a strong case, should you decide to take legal action against the perpetrators.

The Elder Abuse Attorneys at CZ Law Can Fight for Justice

“The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped.” – Hubert H. Humphrey, 38th Vice President of the United States

The problem of elder abuse is unlikely to disappear. In fact, as the baby boom generation continues to age, it is expected that incidents of elder mistreatment will only increase. According to the Population Reference Bureau’s Population Bulletin, “Aging in the United States,” the number of Americans over age 65 is expected to almost double from 52 million in 2018 to 95 million in 2060. Combined with the fact that many more older adults are divorced than in years past, it is anticipated that our nation could see a 50% increase in the number of adults over age 65 requiring nursing home care.

The law firm of Carpenter & Zuckerman was founded on the principle of giving voice to the voiceless and advocating the rights of injury victims against powerful corporations and well-funded insurance companies, CZ Law is steadfastly committed to fighting for justice on behalf of vulnerable elder abuse victims. 

With over 27 years of experience litigating personal injury and elder abuse claims, we have a strong track record of delivering results. To date, we have amassed more than $2 billion in verdicts and settlements for our deserving clients. In each case we handle, we are committed to securing the maximum compensation possible, including medical costs, lost income, property damage, and emotional pain and suffering.

Our firm serves clients throughout California and Washington State. With offices in Beverly Hills, Los Angeles, Orange County, Bakersfield, San Diego, and Seattle, we are standing by ready to fight for you. Call (310) 273-1230 today to receive a FREE consultation with an experienced elder abuse attorney. At CZ Law, we protect the vulnerable; we are committed to standing up for your loved one’s rights and holding the responsible parties accountable for their CZ Law online

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