Elder Abuse Prevention

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 ​Did you know that every day 10,000 people turn 65 in the United States? Our demographics are shifting and we will soon have older adults in the U.S. than ever before. Every year, an estimated five million older Americans are victims of elder abuse, neglect, or exploitation, roughly one in ten older Americans over the age of 60 has been the victim of some kind of abuse, and that's only part of the picture. According to the National Academies of Sciences, Engineering, and Medicine, an estimated 93% of elder abuse cases go unreported each year. 

What is Elder Abuse?

Elder abuse is a single or repeated act of intentional or negligent behavior perpetrated by a caregiver, entity, family member, staff, or trusted individual, that causes harm to a vulnerable older adult. These types of acts constitute a violation of human rights and take many forms, including:
  1. Physical Abuse – The use of force causing harm or pain to an older adult, which includes (but is not limited to) hitting, kicking, pinching, slapping, shoving, shaking, and burning. Other forms of physical abuse involve the inappropriate use of medication or physical restraints.
  2. Financial Abuse/Exploitation – Happens when a person wrongfully takes or uses an older adult’s funds or property through theft, scams, fraud, or predatory lending. (For more specific information on the exploitation of older adults, see our Elder Financial Exploitation page.)
  3. Psychological Abuse – Causing emotional pain towards older adults through verbal assaults, threats, or harassment. Perpetrators intimidate, humiliate, or attempt to isolate their victims.
  4. Sexual Abuse – Having non-consensual sexual contact of any kind, including contact with an older adult unable to consent to such contact (for instance, if they suffer from dementia and are unable to understand.)
  5. Neglect – Occurs when the caregiver fails to meet or try to respond to the needs of an older adult. This may include not providing essential things the older adult needs, such as food, water, shelter, medicine, clothing, or personal hygiene.
  6. Self-Neglect – Involves the failure of an older adult to meet vital self-care needs, which puts them at risk of harm to their safety and/or health. 
​Please note that it is very common for an older adult to be subjected to more than one of the above forms of elder abuse at the same time. They are not mutually exclusive.  

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Who is at risk?

All older adults may be victims of elder abuse. Regardless of whether they are rich or poor, highly educated or undereducated, or suffering from dementia or “sharp as a tack,” seniors of all races, cultures, and creeds are victimized. Elder abuse is a silent problem that robs seniors of their dignity, security, and in some cases costs them their lives. It can occur anywhere - in the victim’s home, a family member’s home, a nursing home, an assisted living facility, or in other institutions. 

What are the signs?

The most common warning signs of elder abuse are strange and sudden changes to an older adult’s mental, physical, or financial well-being. Specific signs of elder abuse and neglect vary depending on what type of elder abuse is affecting the victim. If you notice that an older adult exhibits warning signs of abuse, take immediate action. Here are some signs of elder abuse and neglect that everyone should know.
  1. Emotional & Behavioral Signs
    • ​Increased fear or anxiety
    • Isolation from friends and family
    • Unusual changes in behavior or sleep
    • Withdrawal from normal activities
  2. ​​Physical Signs
    • ​​Dehydration or unusual weight loss
    • Unattended medical needs
    • Unexplained injuries, bruises, cuts, or sores
    • Unsanitary living conditions, poor hygiene, and torn or bloody underclothing
  3. ​Financial Signs
    • ​​Fraudulent signatures on financial documents
    • Unusual or sudden changes in spending patterns, will, or other financial documents
    • Unpaid bills 

How to report suspected Elder Abuse?

Maryland law requires health practitioners, police officers, and human service workers to report suspected abuse to the local department of social services. Social workers, employees of licensed health care facilities, and employees of financial institutions have additional, and in some cases mandatory, reporting requirements.  

Any concerned person who has reason to believe that an alleged older adult has been subjected to abuse may report it, and often the report can be anonymous. The following information on reporting is for members of the public. 

First, if you believe a crime is in progress or is about to be consummated, e.g., an assisted living resident has been or is about to be assaulted by an aide who scammed the resident, start with calling your local police by dialing 911.

Second, follow the steps below to determine what other avenues are available to report suspected elder abuse. Whether or not you have called 911, you still may report the suspected abuse to one or more of the agencies mentioned below. 

Select:

Health Care Facilities

 

I. Reporting suspected elder abuse or neglect in Health Care Facilities


A. Assisted Living Facilities

​1. Report suspected abuse to the local Adult Protective Services (APS) office. There is a local APS office in each county’s Department of Social Services (as well as Baltimore City’s). You can find the list of offices at http://dhr.maryland.gov/local-offices. Alternatively, you can call the statewide abuse number to report at 1-800-332-6347.

​2. You may also report suspected abuse to the Office of Health Care Quality (OHCQ). You may call in your complaint to 410-402-8217 or toll free to 1-877-402-8221. You may also mail in a written complaint or file online. See the following webpage: https://app.smartsheet.com/b/publish?EQBCT=07c94438f6714af1bbfe8ff1037b8b74 

3. If you file a report with APS and OHCQ, let each office know that you have filed a report with the other.

4. If the resident has Medicaid insurance, a report should also be made to the Maryland Attorney General's Office, Medicaid Fraud Control Unit (MFCU). You can call 410-576-6521 or email MedicaidFraud@oag.state.md.us.

5. You may also file a complaint with the Maryland Department of Aging and Long-Term Care Ombudsman Program (LTCOP). The LTCOP receives, investigates, and attempts to resolve complaints made by or on behalf of residents of assisted living facilities and nursing homes. See the following webpage: https://aging.maryland.gov/Pages/state-long-term-care-ombudsman.aspx. To report, you can call 410-767-1100 or 1-800-243-3425.

​B. Nursing Homes

​1. Report suspected abuse to the Office of Health Care Quality (OHCQ). You may call in your complaint to 410-402-8108 or toll free to 877-402-8219. You may also mail in a written complaint or file online. See the following webpage: https://app.smartsheet.com/b/publish?EQBCT=07c94438f6714af1bbfe8ff1037b8b74 

​2. In nursing homes, Adult Protective Services (APS) only investigates complaints regarding financial exploitation. APS does not investigate suspicions of non-financial abuse in nursing homes. There is a local APS office in each county’s Department of Social Services (as well as Baltimore City’s). You can find the list of offices at http://dhr.maryland.gov/local-offices. Alternatively, you can call the statewide abuse number to report at 1-800-332-6347.

​​3. If you file a report with APS and OHCQ, let each office know that you have filed a report with the other.

4. If the resident has Medicaid insurance, a report should also be made to the Maryland Attorney General's Office, Medicaid Fraud Control Unit (MFCU). You can call 410-576-6521 or email MedicaidFraud@oag.state.md.us.

5. You may also file a complaint with the Maryland Department of Aging and Long-Term Care Ombudsman Program (LTCOP). The LTCOP receives, investigates, and attempts to resolve complaints made by or on behalf of residents of assisted living facilities and nursing homes. See the following webpage: https://aging.maryland.gov/Pages/state-long-term-care-ombudsman.aspx. To report, you can call 410-767-1100 or 1-800-243-3425.

C. Hospitals and Mental Health and Developmental Disability Facilities 

​​Suspicions of abuse occurring in a hospital, mental health facility, or developmental disability facility should be reported to the administrator or local police.  ​

Non-Health Care Facilities

 

II. Reporting suspected elder abuse outside of Health Care Facilities (e.g., in the victim’s home or another community setting)


If you suspect that an older adult who does not reside in a licensed health care facility is being, or is about to be, abused, your next step depends on whether that older adult lacks the physical or mental capacity to provide for his or her daily needs. Follow the steps below. 

1. If the person is vulnerable, e.g., lacks the physical or mental capacity to provide for his or her own daily needs, then you should call the local Adult Protective Services (APS) office. There is a local APS office in each county’s Department of Social Services (as well as Baltimore City’s). You can find the list of offices at http://dhr.maryland.gov/local-offices. Alternatively, you can call the statewide abuse number to report at 1-800-332-6347. APS will send out an investigator if it believes the person may be vulnerable.

Please note that if you believe a crime is in progress or is about to be consummated, e.g., an older adult with a disability is about to suffer a theft, then you may also call your local police by dialing 911. 

2. If you are not sure if the older adult has a disability severe enough to qualify him or her as lacking the physical or mental capacity to provide for his or her daily needs, call APS anyway. APS will make the determination. There is no penalty or downside to referring someone to APS as APS will eventually find out if that person has the capacity to provide for his or her own daily needs.

​​3. If the person has the physical or mental capacity to provide for his or her daily needs, then there are quite a few options for referral depending on the nature of the abuse. You may discuss with the victim why you suspect he or she is being abused. You can then explain how he or she can stop the abuse, report it, or both. Keep in mind, you may not be able to convince the victim, or you may decide it would be counter-productive to try to convince the victim that he or she is being abused. Think very carefully about reporting without the victim’s consent. 

Additional information can be found on this document: https://dhs.maryland.gov/documents/Brochures/Adult%20Services%20Flyers/SSA-AdultProtectiveAbuse_dg.pdf ​

Please note that in domestic abuse matters, it can be dangerous to report suspected abuse without the victim’s consent. Matters of physical abuse should generally be reported to the local police. ​
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​​​​What Can You Do to Help Keep Maryland's Seniors Safe from Elder Abuse?

In addition to reporting suspected abuse, you can educate yourself and others about learning how the signs of elder abuse differ from the normal aging process. Check-in regularly on seniors who may have few friends and family members, provide caregivers with emotional and instrumental support, and if possible, involve more people than just family, paid caregivers, and guardians for healthcare and financial matters. 

Here are some informational links:

Additional Resources 

Contact Person: Leonard Croft, Elder Rights Program Manager, 410-767-4665, leonard.croft@maryland.gov