Research indicates that power and control dynamics, such as those found with younger abused women, often present in elder abuse cases. Greed is also a motivator in financial exploitation cases. Perpetrators will often strive to exert power and control over victims/survivors to coerce or manipulate some benefit for themselves, such as money, a place to stay, access to prescription medication, or sexual gratification.

These abusers often feel entitled to do whatever is necessary to get what they want. They may financially exploit an older adult, feeling entitled to take a Social Security check or empty a bank account. To maintain power and control, these abusers typically use various coercive tactics, including physical and psychological abuse and isolation. Abusers may intimidate their victims and prevent them from reporting the exploitation or abuse out of fear of retaliation. They may also lie and manipulate family members, friends, and professionals to hide or justify their behavior.

Additional Factors

In a small number of cases, well-intentioned caregivers cannot provide care, and an older adult is harmed unintentionally. Also, a few abusers cannot control their behavior due to a medical or mental health condition manifesting in aggressive, inappropriate, or violent behavior. Theories that elder abuse is caused by caregiver stress, anger, substance abuse, or retaliation for previous child abuse have not been supported by research.

Often these issues co-exist with abuse, neglect, or exploitation but do not cause abuse. These problems may need to be dealt with as separate issues. But resolving these problems rarely enhances victim safety or improves the quality of an older victim’s life.

Listed below are possible behavioral indicators of abuse by potential victims and abusers. Most or all forms need NOT be present for abuse to occur. One or two indicators may warrant further questioning and investigation.

A potential victim may exhibit some of the following behaviors:

• Has repeated “accidental injuries”
• Appears isolated
• Says or hints at being afraid
• Considers or attempts suicide
• Has a history of alcohol or drug abuse (including prescription drugs)
• Presents as a “difficult” client
• Has vague, chronic, or non-specific complaints
• Is unable to follow through on treatment plan or medical care
• May miss appointments
• Delays seeking medical help
• Exhibits depression (mild or severe)
• Evidence of effects of stress and trauma, such as chronic pain and other illnesses

A potential abuser may do some of the following: 

• Is verbally abusive to workers or charming and friendly to workers
• Says things like “he’s difficult,” “she’s stubborn,” “he’s so stupid,” or “she’s clumsy”
• Attempts to convince others that the person is incompetent or crazy
• Is overly attentive to the victim
• Controls the older person’s activities and outside contacts
• Refuses to let an interview take place without being present
• Talks about the family member as if he/she is not there or not a person (dehumanizes)
• Physically assaults or threatens violence against victim or worker
• Threats of suicide or homicide or both
• Threats of harassment
• Stalking
• Cancels older person’s appointments
• Sabotages older person’s efforts to attend appointments by refusing to provide transportation or some other excuse
• Takes the older person’s to different doctors, hospitals, and pharmacies to cover up abuse
• Uses the legal system to harass the older person (e.g., mutual protective orders, making false charges)
• Financially dependent on older adult

If you are concerned about your safety or mistreatment: If you recognize signs of mistreatment or abuse in your relationships, it is vital to seek help. Call a law enforcement emergency line such as 911 if you are in immediate danger. You may also benefit from speaking with an advocate about resources and support available to help you break free from the abuse. Advocates are specially trained to assist people with their safety concerns and help them to plan for a future free from violence.

You can reach an advocate 24 hours a day, 7 days a week, by calling the Alexandra House Helpline at 763-780-2330. Many elder abuse victims/survivors also benefit from individual or group counseling, emergency housing, and medical or legal advocacy. Please visit our Elder Abuse Services page for a list of services Alexandra House can provide.

If you are concerned about an older adult who may be mistreated:

• Talk to the older adult. Tell them you are concerned for their safety and are there to help. Let them know that domestic violence, sexual abuse, and elder abuse do not stop without some outside intervention. Offer to accompany them to speak with an advocate at a domestic violence or sexual assault program or a social worker at an elder abuse agency.
• Be part of their safety plan. A safety plan is created by the victim with the help of a professional. The intent is to plan for a victim’s safety before another violent episode erupts. If you believe they are in immediate danger, call 911.
• Call Alexandra House’s 24-hour Helpline at 763-780-2330 for additional information and support specific to your concerns.
• Do not do anything that further isolates, blames, or discourages victims. This includes:
  • Telling the victim what to do (e.g., “you should leave immediately”)
  • Judging a victim who returns to an abusive relationship
  • Threatening to or ending services if a victim does not do what you want
  • Breaking confidentiality by sharing information with the abuser or other family members
  • Blaming the victim for the abuse (“if only you had tried harder or done this, the abuse might not have happened”)
  • Reporting abuse to the authorities without permission from the victim (unless mandated by law). If you are a mandated reporter, tell the victim what you are doing and why. Help the victim with safety planning or find someone who can.
  • Documenting opinions (he’s drunk and obnoxious” or “she’s hysterical and overreacting”). These statements are opinions and may not be accurate. However, they can be used against a victim in court.

Do not collude with the abuser and give him/her more power and control by:

• Accepting excuses from the abuser and supporting the violence (“I can understand how much pressure you are under.” “These things happen.”)
• Blaming drugs or alcohol, stress, anger, or mental illness for the abuse. Abusers must be held accountable for their actions before they will change their behavior.
• Minimizing the potential danger to the victim or yourself if you offer help.

Do everything possible to give a victim a sense of hope by:

• Believing the account of the abuse
• Sharing that abuse can happen to anyone and the victim is not alone
• Affirming that the victim is not to blame for the abuse
• Planning for safety and/or seeking support from a professional to create a safety plan
• Offering options and giving information about resources or finding someone who can
• Allowing the victim to make decisions about the next steps (returning power to the victim)
• Keeping information shared by the victim confidential
• Documenting the abuse with photographs, body maps, and victim statements