Long-Distance Caregiving: Checking For Signs of Abuse


From a distance, it can be hard to assess the quality of your parent's caregivers. Ideally, if there is a primary caregiver on the scene, he or she can keep tabs on how things are going. Sometimes a geriatric care manager can help. You can stay in touch by phone and take note of any concerns that might indicate neglect or mistreatment. These can happen in any setting, at any socioeconomic level. They can take many forms, including domestic violence, emotional abuse, financial abuse, and basic neglect.

The stress that may happen when adult children care for their aging parents can take a toll on everyone. In some families, abuse continues a long-standing family pattern. In others, the older adult's need for constant care can cause a caregiver to lash out verbally or physically. In some cases, especially in the mid-to-late stages of Alzheimer's disease, the older adult may become physically aggressive and difficult to manage. This might cause a caregiver to respond angrily. But no matter what the cause or who is the perpetrator, abuse and neglect are never acceptable responses.

If you feel that your parent is in physical danger, contact the authorities right away. If you suspect abuse, but do not feel there is an immediate risk, contact someone who can act on your behalf: your parent's doctor, for instance, or your contact at a home health agency. Suspected abuse must be reported to adult protective services.

Elder Mistreatment

Elder mistreatment is the intentional or unintentional hurting, either physical or emotional, of an older person. Some signs to watch for:

  • Bruises, pressure marks, broken bones, abrasions, and burns may indicate physical abuse, neglect, or mistreatment.
  • Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may indicate emotional abuse.
  • Sudden changes in financial situations may be the result of exploitation.
  • Bedsores, unattended medical needs, poor hygiene, and unusual, unexplained weight loss can indicate neglect.
  • Behavior such as belittling, threats, and other uses of power and control by spouses may indicate verbal or emotional abuse.
  • Strained or tense relationships, and frequent arguments between the caregiver and older person can indicate mistreatment.

If your parent is in a long-term care facility, the facility must take steps to prevent (and report) abuse. Nursing homes, like hospitals, are subject to strict state licensing requirements and federal regulations. Even so, neglect and abuse can occur. For more information, contact the National Center on Elder Abuse. The Resources section of this booklet has details on how to contact the Center.

Signs of Self-Neglect

Self-neglect describes situations in which older people put themselves at high risk. People who neglect themselves may have a disorder which impairs their judgment or memory. They may have a chronic disease. Knowing where to draw the line between self-neglect and a person's right to independence can be hard. Here are some signs that may mean it's time to intervene:

  • Hoarding
  • Failure to take essential medications or refusal to seek medical treatment for serious illness
  • Leaving a burning stove unattended
  • Poor hygiene
  • Not wearing suitable clothing for the weather
  • Confusion
  • Inability to attend to housekeeping
  • Dehydration

If these signs are present, talk to your parent and try to determine what is causing the behavior. Keep in mind, it may be the first sign that your parent is no longer able to care for himself, making it time to think about alternate living arrangements.

The National Institute on Aging (NIA), one of the 27 Institutes and Centers of the National Institute of Health (NIH) leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people.

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It is very hard to watch what is going on with your parent when it is long distance and "you think" that the people who are living close to your parent would never abuse them in any way,money,physical abuse or neglect. Don't let the police off the hook to easy eather. If you send them to do a welfare check and they say well your sister or brother said you are the one causing problems, you start calling and calling, the police, the sheriff of that county,the DA office, elder abuse hotlines, flood them with phones calls. Call their dr and just tell them what you know is going on. Have a welfare check done every few days, my brother started to move my mom around so we couldn't find her. Get a neighbor who may live next to the ones who are watching your parent if possible and have them keep an eye on what they are doing.Some times you can find out more by the neighbors watching the caregivers then sending the police over. Don't ever stop trying to do what is right no matter what or who. You can never bring back your parent after they are gone. You expect your parents at some point to not be there, but it is the way their life ended and the last few years they had,what was it like for them. It is heart breaking when you find out and it's too late to do anything that they were abused in everyway by their own flesh and blood.
I have many thoughts with an ongoing issue of my Mother in law. Her eldest daughter is caring for her and the Mom is thriving. 3 adult siblings who are nurses have decided after 8 years of non involvement to decide her daily actions and have went so far as to contact elder abuse who deemed their claims non worthy and the police who came and spoke with the Mom who said she enjoys where she is staying and wants them to stop harassing her and her oldest daughter. 2 live out of state and now they don't want her to leave the care of her at their sisters. They are jealous because her adopted daughters are closer to her than her natural grand children. They are making her have physical duress about her daily activities and she wants them to stop as she will decide who she sees and when. It is becoming alarming with 3 supposedly educated women creating unnecessary actions with an attorney over a grown woman's right to live peacefully.