Elderly individuals comprise a specific demographic who are vulnerable to abuse, neglect, and get taken advantage of financially. They may have physical or mental incapacities that do not allow them to defend themselves, and oftentimes are unfairly victimized. Elder abuse is often used as a general term that includes physical, sexual, and psychological abuse, neglect, and financial exploitation, causing its millions of victims each year to face an increased risk of death, physical or emotional injury, or financial ruin.
The State of California has various statutes making individuals who abuse the elderly subject to criminal and civil liability, contained in the California Welfare and Institutions Code and the California Penal Code. State laws prohibit physical and mental abuse, financial abuse, and lack of care regarding the elderly.
California Civil Law
Under California law, an elder is defined as any person 65 years or older (CA Welfare & Institutions Code § 15610.27), and elder abuse includes physical abuse, neglect, financial abuse, abandonment, isolation, abduction or other treatment resulting in physical harm, pain or mental suffering to an elder. It also means the deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering. (CA Welfare & Institutions Code § 15610.07). This applies to dependent adults as well, who are defined as individuals between ages 18 and 64 who have physical or mental limitations that restrict their ability to carry out normal activities or to protect their own rights. (CA Welfare & Institutions Code § 15610.23). These are more specifically defined under the law:
- Physical abuse- the infliction of physical pain or injury, assault, battery, unreasonable physical restraint, sexual assault, sexual battery, rape, incest, sodomy, oral copulation, sexual penetration, lewd acts, molestation, as well as use of chemical or psychotropic medication for punishment, or for a period beyond which the medical was ordered. Common physical abuse of elders includes hitting, restraining, kicking, force-feeding, or sexual assault. (CA Welfare & Institutions Code § 15610.63).
- Neglect- the negligent failure to fulfill a caretaking obligation, such as assisting in personal hygiene, proving medical care for physical and mental health needs, providing food, clothing or shelter, protecting an elder from health and safety hazards, or preventing malnutrition or dehydration. Neglect can be active or passive. (CA Welfare & Institutions Code § 15610.57).
- Financial abuse- the misappropriation of an elderly’s assets (real property or personal property) for personal or monetary gains, or assisting in taking the property for a wrongful use, or with intent to defraud. For instance, financial abuse includes wrongfully taking an elderly’s checks, or using undue influence to obtain the transfer of real property. It can include forging checks, taking someone else’s retirement and Social Security benefits, or using another person’s credit cards and bank accounts. It also includes changing names on a will, bank account, life insurance policy, or title to a house without permission from the older person. (CA Welfare & Institutions Code § 15610.30).
- Abandonment- the desertion or willful forsaking of an elder or a dependent adult by anyone having care or custody of that person under circumstances in which a reasonable person would continue to provide care and custody. (CA Welfare & Institutions Code § 15610.05).
- Isolation- the intentional prevention of an elder from receiving mail, telephone calls or visitors, as well as false imprisonment. (CA Welfare & Institutions Code § 15610.43).
- Abduction- the removal of an elder or dependent adult from California who does not have the capacity to consent to removal from the State, or without consent of a conservator. (CA Welfare & Institutions Code § 15610.06).
- Mental suffering –fear, agitation, confusion, severe depression, or other forms of serious emotional distress that is brought about by forms of intimidating behavior, threats, harassment, or by deceptive acts performed or false or misleading statements made with malicious intent to agitate, confuse, frighten, or cause severe depression or serious emotional distress of the elder or dependent adult. (CA Welfare & Institutions Code § 15610.53).
- Goods and services necessary to avoid physical harm or mental suffering –furnishing health care for physical and mental health needs, adequate clothing, and heated and ventilated shelter, as well as assisting with personal hygiene, protecting from health and safety hazards, protecting against malnutrition, and transportation and assistance necessary to secure any of the aforementioned needs. (CA Welfare & Institutions Code § 15610.35).
California Criminal Law
Under the California Penal Code, elder adults and dependent adults, those whose physical or mental disabilities or other limitations restrict their ability to carry out normal activities or to protect their rights, are afforded special consideration and protection. (CA Penal Code § 368). The law makes certain acts against elders and dependent adults punishable by prison terms and/or fines.
Criminal elder abuse is defined as when a person who knows, or reasonably should know, that a person is an elder and willfully causes or permits an elder to suffer, or inflicts unjustifiable physical pain or mental suffering on the elder. It also covers situations where a person willfully causes or permits an elder to be placed in a situation in which the elder’s health or safety is endangered.
The Elder Justice Act is a federal law enacted as part of the Patient Protection and Affordable Care Act (PPACA) on March 23, 2010, and was the first federal legislation passed to authorize a specific source of federal funds to address elder abuse, neglect and exploitation.
The Older Americans Act was passed by Congress in 1965 in response to concern by policymakers about a lack of community social services for older persons. In 2016, the Older Americans Act was reauthorized to provide programs from 2017 to 2019, including provisions to protect vulnerable elders by strengthening the Long-Term Care Ombudsman program and elder abuse screening and prevention efforts.
Recognizing Elder Abuse
Elder abuse may not be immediately recognized by loved ones, especially for latent injuries or financial harm that can go undetected for an extended period of time. Physicians have an ethical obligation to report suspected elder abuse, and are required to report it under California laws.
Signs and symptoms of elder abuse are important to look for. Some signs of elder abuse may include:
- Behavioral indications
- Sudden change in behavior
- Physical indications
- Bruises, cuts, bleeding
- Bed sores
- Sudden weight loss
- Poor hygiene, dirty living conditions
- Fleas, bed bugs, lice, urine, fecal matter
- Missing or dirty clothes
- Poor vital signs
- Medication overdoses or under-utilization
- Missing dentures
- Head trauma /concussions / internal bleeding
- Impaired gait
- Broken bones, fractures
- Financial indications
- Sudden financial downfall
- Sudden transfer of asset or withdrawal of money
- Unexplained disappearance of funds or valuable possessions
- Abrupt changes to a will, trust, or other financial documents
- Signature forgery
- Unnecessary services
- Bank notices
- Credit card notices
- Eviction notices
- Elder’s report of being:
- Hit, slapped, kicked, mistreated
- Denied food or water
- Improperly touched, assaulted, raped
- Verbally or emotionally attacked
- Abandoned, isolated, or a feeling of being imprisoned
Certain risk factors may make elders more susceptible to being the victims of abuse. These include dementia, Alzheimer’s, mental illness, physical limitations (i.e. wheelchair bound, disabled), or substance abuse.
Abuse of elders and dependent adult individuals, when such situations occur, is commonly committed by the following:
- Family members – including spouses, adult children, next of kin, or other relatives
- Caregivers – including rehabilitation workers, nursing home workers, hospital workers, hospice workers, or in-home nursing care
- Fiduciaries – including agents under a power of attorney, court-appointed guardians or conservators, trustees, real estate agents/brokers, financial advisors, or attorneys
- Others – including acquaintances or neighbors
Resources for When Elder Abuse is Suspected
If you suspect that an elder individual has been the victim of abuse or neglect, it is important to document the conditions or injuries. This may be in the form of photographs, videos, requesting medical records, or writing down a timeline of events in a notebook.
If an elder is in immediate danger from physical abuse, it is imperative to call 9-1-1, since elder abuse is a crime. You may also make a formal complaint to the facility where the elder is an inpatient.
It is important to take action to report elder abuse, so that appropriate civil and criminal penalties can be imposed.