Low or no data? Visit zero.govt.nz, scroll down the page then click on our logo to return to our site and browse for free.

Abuse – elder

Known as elder abuse

Key points about elder abuse

Elder abuse is any behaviour causing harm or distress to an older person by someone they should be able to trust.
Elder abuse can be physical, emotional (including verbal), financial, sexual, institutional or involve neglect.
It can be one-off, but more often it happens repeatedly over a period of time.
Some people are at greater risk of abuse, due to issues within a family, carers struggling with their role or, in hospital or residential settings, staff training and support issues.
Signs of abuse may include unexplained behaviours and injuries, confusion and financial issues.
There are ways to prevent elder abuse or get help if you or someone you know is experiencing elder abuse.

Older man in chair with puppy on knee canva 950x690

Print this page

Elder abuse is a global problem. International studies suggest that 3–10% of older people experience abuse or neglect each year.

Elder abuse can:

happen to men and women of every religious, cultural, ethnic and income group
occur in any setting, rural or urban
affect older people living on their own or living with others
occur in private homes or within a residential care or health care setting
affect people who are frail and vulnerable, who depend on others to meet their needs.

Sadly, much abuse goes unreported or is only reported after it has escalated to have caused significant harm to an older person.

What are the risk factors for elder abuse?

Elder abuse occurs for many reasons. Sometimes there has been be a background of difficult relationships or family violence. Occasionally carers struggle with their role. The impact of dementia, substance abuse, mental health problems and economic stress can also contribute. These factors can influence those who abuse, but greed and opportunism to exploit older people is also common.

What are the situations that increase risk of elder abuse?

A family undergoes an unforeseen or unfavourable change in circumstances.
Adult children or grandchildren have difficulties in their own living situation and move in with older relatives.
There is a history of tense relationships or abuse between family members.
Difficulties emerge as a result of role reversal (eg, if a father or mother becomes dependent on a son or daughter).
A person appears to befriend an older person and then manipulates them.
Family members are isolated and lack other relationships that give social, physical and emotional satisfaction.
A carer has been forced to change their lifestyle as a result of caring for the older person.
The older person requires a level of care beyond the capacity of the carer.
There are difficulties due to hearing, visual or speech impairments of the older person or of those caring for them.
Older people are required to give money, resources or property to other generations.
The older person is continuing to provide support for younger relatives with disabilities, mental health or addiction issues.
A carer has conflicting responsibilities or financial difficulties and does not adequately support the older person’s needs.
A carer has not received help or support.
The older person refuses adequate support for themselves or their carer.
The older person has an illness or dementia that can cause unpredictable or repetitive behaviour, wandering or aggression, or major changes in personality.
The relative or carer has a disability, mental illness or addiction issue that affects their safe interaction with the older person.
Financial pressures and/or beliefs about rights of inheritance or ownership lead to control of finances, property or resources.

What factors contribute to elder abuse within hospitals or residential care settings?

Staff working in isolation.
Staff inadequately trained to provide care and to respond to challenging behaviour.
Staff poorly supervised.
Staff having inadequate time per patient to provide respectful care.
Low staffing levels and/or frequent use of agency staff.
High staff sickness levels and/or a rapid turnover of staff.
Staff with low self-esteem or who are stressed or burnt out.
Staff who have a criminal history, personality disorder or who abuse drugs or alcohol.
Inappropriate or poor staff skill mixes and poor staff to patient ratios.
Inadequate management supports.
Ways of working that disregard the social and cultural needs of residents.
Over-cramped or poor working conditions and environment.
Care settings isolated from other parts of the hospital or community.
Attitudes or behaviours that disregard the safety of patients or residents.

There are 5 common categories of elder abuse. You may see signs that may raise suspicion of abuse, but it is important to avoid jumping to conclusions. The whole situation needs to be taken into account.

Type and examples	Warning signs
Physical abuse Any acts of violence, such as: hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, choking or burning inappropriate use of medicines or physical restraints force-feeding physical punishment of any kind.	Multiple injuries, such as bruises, hair loss, grip marks, fractures, burns or scalding, especially if these are of different ages and in unusual places.
Psychological or emotional abuse Any behaviour that causes anguish, stress or fear, including: verbal abuse, intimidation, harassment, damage to property, threats of physical or sexual abuse the removal of decision-making powers treating an older person like a baby giving an older person the "silent treatment" isolating them from family, friends or regular activities.	Feelings such as resignation, fear, shame, depression or mental confusion.
Financial or material abuse This is the illegal or improper use and/or exploitation of funds, property or assets. This includes: forging an older person's signature stealing money or possessions tricking an older person into signing documents that transfer funds, property or assets.	Failure to pay rent or other bills on behalf of the older person, sale of property by an older person who seems confused about the reasons for the sale, lack of money for necessities, lack of money for social activities, depletion of savings, disappearance of possessions.
Neglect (including self-neglect) This occurs as a result of an older person themselves or another person failing to meet the physical and emotional needs of an older person. This includes: failing to provide an older person with food, clothing, personal shelter, or other essentials, such as medical care or medicines can also include failing to pay nursing home or assisted-living facility costs for an older person if you have a legal responsibility to do so.	Malnourished or dehydration, hypothermia, weight loss with no apparent medical cause pallor, sunken eyes, cheeks, bedsores or injuries that have not been properly cared for, poor personal hygiene, clothing in poor repair, abandoned or left unattended for long periods, medicines not purchased or administered.
Sexual abuse Any forced, coerced or exploitative sexual behaviour or threats imposed on an individual. This includes: sexual acts imposed on a person unable to give consent sexual activity that an adult lacking mental capacity is unable to understand acts such as unwanted touching all types of sexual assault or battery, such as rape forced nudity and sexually explicit photography.	Sexually transmitted infection, difficulty walking or sitting, recoiling from being touched, bruising or bleeding, pain or itching in the genital area.
Institutional abuse Any policy or accepted practice within an organisation that causes harm to, or disregards, a person’s rights. It may occur in hospital and residential care facilities, but also in community settings. Examples include: inappropriate rationing of continence products inflexible routines eg, all dressed for breakfast before 8 am.	The older person does not receive the care or support that is promised, eg, written documentation (such as a needs assessment) does not result in adequate care provision. Repeated incidents of an older person’s physical and emotional needs being inadequately resolved by an organisation. An older person being neglected until an advocate or an audit highlights the gaps.

The following signs may raise suspicion of potential elder abuse, but it's important to avoid jumping to conclusions – the whole situation needs to be taken into account:

unexplained behaviour, sleeping or eating habits
confusion, withdrawal and/or edginess
unexplained injuries
drowsiness (due to over-medication)
fear of a particular person or being anxious in familiar situations
recoiling from touch
unusual withdrawals from bank accounts or decisions around property or other assets
unpaid bills and/or not enough money for necessities.

Older people have the right to make their own choices and decisions even if you don’t agree with them. Where older people’s choices are being undermined or over-ridden by others, it is important to question whether their human rights are being upheld.

To help prevent elder abuse, older people should be:

loved and cherished
spoken and listened to respectfully
included in social activities
phoned or visited regularly
supported to spend their money how they wish
encouraged and supported to make their own decisions
enabled to set their own pace.

If you are worried about how you or another older person are being treated, do one of the following:

Talk to someone you trust – a friend or someone in your family/whānau.
Talk to someone you see regularly – a doctor, nurse, member of your church or spiritual leader.
Talk confidentially with a worker from an agency with experience in dealing sensitively with elder abuse, like Age Concern.
Phone 0800 652 105 to ask Age Concern about your nearest elder abuse service.
Visit Age Concern elder abuse services(external link)(external link) to find your nearest service.
Call the national elder abuse 24-hour free phone line on 0800 32 668 65 or text 5032 or email support@elderabuse.nz.
If you or an older person are in immediate danger, call the Police on 111.