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Causes of Elder Abuse and Neglect

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According to where it occurs, elder abuse generally consists of Domestic Elder Abuse and Institutional Elder Abuse.


Domestic elder abuse is that which normally occurs in a private residence. Studies have shown that the great majority of domestic elder abuse cases are perpetrated by either the elderís spouse or adult child, with the spousal abuse being more prevalent.

Often when a spouse abuses the elder it is due to frustration and a long-term relationship in which one or the other spouses has controlled or abused the other, verbally, physically or in other ways.

When an adult child is the abuser, it is often found that the child is living with the elder parent in the parentís home, and is financially dependent on the parent for support. Moreover, the adult child is often found to be also abusing alcohol or drugs, and/or have some type of mental impairment.


Institutional elder abuse is that which occurs in a long-term care facility, usually at the hands of one or more direct-care staff members.

Broadly speaking, institutional elder abuse usually occurs as the result of matters relating to money.

Most nursing homes are run by corporations. In every case they must spend less money than they bring in if they wish to stay in business. And some of these nursing homes are far more concerned with the bottom line financially than they are with the proper care of their residents.

Because the cost of the staff is such a large part of the overall cost of running a nursing home, most institutional elder abuse and neglect comes about because of the facilityís inadequate policies relating to their staff members.


  • Inadequate number of nurses
  • Inadequate number of certified nursing assistants (CNAs)
  • Inadequate hiring practices; for example:
    • Staff members not screened for criminal history
    • Staff members not screened for substance abuse
    • Staff members not screened for domestic violence
    • Staff members not screened about their work ethics
    • Staff members not screened on their ability to manage their stress or anger
    • Staff members not screened on their attitudes toward caring for the elderly
  • Inadequate operational policies; for example:
    • Inadequate communication between staff members and administrators
    • Staff members being paid an inadequate salary
    • Staff members not recognized or respected for the difficulty of their jobs
    • Staff members having no chance for job improvement
    • Staff members not offered job schooling
  • Staff members not offered job training; for example in:
    • Caregiver skills
    • Problem-solving
    • Conflict-resolution
    • Stress-reduction techniques
    • Handling difficult resident care situations
    • Cultural issues affecting residents and staff
    • Mandatory reporting of abuse

What this all means is that in many cases nursing homes have too few staff for the work load, and the staff that are there are under-qualified, under-trained, and over-worked, and in some cases, morally or psychologically unfit to perform the work required.

What happens in these cases is that the residents of the nursing home suffer. Staff members canít spend enough time with each resident, and the time they do spend is rushed. Staff members donít notice the individual needs of residents. They donít spend adequate time feeding those residents who need assistance. They donít adequately help needy residents with their toilet or grooming needs. Nor do they see that residents are participating in activities.

In addition, in these situations staff members donít have time to nurture relationships with residents. They may ignore residents. They may become frustrated and angry and take these feelings out on the residents, even hitting or restraining them to keep them in line. They may look for quick, easy ďsolutionsĒ to their problems which are for their own benefit than the residentsí, and which end up being hard on the residents.

Taken together, these policies and the behavior they foster can result in great discomfort, harm or injury to the residents entrusted to the care of the home and its staff members. Depression malnutrition, dehydration, bed sores, pressure sores, over-medication, under-medication, bruises, cuts, lacerations, infections, falls, dislocated joints, broken bones, sexual abuse, and even death can be the terrible result of a nursing homeís improper policies.

To prevent this type of situation occurring to a loved one who will be going into a nursing home, it is imperative that the best possible nursing home be chosen. See ELDER ABUSE PREVENTION in this web site to assist in making the right choice.

Getting help

If you feel you need assistance to prevent the abuse or neglect of a loved one, call (800) 215-1190 toll free for more information, or to arrange a consultation with an Elder Abuse attorney.

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