COVID-19 and Elder Abuse: the ramifications to our elder adult population after mandatory stay-at-home orders
To report elder abuse, call 1-833-401-0832 and when prompted, enter your 5-digit zip code to be connected to the Adult Protective Services in your county. If you or someone you know is in danger, call a local hotline, or the U.S. National Domestic Violence Hotline at 1-800-799-7233 and TTY 1-800-787-3224, or 911 if it is safe to do so.
The last two years have illuminated the growing health concerns that elder adults face amid the COVID-19 pandemic. But what looms in reality is not often talked about on social media or news sources; it is beyond the virus altogether. What threatens our elderly population can and has been affecting elders in a devastating way. This threatening phenomenon is elder abuse. Before the COVID-19 pandemic, an estimated 1 in 10 elders in the United States reported being victimized of some type of elder abuse.1 After individualized stay-at-home orders swept across the country combined with increased interpersonal stressors, the pandemic has brought with it a surge in elder abuse, amounting to every 1 in 5 elder adults reporting abuse, an increase of 83.6% from prevalence before the pandemic.2
The COVID-19 pandemic has brought with it the perfect storm and environment for elder abusers to thrive. Abusers can now justify isolation of the elder from friends and family and attach the label of “COVID” on it. An already vulnerable population to the virus itself, elder adults are facing higher rates of abuse behind closed doors.
This article intends to shed light on elder abuse, encourage others to look for warning signs, and propose solutions that elder adults may take and that loved ones may take to ensure our elder relatives are properly cared for.
What is Elder Abuse?
More than 54 million people in the United States are adults aged 65 and older. By 2050, the total number of elder adults is projected to rise an estimated 85.7 million – 20% of the overall U.S. population.3 As our aging population increases, so does the threat of abuse. California legislature has recognized that elderly adults are highly susceptible to elder abuse and are more subject to risks.4 Elder adults who suffer from developmental disability, limited mental or verbal functions (often associated with dementia, which is highly prevalent in the elder adult population), are vulnerable to abuse.
The California Welfare and Institutions Code defines “elder abuse” as any:
- Physical abuse, neglect, abandonment, isolation, abduction, or other treatment resulting in physical harm or mental pain and suffering,
- Deprivation of necessary care, or
- Financial abuse.5
- Financial abuse occurs when a person or entity “takes, secretes, appropriates, obtains, or retains” or assists in taking real or personal property of an elder for a wrongful use, intent to defraud, or via means of unduly influencing the elder.6
Isolation:
Isolation is a specific form of elder abuse prohibited under California law.7 Isolation includes:
- Preventing an elder from receiving mail and/or telephone calls;
- Telling a visiting friend or family member that the elder is not present or does not wish to speak with the friend or family member when that statement is false;
- False imprisonment; or
- Physical restraint of the elder to prevent them from meeting with others.8
COVID-19 and Elder Abuse:
According to the National Institute on Aging, social isolation and loneliness are linked to higher risks for health problems, including high blood pressure, anxiety, depression, cognitive decline, Alzheimer’s disease, and even death.9 Abusers have weaponized the mandatory shelter-in-place orders these last two years by isolating the elder adult and prohibiting contact from friends and family, justifying a “no-visitor” policy due to COVID-19. This social isolation and loneliness create a dependency in the elder adult towards the abuser because there is no one else present, opening the door to elder abuse.
Abusers are usually in positions where they have control over the elder adult’s life, sometimes acting as caretakers or providing other necessities of life. Additional factors that contribute to elder abuse include economic instability of the family, resentment of caretaker responsibilities, stress on the caretaker, and abuse of drugs or alcohol.10 COVID-19 has exacerbated these risk factors, with severe widespread layoffs, furloughed employees, and business closures, resulting in personal financial and economic instability. Further stresses and increase in alcohol abuse occurred from the pandemic and COVID-19 quarantine protocol in general.11
What Can We Do?
The California legislature has recognized the prevalence of elder abuse and the need to protect our elder adults, a vulnerable class. On September 23, 2021, the California legislature introduced Assembly Bill (AB) 1243, which creates a new class of “anti-isolation” restraining orders in the state. AB 1243 will enable family members are friends to bring a petition seeking an order to enjoin the alleged isolation of an elder or dependent under the Elder Abuse and Dependent Adults Civil Protection Act. Previously, only the elder or their conservator, trustee, or attorney-in-fact acting within their authority were able to seek protection. AB 1243 is set to go into effect January 1, 2023.
Additionally, family and loved ones should check in with their elder adult relatives and look for warning signs of potential abuse. Abusers often hide behind COVID-19 isolation orders, but abusers should not prevent you from communicating with the elder adult via telephone, video-conferencing software (like Zoom or FaceTime), or socially distanced settings.12
Some potential warning signs of elder abuse may include the following:
- The abuser taking care of all financial matters
- A sudden change in bank account balances, the inclusion of additional names on accounts or credit cards
- Unexplained disappearance of personal property or funds
- Unexplained transfer of assets to a family member or someone outside the family
- Including care services for the elder adult that are not necessary
- Unsanitary living conditions
- Untreated health problems, malnutrition, poor personal hygiene, soiled clothing
- Bruises, wounds, fractures on the elder adult
- The elder adult acting upset or agitated, withdrawn, depressed, or anxious
- The elder adult exhibiting a change in sleeping or eating patterns
Create an Estate Plan
One key way to prevent elder abuse is to create a comprehensive estate plan. An estate plan goes beyond designating who will receive the elder adult’s belongings after passing away. More importantly, an estate plan creates documents that allow for someone to plan for life and care when needed, and to designate trusted individual(s) to make decisions when needed.
Trust: Creating a trust gives an individual complete say over what happens to their assets once the individual has passed away or is no longer able to make decisions for themselves, whether temporarily or more permanently. Essentially, all an individual’s assets are held in the trust, and a “plan” is laid out for how to manage each asset. The individual assigns a trustee, a person the individual trusts and can rely on, to manage the assets according to the trust document, when the person is deceased or incapacitated.
Durable Power of Attorney: This document is drafted for an individual to assign a trusted person as their power of attorney, someone who the individual will give legal authorization to act on their behalf financially if the individual is unable to do so themselves.
By appointing a power of attorney, the individual ensures that someone they trust will be in charge of their finances, making them a less likely target for elder abuse.
Advance Healthcare Directive: An advance healthcare directive is document where an individual appoints a healthcare agent to make medical decisions for that individual if they are unable to do so themselves. This can be temporary or permanent and includes written specifications of the elder adult’s healthcare decision preferences. Again, this healthcare agent is someone the individual designates and trusts to make these decisions.
Elder abuse is a real issue and has become more prevalent since the start of the COVID-19 pandemic. Luckily, through estate planning and spotting warning signs of elder abuse, people can protect themselves and prevent it before it is too late.
References:
1 Chang, E-Shien & Levy, Becca R., High Prevalence of Elder Abuse During the COVID-19 Pandemic: Risk and Resilience Factors, National Library of Medicine (NIH) (Jan. 2021), https://pubmed.ncbi.nlm.nih.gov/33518464/.
2 Id. This number only acknowledges the prevalence of elder abuse reported. In reality, this number is larger due to unreported cases.
3 2021 Senior Report, Page 2 of 62, America’s Health Rankings United Health Foundation (2021), https://www.americashealthrankings.org/learn/reports/2021-senior-report/introduction.
4 Welf. and Inst. Code § 15600.
5 Welf. and Inst. Code § 15610.07.
6 Welf. and Inst. Code § 15610.30.
7 Welf. and Inst. Code § 15600.
8 Welf. and Inst. Code § 15610.43.
9 Social isolation, loneliness in older people pose health risks, National Institute on Aging (NIH) (April 23, 2019), https://www.nia.nih.gov/news/social-isolation-loneliness-older-people-pose-health-risks.
10 Welf. and Inst. Code § 15600(e).
11 Grossman, Elyse R. et al., Alcohol consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults, Int. Journal of Environmental Residential Public Health (Dec. 9, 2020), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763183/.
12 Absent a physician order or if the elder is in reasonably perceivable threat of danger to their property or physical safety. (Welf. and Inst. Code § 15610.43.)