Common needs that older adults may deny themselves or ignore include the following: sustenance (food or water); cleanliness (bathing and personal hygiene); adequate clothing for climate protection; proper shelter; adequate safety; clean and healthy surroundings; medical attention for serious illness; and essential medications. Self-neglect is often created by an individuals declining mental awareness or capability. Some older adults may choose to deny themselves some health or safety benefits, which may not be self-neglect. This may simply be their personal choice. Caregivers and other responsible individuals must honor these choices if the older adult is sound of mind. In other instances, the older adult may lack the needed resources, as a result of poverty, or other social condition. This is also not considered "self-neglect." Institutional abuse refers to physical or psychological harm, as well as rights violations in settings where care and assistance is provided to dependent older adults or others, such as nursing homes. Recent studies of approximately 2,000 nursing home facility residents in the United States reported a growing abuse rate of 44% and neglect up to 95%, making elder abuse in nursing homes a growing danger. Exact statistics are rare due to elder abuse in general and specifically in nursing homes being a silent condition. Warning signs
The key to prevention and intervention of elder abuse is the ability to recognize the warning signs of its occurrence. Signs of elder abuse differ depending on the type of abuse the victim is suffering. Each type of abuse has distinct signs associated with it.
Common abusers
An abuser can be a caregiver, spouse, partner, relative, friend, neighbor, volunteer worker, paid worker, practitioner, solicitor, or any other individual with the intent to deprive a vulnerable person of their resources. Relatives include adult children and their spouses or partners, their offspring, and other extended family members. Children and living relatives who have a history of substance abuse or have had other life troubles are of particular concern. For example, Hybrid Financial Exploitation (HFE) abusive individuals are more likely to be a relative, chronically unemployed, and dependent on the elderly person. Additionally, past studies have estimated that between 16% and 38% of all elder abusers have a history of mental illness. Elder abuse perpetrated by individuals with mental illnesses can be decreased by lessening the level of dependency that persons with serious mental illness have on family members. This can be done by funneling more resources into housing assistance programs, intensive care management services, and better welfare benefits for individuals with serious mental illness. People with substance abuse and mental health disorders typically have very small social networks, and this confinement contributes to the overall occurrence of elder abuse.Perpetrators of elder abuse can include anyone in a position of trust, control or authority over the individual. Family relationships, neighbors and friends, are all socially considered relationships of trust, whether or not the older adult actually thinks of the people as "trustworthy." Some perpetrators may "groom" an older person (befriend or build a relationship with them) in order to establish a relationship of trust.