“I think that as we grow up, we take things with us … you keep your business to yourself. We don’t shout out what’s going on with us. Nobody is saying anything and it’s continuing. It’s continuing! The doors are shut; the windows are shut.” — Survivor of elder abuse.
Elder abuse, including physical, sexual, emotional, and financial abuse, as well as neglect and exploitation, affects an estimated one in 10 older adults in the United States. Rates are much higher for people living in nursing homes or with dementia.
For individuals affected by elder abuse, the impacts can be devastating. Abuse can harm physical and psychological health, threaten personal finances, and elevate risk of premature death. Elder abuse also places enormous strain on the health and social systems tasked with addressing abuse, resulting in billions of dollars in health care expenditures each year.
Prevention Must Be Built Into Care Systems
Elder abuse is not a private family matter, a rare tragedy, or an issue one agency can solve. It is a public health and aging issue that requires the institutions older adults already rely on—federal, state, local, health care providers, aging services, long-term care settings, tribal programs, and community organizations—to recognize risk, respond earlier, and work together to prevent harm.
The most important lesson from this work is clear: Elder justice cannot sit apart from the systems older adults depend on every day. It must be woven into health care, aging services, long-term care, legal services, tribal programs, and community-based supports.
As the population of older adults in the United States grows, elder abuse must be recognized as the important public health issue that it is. More than 61 million people in the United States are now over age 65, a number projected to rise to 76 million by 2035. Addressing elder abuse will require proactive, cross-sector approaches to prevention, identification, and response so that older adults can live free from harm and continue to contribute to families, communities, and society.
Encouragingly, important efforts are already underway. Federal agencies, researchers, advocates, health systems, and community organizations are working to strengthen prevention and response efforts, improve research and evidence-informed interventions, and support collaboration across systems that serve older adults.
But the most important lesson from this work is clear: Elder justice cannot sit apart from the systems older adults depend on every day. It must be woven into health care, aging services, long-term care, legal services, tribal programs, and community-based supports.
For the National Collaboratory, this has meant deepening engagement with health systems, health plans, and state partners to elevate promising practices and strengthen collaboration across sectors. This work reflects an important shift: Elder mistreatment prevention cannot sit outside the places older adults already turn to for care, support, housing, and protection.
What Health Care Leaders Can Do Now
Hospitals and clinics need pathways to identify and respond to suspected abuse and neglect. Health plans can help connect members to services and address risks before crises occur. State and tribal agencies can strengthen coordination among health care, aging services, Adult Protective Services, legal services, and community organizations. Nursing homes and other long-term care settings must also play an important role in prevention, detection, reporting, and resident-centered response.
No single sector can prevent elder abuse alone, but every sector can ask important questions.
No single sector can prevent elder abuse alone, but every sector can ask important questions: Are we prepared to recognize elder abuse? Do staff know what to do when warning signs appear? Do we have trusted community partners to call? Are older adults, family caregivers, and survivors helping shape solutions? And are we treating elder abuse prevention as part of healthy aging, quality care, and community well-being?
Elder abuse prevention and response should be part of the everyday work of caring for and supporting older adults. This means investing in prevention, strengthening partnerships, supporting research and evidence-informed interventions, and ensuring that older adults can live free from harm and remain vibrant contributors to families, communities, and society.
Kristen Lees Haggerty is a national expert in strengthening health care systems to meet the needs of older adults.
Kathy Greenlee is a health and aging policy expert.
Photo credit: Shutterstock/Zurijeta
