5 ways of spotting signs of abuse in people with dementia

The abuse of individuals with dementia is something that no one wants to see.   Therefore we have produced this article to help you identify where abuse may be recurring.

We know that people have used our tips to stop abuse and this is something we are proud of.   The impact of this is that someone that may have struggled to have a voice in the past, now has, and is able to live in comfort and safety.

In the article we will give you some actionable tips on how to spot:

  • physical abuse
  • emotional abuse
  • financial abuse
  • sexual abuse
  • neglect

The background

One of the many unfortunate consequences of a dementia diagnosis is increased vulnerability. Whilst people with dementia do sometimes make false accusations or claims against family or caregivers due to paranoid delusions, there are sadly occasions when they are telling the truth. Impaired memory, loss of communication skills and lack of judgement make dementia sufferers easy targets for abusers and scam artists who know that they can quickly take advantage of them.

As dementia sufferers are likely to forget about or be unaware of the problem, they’re unlikely to report it – and might not be believed if they do.

For these reasons it’s incredibly important to be aware of the types and signs of abuse that can be experienced by older people with dementia. Typical forms of dementia include vascular dementia, lewy body dementia and frontotemporal dementia.  Here we share warning signs and guidance along with recommendations for prevention and reporting should you suspect abuse.

1 – How you can spot physical abuse

Physical abuse involves deliberate injury, pain or impairment inflicted on a person. Isolation (such as locking someone in a room alone for periods of time) and inappropriate restraints can also be classed as physical abuse. Warning signs include:

– Unexplained injuries including bruises, welts, burns, fresh scars. More serious signs include broken bones, sprains, or dislocations

– Broken glasses

– Marks on wrists showing possible restraint

– Suspicious behaviour from caregivers – for example, they won’t allow you to see your relative alone without you, or are defensive when questioned about bruises.

2 – How you can identify emotional abuse

Emotional abuse is invisible – so it can be particularly difficult to spot, especially as people with dementia can often be upset, distressed or anxious due to their condition. It’s best to trust your gut and investigate thoroughly if you suspect anything untoward. Emotional abuse includes verbal abuse, threats, humiliation, intimidation and general harassment. Warning signs include:

– Witnessing threatening or belittling behaviour or comments towards your loved one

– Signs of agitation such as rocking, sucking, or mumbling to themselves

Unexplained or unusual withdrawal from normal activities, a sudden change in alertness, or unexpected depression more than usual.

3 – How to spot if there is financial abuse

Financial abuse occurs when someone without authority or reason improperly uses or takes money, property, or other resources belonging to a person with dementia. This includes stealing money or possessions, cashing cheques without permission, forging their signature and coercing or deceiving them into signing documents, contracts or a will. Here is an actionable article we produced to help those with alzheimers and dementia to manage their finances.  

Warning signs to watch out for include:

– Sudden, unexpected changes in a person’s financial situation

Irregular or erratic spending and withdrawals from the person’s accounts. Continued activity despite penalties

The addition of authorised users to bank accounts and credit cards

Possessions or cash missing from their home

Suspicious changes in legal documents such as wills, power of attorney, titles, and policies

Bills left unpaid or lack of medical care or utilities provision even when the person should have enough money to pay

Any financial activity or transactions the person couldn’t have carried out themselves, like an ATM withdrawal at a time when they’re bedridden, or online banking when they have no internet access

– A new ‘best friend’ or ‘sweetheart’ who you suspect may be acting exploitatively.

4 – How you can spot sexual abuse

Sexual abuse is a particularly upsetting prospect for anybody with a loved one suffering with dementia. Any non-consensual sexual contact constitutes sexual abuse. This includes touching, fondling, and any sexual activity that occurs when the person is unable to understand, is not willing or consenting or is threatened or physically forced. Warning signs of sexual abuse include:

Bruises or wounds around breasts or genitals

Unexplained bleeding

– Torn, stained, or bloody underwear

5 – How you can identify neglect or self-neglect

Neglect is one of the most ambiguous forms of abuse to identify – but it classifies as abuse all the same. Neglect occurs when a caregiver fails to provide or purposely withholds necessities such as food, clothing, medication, physical assistance or a safe environment.

Self-neglect occurs when a person is unable or unwilling to provide for their own essential day to day needs. This is a common occurrence in people with dementia due to symptoms of the condition such as cognitive impairment.

Both forms of neglect can have a significant impact on the health and wellbeing of a person with dementia. Warning signs include:

– Unexplained weight loss, malnutrition or dehydration

Untreated physical problems, such as bedsores

– Unsanitary living conditions – an unclean home, presence of dirt, bugs, soiled bedding and clothes

– The person is dirty or hasn’t been washed

Unsuitable clothing or covering leaving the person too hot or cold

– Unsafe living environment (lack of heat or running water, fire hazards)

-Unattended medical needs, poor hygiene, bed sores left unchecked and untreated

Actions that you can take to stop abuse

If you see signs of abuse, you should intervene immediately on behalf of your loved one.

The action you take will depend largely on the situation and the status of the person you suspect. For example, if your loved one is in a care home you can report them and move them to a more suitable environment. If a home carer is putting them at risk you can report them and choose a new caregiver.

If a family member or ‘friend’ is abusing your loved one you can prevent them from seeing them and notify authorities. It may also be appropriate to call the police on certain occasions. Whatever the situation may be, actions you can take to notify professional bodies once you have dealt with the issue independently include:

Contact social services to report abuse or suspected abuse and ask for advice and support

– Get in touch with charities such as Dementia UK and Alzheimer’s Society to ask for guidance on dealing with abuse issues – especially involving a relative

Contact the CQC to get report any problems in a long-term residential or nursing home

– Calling the police on 999 in an emergency situation – or 111 to report a past crime resulting from abuse.

You can read about examples of elder abuse here.

Browse our related articles here for more support and guidance to help you to look after a loved one with dementia.

Dementia and managing your finances

Tips on managing VASCULAR DEMENTIA

Tips on managing LEWY BODY DEMENTIA