Elder Abuse in the Time of COVID: Knowing the Risks and Recognizing the Signs

Eliza McDermott*

I. Introduction

As COVID-19 began its spread across the country in March 2020, public health officials sounded the warning alarm, alerting Americans that older adults faced a heightened risk of contracting the virus.[1]  In a press briefing on March 10, 2020, Dr. Nancy Messonnier—the Director of the Centers for Disease Control and Prevention’s (CDC) National Center for Immunization and Respiratory Diseases—stated as follows: “This seems to be a disease that affects adults. And most seriously older adults. Starting at age 60, there is an increasing risk of disease and the risk increases with age.”[2]  These early warnings were not overstated; the CDC has found that “8 out of 10 COVID-19-related deaths reported in the United States have been among adults aged 65 years and older.”[3]

Most media attention concerning COVID-19 and older adults has rightfully highlighted this distinct impact on elderly individuals.[4]  However, older adults unfortunately face other pandemic related risks that extend beyond their physical health.[5]  COVID-19 also places older adults at a higher risk of abuse,[6] and legal practitioners should equip themselves with information about elder abuse and its signs to protect older clients.[7]  While this knowledge is always important, it is particularly critical during a public health crisis that already makes older adults so vulnerable.[8]

II. Defining Elder Abuse

Elder abuse is as amorphous as it is pernicious.[9]  While there is no single, all-encompassing definition of elder abuse, state and federal authorities have developed helpful parameters for this web of harms.[10]  In Maryland, “abuse” is statutorily defined as “the sustaining of any physical injury by a vulnerable adult as a result of cruel or inhumane treatment or as a result of a malicious act by any person.”[11]  The Department of Justice’s Elder Justice Initiative (EJI) categorizes elder abuse in five ways: physical abuse, sexual abuse, psychological abuse, neglect and abandonment, and financial or material exploitation.[12]  EJI defines physical abuse as “an act, rough treatment or punishment that may result in injury, pain or impairment,” sexual abuse as “sexual contact or non-contact (e.g., voyeurism) of any kind with an older person without agreement from that person,” and psychological abuse as “verbal or emotional abuse causing suffering, emotional pain, or distress.”[13]  Additionally, neglect and abandonment are defined as “intentional or unintentional failure or refusal to provide care or help to an older adult to whom a duty of care is already owed.  Abandonment can be an extreme form of neglect.”[14]  Finally, financial or material exploitation means “the illegal or improper use of an older person’s money or property.”[15]

III. Knowing the Signs of Elder Abuse

According to the National Center on Law and Elder Rights, “[l]awyers. . .who work with older adults should be aware of signs of physical, emotional, and behavioral abuse, neglect, or exploitation.”[16]  Indications of physical or sexual abuse could include physical signs such as bruises, or emotional signs such as unexplained changes in behavior, like social withdrawal.[17]  A lawyer should also notice when a family member or a caretaker refuses to allow the older client to be alone with you, or if the client displays emotional discomfort when talking about a particular person.[18]  Signs of neglect include an unkempt appearance, missing or broken dentures, glasses, or hearing aids, and subsistence on nutritionally insufficient food.[19]  Signs of financial exploitation could include “[u]nmet needs, or unpaid expenses, despite seemingly adequate income and assets.”[20]  Lawyers should also be on the lookout for any sudden or unexplained changes in estate plans, unexplained purchases of “gift cards” or stored value cards, a client changing the agent on a power of attorney, or a “[n]ew friend, or advisor in the [client’s] life, followed by changes in behavior.”[21]

IV. The Intersection of COVID-19 and Elder Abuse

Unfortunately, the COVID-19 pandemic provides abusers with an environment that both hides and incentivizes abuse.[22]  According to the National Center on Elder Abuse, “social isolation is one of the greatest risk factors for elder abuse.”[23]  Elder abuse is most likely to happen at the hands of someone that an older client knows, and with social distancing still recommended, seniors are most likely only interacting with immediate family members or caregivers whom they depend on for assistance.[24]  Older adults are also staying home and avoiding appointments with individuals who may be mandated reporters of abuse, such as doctors.[25]  Further, the economic downturn caused by the pandemic might put additional financial strain on individuals who act in a caretaking role for an older client.[26]  This financial strain could incentivize those who are otherwise responsible caretakers to exploit their access to an older adult’s assets.[27]  Now, more than ever, it is crucial that legal practitioners who work with older adults stay vigilant and intervene if their client’s physical, emotional, or financial security is threatened.[28]

*Eliza R. McDermott is a second-year student at the University of Baltimore School of Law (UB), where she is a Staff Editor for Law Review. She is a recent recipient of the Maryland Legal Services Corporation Fellowship, through which she spent the summer of 2020 interning at Senior Legal Services in Baltimore, Maryland. Additionally, Eliza serves on the Executive Board of UB Students for Public Interest and was selected to be a member of UB’s American Association for Justice’s Student Trial Advocacy Competition team. Prior to attending law school, Eliza worked at the Center for Community Progress, a national leader in creating solutions for the equitable transformation of vacant, abandoned, and deteriorating properties into sustainable community assets.

[1]           See Transcript – CDC Media Telebriefing: Update on COVID-19, Ctrs. for Disease Control & Prevention (Mar. 10, 2020), https://www.cdc.gov/media/releases/2020/t0309-covid-19-update.html

[2]           Id.

[3]           Older Adults, Ctrs. for Disease Control& Prevention, https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/older-adults.html (Sept. 11, 2020).

[4]           See, e.g., Scottie Andrew, Worried about Coronavirus? If Your Loved One is Over 60, Read This, CNN, https://www.cnn.com/2020/03/12/health/what-60-older-need-to-know-coronavirus-wellness-trnd/index.html (Mar. 13, 2020, 11:23 AM).

[5]           See Grace Birnstengel, Elder Abuse Appears to Be Climbing During the Pandemic, Experts Say, PBS News Hour (June 23, 2020, 11:52 AM), https://www.pbs.org/newshour/nation/elder-abuse-appears-to-be-climbing-during-the-pandemic-experts-say

[6]           Id.

[7]           See David Godfrey, Am. Bar. Ass’n Comm’n on L. and Aging, Signs of Abuse, Neglect, and Exploitation: The Checklist 1 (2019), https://ncler.acl.gov/NCLER/media/NCLER/documents/Signs-of-Abuse-Chapter-Summary.pdf.

[8]           See id.

[9]           See Elder Abuse, Am. Psych. Ass’n, https://www.apa.org/pi/prevent-violence/resources/elder-abuse#:~:text=The%20National%20Center%20on%20Elder,abandonment%2C%20and%20self%2Dneglect (“[D]ue to under-reporting, variations in the definition of elder abuse, and the absence of a nationwide uniform reporting system, it is difficult to determine the scope of this issue.”) (last visited Nov. 22, 2020).

[10]         See Md. Code Ann., Fam. Law § 14-101(b) (West 2020); see Additional Charges Using Elder Justice Initiative Definitions, Dep’t of Just., https://www.justice.gov/elderjustice/file/886971/download (last visited Nov. 10, 2020). 

[11]          Fam. Law § 14-101(b). 

[12]         Additional Charges Using Elder Justice Initiative Definitions, supra note 10.

[13]         Id.

[14]         Id.

[15]         Id.

[16]         See Godfrey, supra note 7.

[17]         Id. at 3.

[18]         Id.

[19]         Id. at 5.

[20]         Id. at 6.

[21]         Id. at 6–7.

[22]         See COVID-19 and Elder Abuse, Nat’l Ctr. on Elder Abuse, https://ncea.acl.gov/Resources/COVID-19.aspx (last visited Nov. 10, 2020). 

[23]         Id.

[24]         See Grace Smith & Ashley Hunter, Elder Abuse is Spiraling in Age of COVID-19, Tennessean (June 14, 2020, 5:00 AM), https://www.tennessean.com/story/opinion/2020/06/14/elder-abuse-spiraling-coronavirus-fifty-forward/3175138001/.

[25]         Id.

[26]         Id.

[27]         Id.

[28]         See supra notes 4–8, 16–21 and accompanying text.

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