Elder abuse is the neglect or mistreatment of older adults by someone responsible for their care. The abuse can be physical, psychological, or financial. Elder abuse can occur at home, in residential care, or in the community. Elder abuse is a serious social and health issue that affects more older adults in Canadian society. It is estimated that between 4% and 10% of older adults in Ontario experience some form of abuse. Harm to older adults includes harm to people they know or have a relationship with, such as a spouse, partner, family member, friend, or neighbour, or people the older person relies on for services. Many forms of elder abuse are considered types of domestic violence or family violence because they are perpetrated by family members. Some paid caregivers have also been known to abuse their elderly patients. There are a variety of situations that constitute elder abuse, but they do not include general criminal activity toward older people, such as home invasion, street “robbery,” or “distraction burglary,” where a stranger distracts an older person on the doorstep while someone else enters to steal their belongings. Elder abuse by caregivers is a global problem. In 2002, the World Health Organization brought international attention to the issue of elder abuse. Over the years, government agencies and professional community groups around the world have identified elder abuse as a social problem. In 2006, the International Network for the Prevention of Elder Abuse designated June 15 as World Elder Abuse Awareness Day. A growing number of events are held around the world on this day to raise awareness of elder abuse and highlight ways to challenge such abuse. Although some older people with dementia or mental illness make false accusations of theft and other forms of abuse against caregivers or family members, all reports of abuse should be investigated. Although there are common themes of elder abuse across countries, there are unique manifestations that depend on the history, culture, economic power, and societal perceptions of older people within countries. The primary common denominator is the use of power and control by an individual to influence their peers and the status of an older person. There are several types of elder abuse that are generally recognized as elder abuse, including: Physical: such as hitting, punching, slapping, burning, pushing, kicking, restraining, unjustified imprisonment/confinement, giving excessive or inappropriate medication, withholding treatment and medications. Psychological/emotional: such as humiliating a person. A common feature is that the perpetrator identifies something that is important to an older person and then uses it to coerce them into doing something. It may take verbal forms such as yelling, name-calling, ridicule, constant criticism, accusation, or blaming, or it may take nonverbal forms such as ignoring, silence, ostracism, or withdrawal of affection. Elder financial abuse: Also known as financial exploitation, it involves the misappropriation of financial resources by a family member, caregiver, or stranger, or the use of financial means to control a person or facilitate other types of abuse, and sometimes the failure to provide financial support to poor older adults in jurisdictions with caregiving responsibility laws, such as France, Germany, and most of the United States. Sexual abuse: For example, forcing a person to engage in any sexual activity without their consent, including forcing them to engage in sexual conversations against their will, which may also include situations in which the person is no longer able to give consent. Neglect: For example, depriving a person of appropriate medical treatment, food, heat, clothing, rest, or essential medications, or depriving a person of services necessary to enforce certain types of actions, financial or otherwise. Neglect can include leaving a vulnerable older person unattended. The deprivation may be intentional or occur due to a lack of knowledge or resources. In addition, some state laws also recognize the following as elder abuse: Abandonment: Abandoning a dependent person with the intent to abandon or leave them unattended in a place for a period of time that may endanger their health or care. Abuse of rights: Denying an elder’s civil and constitutional rights, or failing to inform a court that they are mentally incapacitated. This is an aspect of elder abuse that is increasingly recognized and embraced in various states. Self-neglect: Anyone who neglects themselves by not caring for their own health or safety. Self-neglect is treated as conceptually different from abuse. Elderly self-neglect can lead to illness, injury, or even death. Common needs that older adults may deny or ignore include: sustenance, hygiene, adequate clothing for climate protection, adequate shelter, adequate safety, clean and healthy surroundings, medical care for serious illnesses, and essential medications. Self-neglect is often due to a person’s reduced awareness or mental capacity. Some older adults may choose to deny themselves certain health or safety benefits, which may not be self-neglect. This may simply be their personal choice. Caregivers and other responsible individuals should respect these choices if the older person is mentally sound. In other cases, older adults may lack the necessary resources, due to poverty, or another social condition. This is also not considered “self-neglect.” Institutional abuse refers to physical or psychological harm, as well as violations of rights, in settings where care and assistance are provided to dependent or other older adults, such as nursing homes. Recent studies of nearly 2,000 residents of nursing home facilities in the United States reported a 44 percent increased rate of abuse and a 95 percent increased rate of neglect, making elder abuse in nursing homes an increasing risk. Accurate statistics are scarce because elder abuse in general and especially nursing homes are often a silent phenomenon. The key to preventing abuse and intervening to stop elder abuse is to be able to recognize the warning signs. Signs of elder abuse vary depending on the type of abuse the victim is experiencing. Each type of abuse has distinct signs associated with it. In addition to noticing signs in the elderly individual, abuse can also be detected by observing changes in the caregiver’s behavior. For example, the caregiver may not allow them to talk to or greet visitors, show indifference or lack of affection toward the elderly, or refer to the elderly person as a burden. Caregivers who have a history of substance abuse or mental illness are more likely to commit elder abuse than other individuals. Abuse can sometimes be subtle and therefore difficult to detect. Regardless, awareness and research organizations advise taking any suspicion seriously and addressing it adequately and promptly.