Physical abuse is physical force or violence that results in bodily injury, pain, or impairment. It includes assault, battery, and inappropriate restraint.

Who are the perpetrators?

Perpetrators may be acquaintances, sons, daughters, grandchildren, or others. Physical abuse that is perpetrated by spouses or intimate partners in order to gain power and control over the victim is described in the section on domestic violence. Perpetrators are likely to be unmarried, to live with their victims, and to be unemployed. Some perpetrators have alcohol or substance abuse problems. Some are caregivers for those they abuse.

Who is at risk?

As a group, victims of physical abuse do not differ significantly from seniors who are not abused.

What are the indicators?

Indicators are signs or clues that abuse has occurred. Physical indicators may include injuries or bruises, while behavioral indicators are ways victims and abusers act or interact with each other. Many of the indicators listed below can be explained by other causes (e.g. a bruise may be the result of an accidental fall) and no single indicator can be taken as conclusive proof. Rather, one should look for patterns or clusters of indicators that suggest a problem.

Physical indicators

• Sprains, dislocations, fractures, or broken bones
• Burns from cigarettes, appliances, or hot water
• Abrasions on arms, legs, or torso that resemble rope or strap marks
• Internal injuries evidenced by pain, difficulty with normal functioning of organs, and bleeding from body orifices
• Bruises. The following types of bruises are rarely accidental:
  • Bilateral bruising to the arms (may indicate that the person has been shaken, grabbed, or restrained)
• Bilateral bruising of the inner thighs (may indicate sexual abuse)
• "Wrap around" bruises that encircle an older person's arms, legs, or torso (may indicate that the person has been physically restrained)
• Multicolored bruises (indicating that they were sustained over time)
• Injuries healing through "secondary intention" (indicating that they did not receive appropriate care)
• Signs of traumatic hair and tooth loss

Behavioral indicators

• Injuries are unexplained or explanations are implausible (they do not "fit" with the injuries observed)
• Family members provide different explanations of how injuries were sustained
• A history of similar injuries, and/or numerous or suspicious hospitalizations
• Victims are brought to different medical facilities for treatment to prevent medical practitioners from observing a pattern of abuse
• Delay between onset of injury and seeking medical care

How can I learn more?

Anetzberger, G.J. (1987). The etiology of elder abuse by adult offspring. Springfield, IL: Thomas.

Baumhover, L.A. & Beall, S.C. (Eds.). (1996). Abuse, Neglect, and Exploitation of Older Persons: Strategies for Assessment and Intervention. Baltimore, MD: Health Professions Press.

Quinn, M.J., & Tomita, S.K. (1997). Elder abuse and neglect: Causes, diagnosis, and intervention strategies. (2nd ed.). New York: Springer Publishing Co.

Last Updated March 2003