Preventing Elder Abuse and Neglect

Provided by the Maryland Department of Aging.

Did you know that every day 10,000 people turn 65 in the United States? Our demographics are shifting and we will soon have more older adults in the U.S. than ever before. Every year, an estimated 5 million older Americans are victims of elder abuse, neglect, or exploitation, and that’s only part of the picture. According to the National Academies of Sciences, Engineering, and Medicine, an estimated 93% of elder abuse cases go unreported each year.

What is Elder Abuse and Neglect? 

Elder abuse refers to intentional or negligent acts by a person, including a caregiver or trusted individual, that cause harm to a vulnerable elder.  Mistreatment of elders takes many forms, including: ​

1. Physical Abuse – Use of force causing harm or pain to an individual, which includes (but is not limited to) hitting, kicking, pinching, slapping, shoving, shaking, and burning. Other forms of physical abuse involve the inappropriate use of medication or physical restraints.
2. Financial Abuse/Exploitation – Wrongfully taking or using an older adult’s funds or property through theft, scams, fraud, or predatory lending.  (For more specific information on exploitation of elders, see our Elder Financial Exploitation page.​)
3. Psychological Abuse – Causing emotional pain through verbal assaults, threats, or harassment. Perpetrators intimidate, humiliate, or attempt to isolate their victims.
4. Sexual Abuse – Non-consensual sexual contact of any kind, including contact with an individual unable to consent to such contact (for instance, if they suffer from dementia and are unable to understand).
5. Neglect – An individual failing to meet the needs of an older adult who is under their care. This includes not providing essential things a person needs, such as food, water, shelter, clothing, or personal hygiene.
6. Self-Neglect – Involves the failure of a person to meet vital self-care needs, which puts them at risk of harm to their safety and/or health.

Who is at Risk?

All elders may be victims of abuse or neglect.  Regardless of whether they are rich or poor, highly educated or undereducated, or suffering from dementia or “sharp as a tack,” seniors of all races, cultures, and creeds are victimized.  In addition, it can occur anywhere – in the victim’s home, in a nursing home, in other institutions, or while away on vacation.

How to Report Suspected Elder Abuse or Neglect?

Assisted Living Facilities

1. Report suspected abuse or neglect to the local Adult Protective Services (APS) office.  There is a local APS office in each county’s Department of Social Services (as well as Baltimore City’s).  You can find the list of offices at http://dhr.maryland.gov/local-offices.  Alternatively, you can call the statewide abuse number to report: 1-800-332-6347.
2. You may also report suspected abuse or neglect to the Office of Health Care Quality (OHCQ).  You may call in your complaint to 410-402-8217 (or toll free to 877-402-8221).  You may also mail in a written complaint or file online.  See the following webpage:  https://health.maryland.gov/ohcq/Pages/Complaints.aspx.
3. If you file a report with APS and OHCQ, let each know that you have filed a report with the other.
4. If the resident has Medicaid insurance, a report should also be made to the Maryland Attorney General’s Office, Medicaid Fraud Control Unit (MFCU).  Call 410-576-6521 or email MedicaidFraud@oag.state.md.us.
5. You may also file a complaint with the Maryland Department of Aging, Long-Term Care Ombudsman Program (LTCOP).  The LTCOP receives, investigates, and attempts to resolve complaints made by or on behalf of residents of assisted living facilities and nursing homes: https://aging.maryland.gov/Pages/Ombudsman.aspx.  To report, call 410-767-1100 or 1-800-243-3425.

Nursing Homes

1. ​Report suspected abuse or neglect to the Office of Health Care Quality (OHCQ).  You may call in your complaint to 410-402-8108 (or toll free to 877-402-8219).  You may also mail in a written complaint or file online.  See the following webpage:  https://health.maryland.gov/ohcq/Pages/Complaints.aspx.
2. In nursing homes, Adult Protective Services only investigates complaints regarding financial exploitation.  APS does not investigate suspicions of non-financial abuse in nursing homes.  There is a local APS office in each county’s Department of Social Services (as well as Baltimore City’s).  You can find the list of offices at http://dhr.maryland.gov/local-offices.  Alternatively, you can call the statewide abuse number to report: 1-800-332-6347.
3. If you file a report with APS and OHCQ, let each know that you have filed a report with the other.
4. If the resident has Medicaid insurance, a report should also be made to the Maryland Attorney General’s Office, Medicaid Fraud Control Unit (MFCU).  Call 410-576-6521 or email MedicaidFraud@oag.state.md.us.
5. You may also file a complaint with the Maryland Department of Aging, Long-Term Care Ombudsman Program (LTCOP).  The LTCOP receives, investigates, and attempts to resolve complaints made by or on behalf of residents of assisted living facilities and nursing homes: https://aging.maryland.gov/Pages/Ombudsman.aspx.  To report call, 410-767-1100 or 1-800-243-3425.

Hospitals and mental health and developmental disability facilities

Suspicions of abuse occurring in a hospital or a mental health or developmental disability facility should be reported to the administrator or local police.

Reporting Suspected Elder Abuse or, Neglect occurring in the victim’s home or community, i.e., outside a licensed health care facility.

If you suspect that an adult person who is not in a licensed health care facility is being, or is about to be, abused or neglected, your next step depends on whether that person lacks the physical or mental capacity to provide for his or her daily needs.  Follow the steps below.

1. If the person is vulnerable, i.e., lacks the physical or mental capacity to provide for his or her daily needs, then call the local Adult Protective Services (APS) office.  There is a local APS office in each county’s Department of Social Services (as well as Baltimore City’s).  You can find the list of offices at http://dhr.maryland.gov/local-offices.  Alternatively, you can call the statewide abuse number to report: 1-800-332-6347.  APS will send out an investigator if it believes the person may be vulnerable.

   In addition, if you believe a crime is in progress or is about to be consummated, e.g., a senior citizen with a disability is about to suffer a theft, then you may also call your local police by dialing 911.

2. If you are not sure if the person has a disability severe enough to qualify him or her as lacking the physical or mental capacity to provide for his or her daily needs, call APS anyway.  APS will make the determination.  There is no penalty or downside to referring someone to APS that APS eventually finds does have the capacity to provide for his or her daily needs.
3. If the person has the physical or mental capacity to provide for his or her daily needs, then there are quite a few options for referral depending on the nature of the abuse or neglect.  You may discuss with the victim why you suspect he or she is being abused or neglected.  You can then explain how he or she can stop the abuse, or report it, or both.  Of course, you may be unable to convince the victim, or you may decide it would be counter-productive to try to convince the victim that he or she is being abused or neglected.  Think very carefully about reporting without the victim’s consent.  In domestic abuse matters, it can be dangerous to report suspected abuse without the victim’s consent.  Matters of physical abuse should generally be reported to the local police.

Matters of financial exploitation, on the other hand, have many possible referral options.  See our Elder Financial Exploitation page for those options.

What Can You Do to Help Keep Maryland’s Seniors Safe from Abuse and Neglect?

• In addition to reporting suspected abuse, neglect, and exploitation, there are many more steps you can take:
  1. ​Review the National Center on Elder Abuse’s “12 Things Everyone Can Do to Prevent Elder Abuse.”
  2. Participate in World Elder Abuse Awareness Day (WEAAD).
  3. Read Senior Living’s “A Guide for Preventing Elder Abuse, Assault, and Theft.”

Additional Resources

• National Center on Elder Abuse
• National Consumer Voice for Quality Long-Term Care
• The Center of Excellence on Elder Abuse & Neglect
• Elder Abuse Toolkits for Prosecutors and Courts
• United States Department of Justice’s Elder Justice Initiative
• National Adult Protective Services Association​