Human Services Agency of San Francisco
Department of Aging & Adult Services * Department of Human Services

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Physical abuse includes slapping, hitting, bruising, beating or any other intentional act that causes someone physical pain, injury or suffering. Physical abuse also includes excessive forms of restraint used to confine someone against their will (i.e., tying, chaining or locking someone in a room).

Emotional abuse is threatening, intimidating or humiliating an individual and causing them emotional pain, distress or anguish. Emotional abuse can be verbal or non-verbal; it includes insults, yelling and threats of harm or isolation.

Sexual abuse is any sexual activity to which the older or dependent adult does not consent or is incapable of consenting. Non-consensual sexual activity includes everything from exhibitionism to sexual intercourse.

Financial or material exploitation is when someone misuses, mishandles or exploits the elderly or dependent adult's property, possessions or financial assets. This includes using those assets without the individual's consent or manipulating the older or dependent adult for the financial benefit or material gain of another.

Neglect takes place when, intentionally or unintentionally, a caregiver fails to support the physical, emotional and social needs of the elder or dependent adult. Neglect can include denying food or medication, health services or contact with friends and family. Neglect is the most common form of elder mistreatment in domestic settings.

Isolation means any of the following:

• Acts intentionally committed for the purpose of preventing, or that serve to prevent, an elder or dependent adult from receiving his or her mail or telephone calls.
• Telling a caller or prospective visitor that an elder or dependent adult is not present, or does not wish to talk with the caller, or does not wish to meet with the visitor where the statement is false, is contrary to the express wishes of the elder or the dependent adult, whether he or she is competent or not, and is made for the purpose of preventing the elder or dependent adult from having contact with family, friends, or concerned persons.
• False imprisonment, as defined in Section 236 of the Penal Code.
• Physical restraint of an elder or dependent adult, for the purpose of preventing the elder or dependent from meeting with visitors.

Abandonment occurs when a caregiver deserts an elderly or dependent person.

Self-neglect requires intervention when elderly or dependent adults fail to meet their own physical, psychological or social needs or they threaten their health or safety in any way. Often times, physical or mental illness, isolation or substance abuse prevent elderly or dependent adults from being able to take care of their own basic needs.

Signs of Trouble

The following items are possible warning signs that abuse might be occurring to an elder or disabled adult. If you observe some or all of these occurring with an an elder or disabled adult you know, consider alerting Adult Protective Services.

• Injury that is inconsistent with the explanation for its cause
• The elder or dependent adult has recently become confused or disoriented
• The caregiver shows anger, indifference, aggressive behavior toward the person
• Personal belongings, papers, credit cards are missing
• Hesitation from the elder to talk openly
• The caregiver has a history of substance abuse, mental illness, criminal behavior or family violence
• Lack of necessities, such as food, water, utilities, medications and medical care
• Another person's name added to the client's bank account or important documents, or frequent checks made out to CASH

Benefits to Reporting Abuse

• The elder or dependent adult will be given options to keep him/her safe from harm
• The APS worker can link the client, family to needed community resources
• Unaware family members, friends can be alerted to step in to help
• The APS worker can find ways to help the caregiver handle stress
• In some cases, the abuse perpetrator can be prosecuted, lessening the harm to others
• The reporter feels relief that a professional is assessing the situation