Issue Summary
Elder abuse is the physical, sexual, psychological, or financial abuse or neglect of older adults who may be unable to defend or fend for themselves. Perpetrators of elder abuse can include strangers, family members, caregivers, or guardians appointed by a judge. As the size of the older population grows, the incidence of elder abuse is expected to increase, further straining the social service, health care, and criminal justice systems charged with protecting this population.
Thirteen federal agencies help protect older adults from scams, financial exploitation and abuse. There are many opportunities for these federal agencies to improve how they prevent, respond, and monitor their efforts.
For instance:
- Scams. Scammers manipulate victims into sending them money. These scams may be costing Americans billions of dollars annually. For example, based on banking data filed in 2021, Treasury estimated $200 billion in impersonation-related suspicious activity. That's when a scammer impersonates someone else—like a potential romantic partner or employer, or a customer service representative—to get money. There is no government-wide estimate of the money lost to scams, no common definition of scams, and no national strategy for combating them.
Examples of a Scam Execution Process
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- Financial exploitation. Financial exploitation of elders—illegal use of their funds or property—affects the victims, their families, and society. Estimated financial costs to victims are in the billions. Most state-run adult protective services agencies have provided some data on financial exploitation of elders to the Department of Health and Human Services. But it's hard to collect the data because not all incidents of exploitation are reported to state agencies, and victims can be reluctant to implicate family members or caregivers. HHS and state data systems also may not align. HHS should work with state agencies to improve the data on financial exploitation.
- Abuse in nursing homes. HHS’s Centers for Medicare & Medicaid Services (CMS) oversees the health and welfare of about 1.4 million residents receiving care in nursing homes that participate in Medicare or Medicaid. To protect vulnerable nursing home residents from abuse, CMS contracts with state agencies—known as survey agencies—that can cite nursing homes for incidents of abuse. Abuse citations doubled from 2013-2017. However, CMS does not require that survey agencies enter the abuse and perpetrator type for incidents of abuse, which it could use to improve oversight by focusing on the most prevalent problems.
- Medicaid oversight. Older adults and people with disabilities receiving Medicaid assisted-living services—over 330,000 in 2014—are also vulnerable to abuse, neglect, or exploitation. CMS oversees how states monitor such incidents, but its guidance has been unclear. In 2014, more than half of the 48 states providing these services couldn’t determine the number or nature of critical incidents in these facilities. In addition, states may not be monitoring things you might expect them to, such as medication errors (7 states) or unexplained deaths (3 states).
Recent Reports
GAO Contacts
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