As of July 2022, there were more than 15,300 certified nursing homes in the United States, according to the Centers for Disease Control and Prevention (CDC). And while pre-pandemic studies estimate one in 10 older older adults who live in community dwellings have experienced some form of elder abuse, a more recent study found one in five older adults reported elder abuse during the pandemic.
Elder abuse includes physical abuse, emotional/psychological abuse, sexual abuse, neglect, abandonment, and financial exploitation. According to various studies in the National Library of Medicine, elder abuse has been linked to major adverse health outcomes, including dementia, depression, and mortality,
RELATED ARTICLE: Pennsylvania Nurse Linked to 17 Nursing Home Deaths Pleads Guilty
While physical and emotional neglect are the most common types of elder abuse, financial abuse is increasingly becoming a threat as more scammers target the older population for various reasons, including cognitive impairment or the inability to safely navigate technology. In fact, it is estimated that financial exploitation leads to $28.3 billion in losses each year for older adults, according to the National Council on Aging.
Who Is Abusing the Elderly?
An analysis of calls to the National Center for Elder Abuse resource line found abusers are most commonly family members (47%) and non-family medical caregivers (13%). Only 6.7% of callers did not know their abuser.
It is also estimated that only one in 24 cases of elder abuse are reported to authorities. These statistics emphasize the importance of both family members and medical caregivers recognizing signs of elder abuse and reporting them.
To shed light on the issue, each year, WalletHub releases a study that compares the 50 states and the District of Columbia based on 16 key indicators of elder-abuse protection in three overall categories: prevalence, resources, and protection. Let’s start by looking at the states with the best elder abuse protections.
States with the Best Elder Abuse Protections
This year’s findings are very similar to last year’s with the exception of Maine being booted from the top 10 and Minnesota being added. Here are the top 10 states, according to the analysis:
- Wisconsin
- Massachusetts
- Vermont
- Ohio
- Virginia
- Maine
- Iowa
- Kentucky
- West Virginia
- Minnesota
The study also highlights some additional important findings about the states with the best protections, including:
- Wisconsin requires assisted living facilities to have two inspections per year, the most in the country, and it allows surveillance cameras in the rooms of nursing home residents in order to catch misconduct by employees or visitors.
- Massachusetts has the highest spending on elder abuse prevention per elderly resident. it also has an elder abuse working group, the Elder Protective Services Commission, which was formed in 2013 to “assist in being adequately prepared to prevent, recognize and respond to cases of elder abuse.”
States with the Worst Elder Abuse Protections
This year’s findings were also very similar to last year’s in regard to states with the worst elder abuse protections. This year, Nebraska is no longer in the bottom 10 (although it is #11) and Rhode Island has been added to the list. Here’s the breakdown, starting with the state with the worst protections, according to the researchers:
- South Dakota
- Utah
- South Carolina
- California
- Montana
- Delaware
- Tennessee
- Nevada
- New Jersey
- Rhode Island
See the full list here and a heatmap below.
More Detailed Breakdown of Elder Abuse Protections by State
1. Elder-Abuse, Gross-Neglect and Exploitation Complaints
- Louisiana
- Florida
- Pennsylvania
- Indiana
- New Hampshire
- Tennessee
- Montana
- South Carolina
- Nevada
- California
2. Total Expenditures on Elder-Abuse Prevention
The states with the highest total expenditure on elder abuse preventative measures are:
- Massachusetts
- Rhode Island
- Wisconsin
- Virginia
- Nevada* This is interesting to note because although Nevada is in the top 5 states for expenditure on elder abuse prevention, it also is in the top 5 states for the highest number of complaints
The states with the lowest total expenditure on elder abuse preventative measures are:
- Texas
- Georgia
- Louisiana
- Maine
- Montana
3. Total Long-Term Care Ombudsman-Program Funding
The Long-Term Care Ombudsman Program (LTCOP) receives federal funding from the Administration for Community Living (ACL) through grants to states. The amount of funding each state receives is based on a formula that considers the state’s population of people age 60 or older relative to other states, according to the U.S. Government Accountability Office.
Here are the states that receive the most funding:
- Alaska
- District of Columbia
- Vermont
- South Dakota
- Maine
Here are the states that receive the least funding:
- Hawaii
- Tennessee
- Michigan
- Indiana
- Florida
4. Eldercare Organizations and Services
The states with the most eldercare organizations and services are:
- Alaska
- Vermont
- Wisconsin
- Montana
- North Dakota
The states with the fewest eldercare organizations and services are:
- Rhode Island
- Missouri
- Texas
- Delaware
- Florida
5. Certified Volunteer Ombudsmen
A Certified Volunteer Ombudsman (CVO) is a free advocate for the health, safety, and rights of long-term care residents. CVOs work to resolve issues that affect the quality of care in nursing homes, assisted living facilities, and rest homes.
The states with the most CVOs are:
- District of Columbia
- Vermont
- North Carolina
- Alaska
- Nebraska
The states with the fewest CVOs are:
- Delaware
- Mississippi
- Nevada
- South Dakota
- West Virginia
6. Nursing Homes Quality
The states with the highest nursing homes quality are:
- Idaho
- Delaware
- Hawaii* Interesting to note that although Hawaii is in the top 5 states that receive the least LTCOP funding, they rank in the top 5 for nursing homes quality
- South Dakota
- North Dakota
The states with the lowest nursing homes quality are:
- Illinois
- Missouri* Missouri also made the top 5 states with the fewest eldercare organizations and services
- Mississippi
- West Virginia
- Louisiana
RELATED ARTICLE: Responding to Elderly Patient Elopement and Wandering: Part 2
Signs of Elder Financial Abuse
Like last year, WalletHub is again emphasizing how to spot signs of elder financial abuse. Those signs include:
- Keeping an eye out for unusual bank or credit card activity
- Being cautious of new or unfamiliar “friends”
- Monitoring social media and internet use
- Watching for changes in legal documents, such as wills, trusts, and powers of attorney
- Taking note of changes in behavior, such as sudden fearfulness, anxiety, or secretiveness regarding finances
- Being mindful of any decline in personal care conditions
Elderly Population Expected to Skyrocket
According to the Administration for Community Living, the number of people in the U.S. who are 65 or older is projected to increase from 17% of the population in 2022 to 22% in 2040. This is due to a combination of longer life spans and the aging of the baby boom generation.
By 2040, about 78.3 million people will be 65 or older — more than twice as many in 2000. The population is also projected to reach 88.8 million by 2060. As part of its report, WalletHub interviewed two experts about ways families, organizations, and lawmakers can protect America’s growing elderly population. Their responses can be found under the “Ask the Experts” dropdown in the report’s Table of Contents.
Curious if your state has made improvements? Here are last year’s findings.
