Recognizing The Signs of Physical Elder Abuse

Abuse does not discriminate against age, race, religion, gender, or ethnic background.  Our elderly should be receiving care with dignity and respect.  The sad truth is abuse can happen no matter who you are.  Elder abuse is most often broken apart into five different subtypes: physical elder abuse, financial abuse, scams and exploitation, neglect and abandonment, psychological abuse, and sexual abuse.  According to the National Counseling of Aging, over 5 million seniors fall victim to elder abuse each year in the United States.    

No one wants to think someone they love is the subject of abuse, especially when related to elderly parents or grandparents.  It can be challenging to identify abuse is happening behind closed doors.  However, it is crucial to know the signs and risks.  In this article, we will be focusing on what physical elder abuse is, the signs of abuse, why it happens, and what you can do if you suspect someone you know is a victim of this crime.

This blog is for educational purposes only and should not be considered legal advice. The use of the Paths Law Firm website does not constitute a client-lawyer relationship.

What is Physical Elder Abuse

Physical elder abuse is when someone physically injures an older adult, causes them pain, distress, functional impairment, and even death from the use of physical and intentional force.  This type of abuse may include hitting, kicking, restraining, pushing, shoving, slapping, or burning.  This abuse often shows itself in visible injuries. However, some acts of physical abuse do not.  One such example of physical abuse against seniors not showing visible signs is locking a senior in a room. 

This sad form of abuse victimizes older people and can leave them reeling in the aftermath for months or even for the rest of their life. Elder abuse can take many forms; however, one thing common in all physical abuse types is the distress caused to the individual and the whole family when the incident comes to light.  It is important to note when physical abuse exists, other forms of abuse may likely be present.  

sad elderly man

Warning Signs To Watch Out For

All family members need to know how to recognize the signs of physical elder abuse. Unfortunately, it is not always apparent abuse is happening. Below are some of the physical and emotional symptoms indicating further investigation is required:

Physical Signs of Abuse

  • Bruise marks (these may especially be around the arms)
  • Hair loss or tooth loss
  • Burn marks (these may look like the burn from a cigarette or appliance)
  • Unexplained weight loss or signs of malnutrition
  • An onset of poor hygiene
  • Problems sleeping
  • Messy appearance
  • Dislocated or broken bones
physical abuse
Emotional Signs of Abuse

Physical signs may not always be visible in the circumstances related to abuse situations. However, emotional symptoms of abuse can be more challenging to hide. These include the following: 

  • A withdrawal from activities which the older adult usually enjoyed
  • Signs of depression, confusion, or anxiety
  • A quieter disposition when spending time with family members
  • A more anxious nature
  • A strained relationship between the caregiver and senior
recognizing physical elder abuse

Signs of Abuse From A Healthcare Perspective

There are a few obvious signs of physical abuse alerting further investigation from a health care perspective; these are as follows:  

  • Various trips to emergency rooms at different locations over some time (to avoid detection)
  • Hospitalization several times for similar type injuries
  • A delay in the caregiver seeking treatment for an injury sustained by the older person

Causes Of Physical Abuse And Risk Factors

What causes a caregiver of an older adult to be abusive? How can a role of providing care turn into a situation of abuse?  Are there factors related to the care recipient which can increase their risk of being physically abused? Allow us to answer these questions in turn by first looking at the caregiver’s role and then the circumstances of the senior care recipient.

anxiety from abuse

Risk Factors Related To The Caregiver

Unfortunately, it is not possible to provide one typical cause of such sad scenarios. There is an endless list of reasons why physical elder abuse occurs. In some cases, it is difficult to identify one sole basis for the abuse. That said, where caregivers negatively suffer themselves, there could certainly be a greater risk. Below is a list of situations when caregivers may be more likely to commit abuse: When they are under the influence of alcohol or drugs.

  • The caregiver has a criminal history
  • In cases where they are suffering from an illness related to their mental health
  • Where they live permanently with the person they care for
  • If they have suffered abuse themselves as a child 

There is never an excuse for physically abusing another person. The above list highlights reasons increasing the likelihood of physical elder abuse.  A difficult caring situation which has been unfolding for years and has placed the caregiver under continual stress may also be a catalyst for physical elder abuse. Indeed, this stresses the importance of dealing with such situations before taking a turn for the worse. We will discuss this a little later on in more detail.

frustrated caregiver

Risk Factors Related To The Senior

Several factors related to the senior may also put them at greater risk. These include the following:

Having A Disability: Unfortunately, according to the National Council of Aging, seniors with a disability are at a higher risk of suffering abuse than those who do not.

Mental Illness: According to the Alzheimer’s Association, older adults who have a neurological condition are more at risk of abuse. The higher risk factor may be related to seniors requiring more intensive care, resulting in a higher stress level for the caregiver.

Living In A Remote Area: When an older adult lives in a remote area, far away from their family, there may be a greater risk of abuse from the caregiver.  

Being Over The Age Of 80: A Medical study by Northwestern University and Rush University found seniors over the age of 80 were more at risk of physical abuse than their younger counterparts.

preventing abuse

How To Prevent Abusive Situations

The best course of action anyone can take is to do everything within their power to prevent physical elder abuse from happening.  While we may not have the ability to avoid some circumstances, even where a host of preventative measures are in place, there are certain things we can control. Below is a list of things to help prevent the abuse of our seniors:

Make Regular Visits

Whether the senior within the family lives in a nursing home or is cared for in a family member’s home, regular visits are essential to ensure they are being cared for and abuse is not occurring. Such frequent visits go a long way to show caregivers the family is vigilant and want to feel confident their loved one is being cared for appropriately. Regular visits also provide an opportunity to take note of any warning signs of abuse, as listed above.

Take Note Of The General Environment 

When visiting a nursing home, the residence’s general state is a good indicator of how seriously the staff takes their jobs. The facility should be in good condition, with attention to detail, and the team should appear happy and dedicated as they care for the residents. An unkempt nursing home with staff members who look frustrated and unhappy could be an at-risk environment for physical elder abuse to take place.

abuse of seniors

Be Aware Of Mounting Stress In Family Care-Scenarios

If a family member provides care, the whole family needs to keep in touch and be honest and upfront with each other regularly. The family member who is the primary caregiver may find themselves in a continual cycle of frustration and anxiety. As we noted above, these factors can be dangerous catalysts for abuse. By the whole family viewing their senior care as a collective responsibility and ensuring the primary caregiver has sufficient respite and support, it is more than possible to prevent or significantly minimize the risk of mistreatment or abuse occurring within the family setting.

There is also a responsibility on the actual primary caregiver to be aware of their limitations, recognize situations causing feelings of anger or resentment, and plan how to cope in such cases. Asking for help and support should never be viewed as a failure in the role of caregiver.  After all, the caregiver also requires care and support.  For more information on caring for a caregiver, read our blog “Caring for the Caregiver – Self-care Tips to Prevent Burnout.”

What to do If You Suspect Abuse

Reporting abuse of a senior can be a stressful and traumatic experience.

Act Immediately

When physical abuse is suspected, it is crucial to act immediately.  Often, older adults are more fragile, in the physical sense, than when they were younger.  With age, our bodies become more prone to injury and broken bones.  The abuse of an older adult can be life-threatening. 

Even if the injury does not seem significant, it is imperative to act without delay. A visit to the emergency room needs to be the priority. Quick treatment for physical abuse can be the difference between a long slow recovery or a faster recovery with much less stress for the senior.

abuse of older adults

Do Not Return To The Scene Of The Crime

Family members who find their loved ones suffering from abuse in a nursing home mustn’t return them to the same care facility. The senior needs to go to a safe environment after they receive treatment.

Report The Abuse

It is always best to speak up if you suspect abuse is happening. Even if you are not sure, always voice your concerns. It is crucial to report suspicions of abuse, even if the senior is no longer in the care facility where the abuse took place.  No one wants the scenario to repeat itself to the next vulnerable resident in the caregiver’s hands.

Statistics On Elder Abuse In The United States

The below statistics may be shocking in showing how significant the issue of physical elder abuse is here in the United States: 

  • The Office of Women’s Health says that physical elder abuse is more likely to be caused by a spouse or partner, in their opinion. 
  • The Department of Justice claims that only 1 in every 24 physical elder abuse cases are reported to the authorities.
identifying physical elder abuse

Stories of Elderly Abuse

Margaret, age 81, diagnosed with Dementia, moved to her son’s home.  Margaret did not sleep well and often had outbursts of uncontrolled anger.  If left unattended, Margaret would wander away from her son’s house.  Her son and daughter-in-law were worried Margaret would become lost and unable to find her way home or become injured.  They decided to lock Margaret in the house to keep her safe while they were at work.  A neighbor across the street saw Margaret banking on the windows and at the front door, unable to get outside.  The neighbor contacted the police as well as Adult Protective Services to help Margaret.  

Robert, age 73, was adamant about staying in his home. However, he needed assistance with daily living tasks.  Robert hired a full-time home care aid to assist him.  The aid moved into Roberts’s house so Robert could have round-the-clock assistance.  The aid was very caring and nurturing initially; however, she became frustrated with Robert and began to lose her temper.  She began to shove Robert to get him out of her way, in a hurry to finish tasks.  The result of the abuse end with Robert falling or bruising his body.  Robert’s niece Jessica came to visit and found her uncle on the bedroom floor, confused and in pain with a broken arm.  Jessica contacted the police and Adult Protective Services.

Francis, age 67, moved to a long-term-care facility after being diagnosed with End-Stage Renal Disease (ESRD).  His children came to visit the nursing home once a month to check on Francis.  During a visit, his children noticed severe bruising on his arms and face and became suspicious Francis was a victim of abuse.  The next day his children returned to the nursing care facility and installed a camera in an inconspicuous spot in the room.  Francis’s children started visiting daily to check the video on the camera.  A week later, they found a video of an attendant grabbing Francis by the arms and slapping him in the face.  Francis’s children reported this information to the facility’s administrator and moved him to a new facility.  His children also reported the incident to Adult Protective Services, which triggered state involvement by the local nursing home ombudsman and police department. 

The events and characters in the stories above are fictional representations of abuse scenarios.  

physical elder abuse signs

Resources and Assistance

For additional resources or assistance, click the links below:

The Bottom Line 

While it is undoubtedly a topic no one likes to think about, physical elder abuse can happen to anyone.  Unfortunately, this type of abuse occurs more often than most people realize. To ensure the protection of our elderly loved ones, identifying physical elder abuse is crucial.

It is important to remember abuse can look different in each case. While physical injuries may be apparent, emotional injuries are more difficult to see.  You may notice things such as a change in nature, withdrawing from activities, or being quieter in family members’ company.  These are all signs alerting you something may be wrong.

If the signs of physical abuse are there, it is crucial to act without delay. Seek medical help, ensure a safe environment is available for the senior to return to, and report the matter as soon as possible. In this way, we can all protect the people we love and allow them to thrive and find enjoyment in the precious days lying ahead for them.

At Paths Elder Law, we are dedicated to helping seniors and their families for close to 30 years by providing legal counsel and support.  We take a holistic approach in providing legal advice and consider all the issues seniors may face.  If you or someone you know has fallen victim to physical elder abuse, contact Paths Elder law today.  We are here to help.





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Community Relations

Jeane M. Fracassa

Community Relations

Jeane M. Fracassa

Jeane Fracassa – a dedicated and accomplished professional who retired with an impressive 38-year service record from the Kansas City Missouri Police Department. Throughout her illustrious career, Jeane served as a Civian Supervisor in the Communications Unit, where she played a pivotal role in ensuring efficient and effective communication within the department.

Even in retirement, Jeane’s commitment to community service remains unwavering. Currently, she serves in various capacities within Community Relations at Paths Law Firm. Actively engaged in the Lee’s Summit and Overland Park communities, she proudly represents the law firm.

In all aspects of her life, Jeane Fracassa exemplifies the values of community, compassion, and family. Her commitment to making a difference and her love for exploration make her a remarkable individual, whose presence brightens the lives of those she encounters. Whether at work, with family, or during her travels, Jeane’s genuine care for others and her zest for life make her a truly remarkable and inspiring person.

Administrative Assistant

Laura E. Messer

Administrative Assistant

Laura E. Messer

Laura is the Law Firm’s marketing assistant, supporting all marketing tasks, including managing calendars, researching upcoming events, updating marketing software and spreadsheets, and partnering with organizations to maintain relationships that benefit Paths Law Firm’s clients.  Laura is also the law firm’s professional photographer as she provides the professional photographs for the headshots, organizations, events, and networking.

Laura has over 10 years of experience as a professional photographer.  She is also Adobe and Microsoft Certified.  She graduated from Columbia College, Columbia, Missouri with her Bachelor of Arts degree, Magna Cum Laude, in Behavioral Psychology (minors in Social Work and Criminal Justice), and her Photographic Craftsman degree from Professional Photographers of America. She is certified as a Qualified Mental Health Professional, Certified Gentle Teacher, Medicaid Billing Certified, Crisis Intervention Counselor, and a Missouri Notary.

Laura has been married more than 26 years and has a daughter and a son. She has four brothers, a niece, and a nephew. Her four spoiled pets that love her attention. A lot of Laura’s off time is spent taking photos and she is an internationally published photographer. Laura owns a studio on the historic Independence Square. 

Administrative Assistant

Holly D. Bramble

Administrative Assistant

Holly D. Bramble

Holly is our newest member of the administrative team. She is hardworking, has proven organizational skills and excellent communication skills. Holly has transitioned to the Estate Planning field from healthcare administration where she gained valuable knowledge that has contributed to her success here at Paths.

Holly enjoys spending time with loved ones, cheering for the Chiefs, and relaxing on the beach.

Administrative Assistant

Tressa L. Purdy

Administrative Assistant

Tressa L. Purdy

Tressa has the important role of being a client’s initial point of contact as the law firm’s receptionist for all locations.  She also welcomes, assists, and cares for clients at the Lee’s Summit office. Additionally, she provides support in an administrative capacity for the attorneys, staff, and clients.  When you meet Tressa, the first quality many note is her readiness to be of assistance.


Tressa is a graduate of Park Hill High School with extensive administrative experience and executive level management. Tressa brings a stability and comfort to the law firm experience having worked in a variety of industries and having lived in six different major metropolitan cities.


Tressa has a daughter, two sons, and one grandchild.  In her free time, she enjoys her family and friends, loves being outdoors, gardening, bike riding and bird watching. Indoor hobbies include scrapbooking, painting cookies, and cheering on Chiefs football. She is a Kansas City native but enjoys traveling but is always happy to be back in her hometown.  


Kathleen E. Overton


Kathleen E. Overton

Kathleen Overton is an attorney and owner at Paths Law Firm. She has more than 17 years of experience advocating for those with special needs and navigating the state and federal agencies formed to help the disabled and elderly. At Paths Law Firm, Kathleen’s practice focuses on helping the elderly qualify for nursing home Medicaid, creating estate plans to protect beneficiaries, as well as a lot of time planning and forming businesses. Kathleen also enjoys helping clients form non-profit organizations and obtain 501(c)(3) tax exempt status.


After attending law school at the University of Oklahoma, Kathleen began representing clients before the Social Security Administration. Eventually her practice switched to federal court appeals and Kathleen spent years representing clients before the Eastern and Western District of Missouri, the District of Kansas, and the Eighth Circuit Court of Appeals. Kathleen has since focused her practice on estate planning and elder law after watching clients struggle to find ways to financially care for loved ones with special needs or aging parents.


Kathleen lives in the Northland with her husband and four children. She spends her free time attending soccer matches and ballet performances with her children and starting endless home improvement projects with her husband. 

Medicaid paralegal

Tena K. Dooley

Medicaid Paralegal

Tena K. Dooley

Tena is a Medicaid Paralegal.  She is very meticulous and organized.  She works closely with the attorneys, clients, and State representatives. 

Tena has an associate in applied science and has over 20 years of office management experience. She has two daughters and one grandson.

Tena enjoys spending time with her family.  She enjoys everything outdoors and her hobbies include fishing and gardening.


Sydney R. Morris


Sydney R. Morris

Sydney is the law firm’s internal accountant and one of their experienced paralegals having been with Paths Law Firm since 2017. She is a primary point of contact for estate planning and business planning.

Sydney graduated with honors from the University of Missouri Kansas City in 2022 with her Bachelor of Science Degree in Accounting. She is a Bloch Launchpad, Phi Theta Kappa, and National Honor Society alumni.

In her free time, Sydney enjoys spending time with her husband, reading, baking and going on long walks. 


Christy L. Phillips


Christy L. Phillips

Christy has three years of experience in elder law working for seniors and their families. She is currently the Senior Administrative Assistant and organizes the day to day functions of the office and makes sure everything runs smoothly. When asked why she loved what she does, Christy said at Paths Law Firm, she gets the opportunity to help clients in more ways than one. Her favorite parts of the job are getting to know the clients and helping them get their questions answered. 

Christy’s experience in the finance industry has been extremely beneficial to her role as the Senior Administrative Assistant. Christy has a special place in her heart for the elderly and attributes this to the relationship she had with her grandparents. 

Christy was raised in Ogden, Utah and moved to Independence, MO, when she was ten years old. She has been with her high school sweetheart for 25 years and they have two beautiful children together. Her daughter works in the medical industry, and her son currently attends High School and plays Baseball. When Christy is not working, she enjoys crafting and spending time with her family and friends.

Christy’s experience in the finance industry has been extremely beneficial to her role as Benefits Coordinator. There have been many influences that went into her decision to select the field of Elder Law. Christy has a special place in her heart for the elderly and attributes this to her relationship with her grandparents.

When asked why she loves what she does, Christy said that at Paths Elder law, she gets the opportunity to help clients in more ways than one. Her favorite part of her job is getting clients approved for Medicaid or VA benefits as it is a huge relief for them and their loved ones.

Christy was raised in Ogden, Utah, and moved to Independence, MO, when she was ten years old. She has two children that keep her busy and fill her life with joy! Christy’s daughter cheers for Avila University, and her son plays competitive baseball for the Bucks and races BMX locally for the Motorcycle Closeout Team.

When Christy is not working, she enjoys crafting and making homemade gifts for her loved ones and raising her kids to be healthy, happy, and positive humans.


Practice Areas

  • Medicaid Benefits
  • VA Benefits


Professionalc Memberships and Affiliations

  • Missouri Notary


René A. Fracassa

Rene A. Fracassa, Paths Law


René A. Fracassa

René is the Financial Manager at Paths Law Firm overseeing all aspects of revenue, expenses, and financial planning. She is also responsible for general office management, including assisting in many of the administrative matters that periodically arise. 

René earned her Bachelor of Science in Hotel and Restaurant Management from Central Missouri State University in Warrensburg, Missouri and soon thereafter worked her way through management at The American Restaurant where she worked almost 17 years before relocating to the country of China.

In her spare time, René is currently quite active managing multiple generations of her family, including parents and grandkids.  René has had great impact on the lives of many women teaching discipling and teaching and abundance of Bible Studies. Her former career in management and event planning trained her well to juggle all the activity.


Hilary R. Tichota


Hilary R. Tichota

Hilary plays a vital role in managing the Marketing Department at Paths Law Firm.  She is excellent at bringing new ideas and sharing valuable resources with the law firm and our community. Hilary has been with the law firm since the beginning, working in nearly every role which is invaluable in her marketing endeavors as she brings a unique set of skills into the Marketing Department.

Hilary is nearly complete in her Bachelor’s of Arts Degree in Marketing at Park University.  She has earned the honor of being listed in National Honors Society, Phi Theta Kappa, and the Dean’s List. Hilary is always looking for new and innovative ways to share the law firm’s message.

While not working, Hilary spends her time with her family at their rural home. They tend to their chickens and honeybees and enjoy the solitude of country living.


Jennifer A. Bronson



Jennifer is the Sr. Paralegal and Operations Manager at Paths Law Firm.  She oversees the firm’s probate department as well developing, implementing, and managing all the firm’s administrative processes having been with the law firm almost from the beginning.  She enjoys client contact as well as behind-the-scenes operations.


Jennifer began her legal career in 1990 as a legal secretary.  She has worked in small and medium sized firms, as well as court operations.  She has her Paralegal Certificate from Boston University, Law Office Management Certificate from University of Central Missouri, and she is a Master Financial Coach. 


Jennifer has two daughters, twin sons, and twin grandsons.  She spends as much time as she can with them.  She enjoys reading, listening to podcasts, and tending her yard. 


Russell A. Fracassa (Rusty)


Russell A. Fracassa (Rusty)

When asked what he wants to do, his reply was “I just want to sit at the kitchen table and work directly with people.” Rusty enjoys working with clients providing experienced advocacy and supporting them through their unfamiliar and overwhelming situations. Due to all the challenges faced by seniors, it is essential to work with an experienced elder law attorney who has expertise in the law, issues, and concerns affecting seniors and their families.

Rusty brings more than 30 years legal experience and expertise working for seniors and their families as an elder law attorney in Kansas City and surrounding. Prior to law school, Rusty was an accountant and his first couple years practicing law was as a tax attorney. This provides invaluable experience in his current practice of law. Rusty’s focus is helping protect seniors’ assets from taxes and long-term care costs, benefit qualification, and navigating more complex family scenarios in their estate planning.

Rusty has personally experienced the loss every parent fears, caring for a spouse suffering with cancer and the treatment, and working with aging parents through all stages of their lives.  He intimately understands the challenges faced by individuals and their caretakers when capacity or health declines, how to prepare for it, and the legal matters while in the midst of it.  He may not be able to eliminate his client’s grief, but he strives to provide clients with peace of mind.

In 2010, Rusty’s faith and love led him and part of his family to China as Christian missionaries. He and his wife, went permanently, but ended up dedicating 3 years to that ministry. They returned to Missouri to help with grandchildren after a family tragedy and later began anew with Paths Elder Law. The goal is providing compassionate care through legal advocacy.

Rusty has multiple degrees and advanced study spanning his Bachelor’s of Arts in Business Administration – Accounting at Rockhurst College (now Rockhurst University), Masters of Arts in Accounting and in Intercultural Studies, as well as his Juris Doctorate from the University of Missouri at Kansas City School of Law.

When Rusty is not practicing law, he enjoys spending time with his family, grandchildren, and excessive eating at local restaurants.

Practice Areas

  • Wills and Trusts
  • Estate Planning
  • Asset Protection
  • Medicaid Benefits
  • VA Benefits
  • Probate
  • Guardianship and Conservatorships
  • Education


BSBA and Master’s in Accounting, Master’s in Inter-Cultural Studies, and Doctorate in Juris Prudence

  • Rockhurst University
  • Liberty University
  • University of Missouri – Kansas City

Admissions to Practice

  • Missouri

Professional Memberships and Affiliations

  • State Bar of Missouri
  • National Academy of Elder Law Attorneys (long-time Member)
  • Elder Counsel (Charter and Ongoing Member)
  • Missouri Association of Trial Attorneys (Past Member)
  • Kansas City Metropolitan Bar Association
  • Missouri State Bar Committees – Elder Law, Estate Planning, Probate