Sexual Abuse of Elderly Patients

One common sign of elder abuse is bruising on or around an elder’s genitals. These bruises appear in the anogenital region, including an elder’s thighs, genitals, anus, or the surrounding area.

Bruises on the genitals and inner thigh are signs of sexual abuse. The elderly are more prone to accidental bruising; thus not all bruises are evidence of abuse. However, a study of bruises on 100 adults, ages 65+, found no accidental bruises on the genitalia. Thus, it is unlikely that bruises in this region are accidental.

What Is Sexual Abuse?

According to the American Psychological Association, sexual abuse is “unwanted sexual activity, with perpetrators using force, making threats or taking advantage of victims not able to give consent.”  Elder sexual abuse is unwanted sexual conduct against a person over the age of 60. The Nursing Home Abuse Guide adds that “elder sexual abuse may cause harm by tricking, manipulating, or coercing the elder person into undesired sexual contact.”

Signs of Sexual Abuse in Elderly

As aforementioned, bruising on or around an elder’s genitals is a sign of sexual abuse. Other signs of sexual abuse include (but are not limited to):

  • Withdrawal from social interactions
  • Bloody or turn undergarments
  • Pelvic injury
  • Difficulty sitting or walking
  • Bruising of the uvula
  • Contraction of a sexually transmitted infection (STI)
  • Inappropriate or unusual behavior between the victim and the suspect

A Growing Concern

There is limited research on sexual abuse in nursing homes. However, the issue is becoming more pressing as the elderly population grows. Predators often see the elderly as easy victims, especially those seniors who are weak or mentally impaired. Studies have found that the majority of elder victims of sexual abuse have cognitive impairments or functional limitations.

Abuse can occur in men or women. Be wary of aides that seek retaliation against an elder by using hot or cold water or rough behavior when bathing or showering the elderly.

Why People Fail To Report Cases of Elder Sexual Abuse

Sexual abuse is the least frequently reported type of elder mistreatment. Authorities may not trust the accounts of seniors with failing memories and thus do not take action following reports. Also, elders may not report their cases because of:

  • Feared retaliation
  • Perceived stigma at being victimized
  • Embarrassment or shame
  • Difficulty communicating the details of the incident
  • Desire to protect the perpetrator

However, sexual abuse, like other types of abuse, can have adverse effects on the health and welfare of the elder victim. Long-term effects of sexual abuse include:

  • Anxiety
  • Fear
  • Post-traumatic stress disorders
  • Health complications from sexually transmitted infections (STIs)

Thus, it is important to report sexual abuse cases and prevent repeat offenses.

Reporting Sexual Abuse Cases

Follow these steps if you suspect sexual abuse:

  1. Report the incident(s) to the manager of the nursing home. Be prepared to take further action if the facility manager does not take steps to remediate the situation.
  2. Alert state authorities of the situation. If the nursing home is in New Jersey, visit the New Jersey Department of Health website to learn more about filing a complaint about the care quality or staff.
  3. If you believe that the genital bruising is the result of negligence or abuse or if urgent action is needed, we suggest having a discussion with an attorney ( In New Jersey, contact Gartenberg Howard at (201) 488-4644.)

Preserving any evidence is important. According to a study sponsored by the National Institute of Justice, “perpetrators are more likely to be charged if there are signs of physical trauma.” Pictures of bruises or doctor’s reports of bruises will strengthen the claim of sexual abuse. It can be difficult to prove sexual abuse cases, but physical evidence helps to support the argument.

For a case evaluation call (201) 488-4644 or fill out the form on the right side of this page.



National Institute of Justice

Nursing Home Law Center

American Psychological Association

Nursing Home Abuse Guide

Dyer, Connolly, and McFeeley 2008

Mosqueda, Burnight, and Liao 2005