Elder abuse, like any other kind of abuse takes many forms- subtle and not so subtle.

Unfortunately, it is very common.

According to the San Diego Country District Attorney’s website, over 9000 cases of senior abuse cases are processed each year.

Sadly, even with that high number, many of these incidents go unreported.

As a caregiver, it’s important that you are able to tell when elder abuse is happening for two reasons:

  1. So you don’t do it yourself
  2. So you have the knowledge and tools to report it when you spot it.

In today’s post, we’ll go over the definition of elder abuse, the signs that elder abuse is going on and what you can do when you find out.

What is Elder Abuse?

The best way to define elder abuse is to talk about the different types of elder abuse that exist.

  • Physical abuse – This happens when a person is harmed physically.  Hitting, pushing, shoving or is roughly handling a senior are all examples of elder abuse. Most of the time this happens because the elder is physically weak and cannot retaliate.
  • Emotional abuse – Emotional abuse is also called psychological abuse. This involves yelling, insulting and using abusive words, threatening and repeated ignoring the elder. Anything that is done to intentionally make a person unhappy can be considered emotional abuse.
  • Neglect – This occurs when the caregiver does not try to respond to the older person’s needs.
  • Abandonment – This happens when the senior is left alone without a plan for his or her care.
  • Sexual abuse – Forcing an elderly person to watch or participate in sexual acts is sexual abuse.
  • Financial abuse – This involves mismanagement of money and property that belongs to the elder. This would include family members lying about having financial needs and taking money from the elderly and then refusing to pay it back. Financial scams can be categorized as financial abuse as well.

Signs of Elder Abuse

The following are signs that there is elder abuse going on.

  • Elder has trouble sleeping
  • An otherwise upbeat elder is now quiet and withdrawn
  • Elder has trouble eating
  • Unexplained weight loss
  • Elder does not make eye contact with the abuser when they are around
  • The elder complains of aches and pains constantly
  • Multiple bruises at different stages of healing
  • The elder loses weight for no reason
  • A visit to the elder’s home shows an unkempt room/smells of urine and feces
  • Elder is wearing clothes that look unwashed and stained
  • The elder is easily agitated and violent
  • The elder develops bed sores and other preventable conditions

If you notice any of these signs of elder abuse, it is important for you to talk to the elder to find out what is going on.

It is possible that when you broach the subject, the elder will be resistant to open up. This can happen because they may feel they don’t want to incriminate the abuser especially if they are family members.

When you talk to such a person, assure them of that while you respect their privacy, it is important that you report the abuse to the right authorities to protect them.

This is not an easy conversation for the abused.

So please understand the emotions the person might go through in sharing this bit of news with you.

What To Do After You Confirm Abuse

Elder abuse will not stop on its’ own. It is not a “phase” or “season”. It is a chronic problem that can go on for years.

Because most abusers are close relatives, it is likely that an abused elder will not report the abuse themselves.

It is therefore important that after you’ve confirmed the abuse that you report it to the appropriate authorities.

You can report elder abuse to:

  • Your local police
  • If you overhear physical abuse going on, call 911
  • The National Domestic Violence Hotline (1-800-799-7233 – toll-free, 24/7
    1-800-787-3224 – TTY/toll-free)
  • You can also locate resources using the Elder Care Locator (call 1-800-677-1116 toll-free) and the National Center on Elder Abuse (call 1-855-500-3537 toll-free).

Elder abuse is real.

And it is a terrible problem.

When you see it and confirm it, please report it.

The life of the elder may be at stake.

Did you find this post useful?

Please share it with someone else. It might save a life.


San Diego palliative care. What is it?

A serious illness does not just affect a person physically.

It can adversely affect a person’s sense of self-worth and what it means for them to be productive members of society.

A serious illness can affect a person’s ability to eat and enjoy family events. It can affect the ability to do the basic activities of daily living like using the bathroom, taking a shower and putting on clothes.

These serious illnesses are debilitating and can leave individuals feeling depressed.

That is where palliative care comes in.

Palliative care is care that is given during a serious illness to help the person feel better physically, emotionally, socially and spiritually.

The ultimate goal with palliative care is to provide comfort that helps improve a person’s quality of life throughout the course of the serious illness.

Serious illnesses that may require palliative care include:

  • Cancer
  • Heart disease
  • Lung disease
  • Kidney failure
  • Dementia
  • Alzheimer’s Disease

While receiving palliative care, people can still receive curative care for the disease from a regular doctor.

Occasionally, palliative care is confused with hospice.

Although palliative care and hospice care are similar concepts, they are not the same thing.

Palliative care is provided for people to receive comfort during their serious illness, as we established above.

On the other hand, hospice care is provided to people who are expected to live for 6 more months or less.

Who provides palliative care?

Different aspects of palliative care can be provided by a number of healthcare professionals including doctors, nurses, physical therapists, registered dietitians and social workers.

Home health and home care agencies can also provide you and your loved one with palliative care.

In San Diego, you can rely on GreenTree Home Care for palliative care if need be.

Does your loved one need it?

Determining if your loved one needs palliative care is a collective decision.

You cannot force it on your loved one.

The decision to start palliative care however is made simpler if there is an advance directive.

An advance directive is a legal document that states what decisions should be made during a serious illness. Palliative care measures can be included in an advance directive.

In the case where the advance directive names a healthcare proxy- the healthcare proxy can decide if palliative care is right.

*A healthcare proxy is a person who is appointed in an advance directive to take crucial healthcare decisions should the seriously ill person become incapable of making healthcare decisions. Such an instance includes if the person becomes unconscious because of their illness.

If an advance directive does not exist however, and the person is conscious, you can have this important conversation with them.

During this conversation, it is important not to force your will or ideas on your loved one.

If a family doctor is present during this conversation, this is great.

The doctor will be able to explain the healthcare implications of receiving palliative care.

It is also important to listen to what your loved one is saying during this conversation.

Not everybody wants palliative care. Even though, research shows that it is beneficial.

If your loved one communicates this to you, respect it.

On the other hand, if they decide to go for palliative care, you can make arrangements with the healthcare practitioners taking care of your loved to start care as soon as possible.

How to pay for San Diego palliative care

One of the reasons people never even look into palliative care is because they are afraid of facing more financial responsibilities.

You will be glad to know however that palliative care is covered by Medicare Part B and Medicaid.

Some private insurance companies cover it too.

You can reach out to your insurance’s customer service or you can reach Medicare at 1-800-MEDICARE and Medicaid at 877-267-2323.

Find out what the options are to pay for palliative care from these sources so your loved one can receive the quality care they need.

Closing Thoughts

Choosing palliative care does not mean a person has given up on life.

Nor does it mean a person is going to die.

Choosing palliative care can in fact be the reason why a person with an otherwise debilitating disease gets to enjoy life in spite of their serious illness.

If you found this post helpful, make sure to bookmark it and share it with someone else who is asking questions about receiving palliative care.


There are many home care companies in the San Diego area. You need to pick one, but what should you look for? Not all licensed San Diego home care companies are equal. Owning and operating a home care company became a state licensed category a mere two years ago. Licensing requires all companies to carry insurance, ensure caregivers complete background checks, and act as the caregiver employer. All licensed San Diego home care organizations are expected to offer these basic services. But, this is where similarities end. Each company has a unique vibe. And, policies around hiring, customer service, and follow-up vary and mean distinctly different client experiences. Below are the questions you should ask any home care you are considering.

Are you a licensed San Diego home care company?

This may sound like a simple question but there are several different types of companies. Not all agencies currently offering services in San Diego county are licensed or in good standing. You can check the license status of a License San Diego home care company by checking the license status online. If the company is not current on licensing or has infractions, the site will show that information.

Some companies operate under a different model called a domestic referral agency. These organizations are not licensed home care agencies. There are a few key differences between a Licensed San Diego home care organizations and domestic referral agencies:

Insurance – Licensed companies carry workman’s comp and contribute to unemployment insurance. They also take out bonds. Domestic referral agencies do not provide insurance for in home caregivers.

Employment – Licensed San Diego home care agencies officially employ caregivers. This means licensed agencies manage all employment aspects. Domestic referral agencies simply facilitate the connection between caregiver and prospective client.

Ongoing Management – great licensed home care agencies offer ongoing client management and remain important in the continued relationship between caregiver and client. Domestic referral agencies cannot have continued contact with the caregiver after placement. They may answer client questions but do not offer continued client management.

Domestic referral agencies offer do-it-yourself solutions for home care. But, if you desire comprehensive legal, employment, and insurance protection, you want the support of a licensed San Diego home care organization.

You can find more resources and information about San Diego home care here.

What Ongoing Support Do You Offer?

You don’t want a set-it-and-forget-it home care organization. Not all agencies are created equal. Great agencies offer field support and training. The team at Green Tree Home Care has a dedicated field manager who does monthly or bimonthly quality visits. The benefit of a field manager is the global perspective. Because our field manager develops long term relationships with clients she can spot changes and offer support. This is especially important for family members who are not local. We have helped clients get new refrigerators, locate a dog groomer, and flag emerging urinary tract infections. Great licensed San Diego home care agencies are partners in the care landscape.

How Do You Find Your Caregivers and How Do You Know They are Good?

Essentially all home care organizations find caregivers from the same sources: online, schools, networks, and word-of-mouth. Great companies create and enforce systems that ensure the caregivers they hire are the best. Ask what qualities the company looks for in caregivers that join the team. The representative you speak with should have a clear idea of the values the company looks to attract. Some companies hire anyone who meets the minimum requirements and then see who sticks with the organization. Others – like Green Tree Home Care – believe in only bringing on people who have genuine compassion, experience, and dependability.

What Do You Charge For?

Most companies don’t charge for in home assessments. But a few may try to charge for the initial meeting. Most companies charge for mileage if the caregiver uses his or her own car.

Home care organizations observe wage and hour laws. They have to pay overtime for longer shifts. Some companies charge time and a half when the hours go over 8 or 9 while other don’t. Make sure you understand how the perspective company charges and how this might affect you now and in the future.

What Happens if I Need Help After Hours or Weekends?

Nothing is worse than sitting on call center hold on a Sunday morning when you need to quickly cancel a caregiving shift and take your loved one to urgent care. Some companies use call centers to handle after hours and weekend calls while others keep all call handling in house. Our team at Green Tree Home Care handles all phone calls in house. We believe it is important that someone who knows your loved one answer questions or support emergency situations no matter the time or day. Home care is pretty quiet until it isn’t. Great home care agencies realize accidents, emergencies, and changes can happen any time and want to provide support any time.

What Does Your Company Do to Retain Great Caregivers?

You want to make sure the company you choose has programs designed to keep caregivers happy and onboard. You don’t want your favorite caregiver jumping ship for better pay or opportunity because the company hawks the bottom line. Great companies are generous with PTO and flexibility. A very small handful – like Green Tree Home Care offer medical insurance for caregivers.

Wrap Up

You have choices when it comes to licensed San Diego home care companies. It is important to ask questions before you agree to services with any company. Make sure their operations are designed to care for you and your loved one above all else. Any company can do the minimums but you want to look for organizations that go the extra mile.



While you may have wanted June Cleaver to tuck you in at night, you didn’t get to pick your parents. For those who got the short end of the parental stick, caring for a family member you don’t like can feel like salt in a wound. Creating and executing a care plan for a family member is difficult and stressful. Add in years of mistreatment and neglect, and you have a hot bed of emotional stress.

I have had MANY conversations with adult children and relatives who suddenly find themselves unwilling caretakers. A guy friend of mine suffered severe abuse at the hands of a father he later cared for over 15 years. I asked him how he managed to put years of abuse aside to take care of his father after a massive stroke. Here were his words of wisdom.

Make Choices that Align with Your Personal Beliefs

You may not be able to pull from years of parental modeling of love and nurturing. But, as an adult you live a life of purpose and compassion. You may remember the old wounds and still have scars from mistreatment but you must act in a way that exemplifies your own moral code.

“I was angry at my father for the years of abuse and neglect. But, at the end of the day he was still a human that needed help and compassion. Sure, I was angry at the past. But, I could either follow in his footsteps and practice cruelty and hate. Or, I had the power to care and forgive. I chose to forgive, not for him, but for me”.

Most adult children who agree to care for a family member they don’t like find some peace in the situation. Not everyone chooses the path of caregiving. It is truly a personal decision that must feel right to the individual. Don’t feel pressured to accept a role you fundamentally do not want. Caring for a family member you don’t like requires a lot of emotional and physical work. You need to do what is right for your life.

Create Boundaries

Boundaries help keep the mission clear. If your role is to talk to medical professionals and manage funds, keep to the business. You may have signed up to help. But, that doesn’t mean you have to fall into old patterns – especially toxic ones. As an adult child, you are incontrol of how deep the relationship goes. Open communication with your family member and service providers helps create healthy expectations for the relationship.

Be honest about the extent of your involvement. If you feel uncomfortable spending lots of time with your family member, avoid taking on the direct care role. Remember, you do not HAVE to do anything. Your decision to get involved should be for your own reasons like setting the example for your children, or sharing human kindness.

Take Care of Yourself

It is important to maintain your health and mental wellbeing. You don’t want to burn out or lose focus and that can happen to any caregiver. It is especially important when you don’t want to care for a family member since burn out can come much faster.

Make sure you have emotional outlets you can connect with. You may want to secure the emotional support of a trusted friend. Or seek out the support of a social worker or therapist. While you may have made peace with the injuries of the past, renewal of intimacy and care may bring back old wounds.

Create a Support System

Caregiving is an important and sometimes intense role. Don’t feel like you have to handle every aspect of caring for your family member alone. There are professionals who can help with roles you prefer not to handle:

Fiduciaries – help with financial management and sometimes support clients by arranging medical resources.

Home Health and Hospice – these services are covered by medicare. Your loved one may receive regular visits from medical professionals. The visits are episodic but may give you needed respite and support.

Home Care Organizations – These organizations employ and manage caregivers. If you do not wish to provide daily care, you can find great caregivers to see to the needs of your family member.

Other Family Members – This resource is often overlooked. If you and your siblings share the same history, they may not share a willingness to care for a disliked family member, but might want to support you. By sharing your journey with other family members you may find support you didn’t know existed.

You can find out more about San Diego home care resources in this article:

San Diego Home Care – Everything You Need to Know

Wrap Up

When it comes to caring for a family member you don’t like, you set the rules. Don’t be afraid to honestly consider your motivations for providing care. Armed with that honest information you can set boundaries and create support systems that meet your emotional and life needs.


Green Tree Home Care - 9466 Cuyamaca Street #102, Santee, CA 92071