The hidden side of elder mistreatment

When we hear the word “abuse,” we usually think of bruises or broken bones. But not all abuse leaves marks. Sometimes it is a cold shoulder, an unkind word, or a pattern of neglect that can drain a person’s dignity without us recognizing it.Emotional abuse is one of the least understood, and most harmful, kinds of abuse or mistreatment of older persons. As a clinical psychologist, I have seen how deeply emotional abuse can cut. Sometimes deeper than a bruise, or injury.

It doesn’t always look like abuse

Emotional abuse can show up as chronic criticism, exclusion, manipulation, threats, or being treated like a child. Sometimes it’s loud—shouting, name-calling. Sometimes it’s quiet—a refusal to speak, prolonged silence, or controlling behavior masked as “care.” In many cases, it happens behind closed doors and is inflicted by those meant to protect: spouses, adult children, or caregivers.Because of this, older adults often remain silent. Some are afraid, others feel ashamed, and many worry about being a burden. Some may not even recognize they’re being mistreated at all—especially those who grew up in an era when emotional needs were rarely acknowledged.

Why it’s so hard to prove

Unlike physical or financial abuse, emotional mistreatment leaves no paper trail. There are no receipts, bruises, or police reports—just subtle cues: sadness in the eyes, hesitation in speech, or a shrinking presence. When older adults do speak up, they’re often not believed. “She’s just confused.” “That’s just how he is.” And when cognitive decline is present, it’s even easier for others to dismiss their pain.As a psychologist, I often see the long-term effects only after the damage has settled in: anxiety that won’t subside, depression that lingers, withdrawal from loved ones, or even a decline in physical health. By the time help is sought, the emotional wounds have often taken deep root—quietly and devastatingly shaping the person’s well-being over months,even years.

Who is most at risk?

Elderly women, particularly those living alone or widowed, are among the most vulnerable. So are individuals with chronic illnesses or dementia. Often, the abuser is not outwardly cruel, but overwhelmed—coping with their own stress, mental health issues, or lack of support.That doesn’t justify the abuse. But it shows why solutions must involve both accountability and care.

How emotional abuse begins

At its root, emotional abuse often stems from broken communication. A stressed caregiver may lash out. A confused elder may be met with sarcasm or dismissal. Over time, these responses harden into a pattern—one that neither side knows how to change.

Breaking the silence

We must listen and learn to listen better-to hear what older adults are saying (even when it may be difficult to hear). The warning signs of their pain may not come with a label, and that doesn’t diminish its meaning. We must validate their experiences and advocate for them, create environments and opportunities for more conversations to take place, and to foster emotional safety to help them feel seen and heard.Providing caregiver training, and ongoing emotional support, and connecting to mental health services that are accessible is crucial for prevention.

Changing the narrative of aging

Essential to understanding this issue is the narrative that society creates around older people. Older adults are not burdens. They are fully realized human beings, with a history, needs, and voices that are entitled to be heard.Emotional abuse may be silent- but it is loud and lasting. To recognize and acknowledge it is not only our job as professionals; it is our societal obligation.Ms. Savi Bansal, Clinical Psychologist