Elder abuse is a complex and concerning issue that affects vulnerable older Americans in various ways and cost us more than $1.6 billion last year. It is important that we take action to address this issue and ensure that older Americans are protected and their dignity is preserved, especially as the older population grows. The U.S. Census Bureau predicts that the population aged 65 and older will almost double from 49.2 million in 2016 to 94.7 million in 2060. By taking action now, we can pave the way for a brighter and safer future for our older generations.
WalletHub is raising awareness of this critical issue by comparing the 50 states and the District of Columbia based on 16 key indicators of elder abuse protection in 3 overall categories. Our data set ranges from the share of elder abuse, gross neglect and exploitation complaints to financial elder-abuse laws.
Cassandra Happe, WalletHub Analyst
Main Findings
States with the Best Elder-Abuse Protections
Overall Rank | State | Total Score | Prevalence Rank | Resources Rank | Protection Rank |
---|---|---|---|---|---|
1 | Wisconsin | 62.45 | 22 | 1 | 5 |
2 | Massachusetts | 55.07 | 14 | 4 | 19 |
3 | Ohio | 52.71 | 31 | 16 | 1 |
4 | Virginia | 49.76 | 8 | 11 | 35 |
5 | Kentucky | 49.69 | 1 | 28 | 26 |
6 | Vermont | 49.36 | 18 | 9 | 21 |
7 | Wyoming | 48.91 | 21 | 5 | 49 |
8 | Iowa | 48.31 | 13 | 27 | 10 |
9 | West Virginia | 47.61 | 12 | 17 | 27 |
10 | Louisiana | 47.23 | 2 | 44 | 25 |
11 | Pennsylvania | 46.69 | 5 | 25 | 29 |
12 | North Carolina | 46.45 | 28 | 29 | 7 |
13 | Washington | 45.97 | 34 | 30 | 2 |
14 | Maine | 45.90 | 20 | 18 | 31 |
15 | Minnesota | 45.27 | 36 | 20 | 3 |
16 | Missouri | 44.96 | 9 | 46 | 17 |
17 | Maryland | 44.90 | 38 | 10 | 4 |
18 | Illinois | 44.50 | 29 | 21 | 11 |
19 | Oregon | 44.32 | 10 | 22 | 43 |
20 | Michigan | 44.29 | 3 | 49 | 39 |
21 | Texas | 44.25 | 19 | 42 | 15 |
22 | District of Columbia | 44.07 | 33 | 6 | 13 |
23 | Alabama | 43.81 | 15 | 32 | 32 |
24 | Kansas | 43.69 | 23 | 48 | 9 |
25 | Connecticut | 43.45 | 27 | 24 | 18 |
26 | Florida | 42.92 | 6 | 51 | 30 |
27 | Arizona | 42.80 | 25 | 40 | 16 |
28 | Hawaii | 42.68 | 16 | 45 | 22 |
29 | New York | 42.20 | 17 | 43 | 23 |
30 | New Hampshire | 41.59 | 7 | 41 | 47 |
31 | Alaska | 41.26 | 39 | 7 | 20 |
32 | Indiana | 41.01 | 4 | 50 | 50 |
33 | Mississippi | 40.84 | 11 | 26 | 51 |
34 | Idaho | 40.46 | 26 | 23 | 45 |
35 | North Dakota | 40.30 | 32 | 14 | 44 |
36 | Oklahoma | 39.74 | 41 | 13 | 8 |
37 | New Mexico | 39.49 | 24 | 35 | 46 |
38 | Georgia | 37.96 | 30 | 34 | 38 |
39 | Colorado | 37.76 | 40 | 15 | 14 |
40 | Arkansas | 37.26 | 35 | 37 | 28 |
41 | Rhode Island | 36.61 | 45 | 2 | 40 |
42 | Nebraska | 33.53 | 37 | 47 | 41 |
43 | Nevada | 31.70 | 50 | 3 | 33 |
44 | South Dakota | 30.61 | 48 | 8 | 24 |
45 | Tennessee | 27.88 | 44 | 36 | 12 |
46 | Delaware | 27.45 | 42 | 31 | 48 |
47 | New Jersey | 27.32 | 43 | 33 | 34 |
48 | South Carolina | 26.90 | 47 | 19 | 36 |
49 | Montana | 26.78 | 49 | 12 | 42 |
50 | Utah | 23.64 | 46 | 38 | 37 |
51 | California | 23.19 | 51 | 39 | 6 |
Note: With the exception of “Total Score,” all columns in the table above depict the relative rank of that state, where a rank of 1 represents the best conditions for that category.
An In-Depth Look at the Best States for 2023
Wisconsin
Wisconsin ranks as the top state for elder-abuse protections, boasting high numbers of eldercare organizations and services, and investing three times more per elderly resident in elder-abuse prevention programs than the state average. The state’s resources for elder-abuse prevention and assistance rank as the best in the country.
When it comes to the quality of its elder-abuse protections, the Badger State ranks high because it has implemented criminal legislation to combat financial crimes against the elderly. Plus, Wisconsin is one of only 22 states that have elder-abuse shelters in place.
Massachusetts
The Bay State ranks second in the U.S. for elder-abuse protections. The state invests a substantial amount per elderly resident in elder-abuse prevention programs each year and has legal protections in place to help minimize elder abuse, including mandatory abuse-reporting laws and a dedicated elder protective services program.
These initiatives have had a positive impact on the rate of home-care elder abuse, neglect, and exploitation claims in the state. Massachusetts has maintained the second-lowest complaint rate per 100,000 older adults in our study since 2020.
However, Massachusetts hasn’t invested as much in its long-term care ombudsman program as many other states have, including Wisconsin.
Ohio
Ohio has the third-best elder-abuse protections overall. The Buckeye State has invested significantly in its ombudsman program and many residents serve as volunteers to advocate for the elderly population, earning the state high rankings in both metrics this year.
In addition, Ohio has implemented mandatory reporting laws, legal protections, and educational programs to raise awareness about elder abuse – similar to other top states. However, Ohio's elder financial fraud rate is estimated to be the 10th highest among all states, indicating a need for improvement in protecting the older Buckeye population's financial stability.
- Lowest
- 1. Louisiana
- 2. Florida
- 3. Pennsylvania
- 4. Indiana
- 5. New Hampshire
- Highest
- 47. Tennessee
- 48. Montana
- T-49. California
- T-49. Nevada
- T-49. South Carolina
- Highest
- 1. Massachusetts
- 2. Rhode Island
- 3. Wisconsin
- 4. Virginia
- 5. Nevada
- Lowest
- 47. Texas
- T-48. Georgia
- T-48. Louisiana
- T-48. Maine
- T-48. Montana
- Highest
- T-1. District of Columbia
- T-1. Alaska
- 3. South Dakota
- 4. Vermont
- 5. Montana
- Lowest
- 47. Kansas
- 48. Michigan
- 49. Indiana
- 50. Florida
- 51. Tennessee
- Most
- 1. Alaska
- 2. Vermont
- 3. Wisconsin
- 4. Montana
- 5. North Dakota
- Fewest
- 47. Rhode Island
- 48. Missouri
- 49. Texas
- 50. Delaware
- 51. Florida
- Most
- 1. North Carolina
- 2. Arkansas
- 3. Nebraska
- 4. Vermont
- 5. Alaska
- Fewest
- 47. Virginia
- T-48. Alabama
- T-48. Mississippi
- T-48. Nevada
- T-48. South Dakota
- Highest
- 1. Hawaii
- 2. Alaska
- 3. North Dakota
- 4. Idaho
- 5. Utah
- Lowest
- 47. Texas
- 48. West Virginia
- 49. Illinois
- 50. Mississippi
- 51. Louisiana
*Per resident aged 65+
Ask the Experts
There are ways for families, organizations and lawmakers to protect America’s elderly population. We consulted a panel of experts in fields such as social welfare and aging for insight and advice. Read about the panelists and their thoughts on the following key questions below:
- What are the most common types of elder abuse?
- How can policymakers protect the elderly from abuse, financial or otherwise?
- Should there be legal restrictions against caregivers financially benefiting from the death of the person he/she was caring for?
- What can families do to protect elderly family members from being abused financially?
Ask the Experts
Tips for Spotting Signs of Elder Financial Abuse
- Look Out For Unusual Bank or Credit Card Activity: Be vigilant for any unexpected or abrupt alterations in the financial circumstances of an elderly individual, like substantial withdrawals, transfers, or expenditures. Be mindful of any irregular ATM usage or unfamiliar purchases.
- Be Cautious of New or Unfamiliar “Friends”: If an elderly person has recently befriended someone who shows an unusual interest in their finances or property, it is important to be cautious. This behavior could indicate that the new acquaintance has malicious intentions. Some scammers take advantage of the elderly person's kind nature and willingness to make new friends to gain their trust, which they can then use as a means to exploit them financially.
- Monitor Social Media and Internet Use: It is wise to keep a close watch on an older adult's social media and internet use as these platforms can make them vulnerable to fraudsters. One should regularly check an older adult's social media profile for any suspicious connections or posts that may reveal personal information to others. Additionally, monitoring their email accounts can help identify any potential security concerns.
- Watch For Changes in Legal Documents: It is important to be alert to any modifications made to legal documents, such as wills, trusts, powers of attorney, or other documents that may appear to benefit someone other than the elderly person. These changes could be made due to coercion or manipulation by family members, caregivers, or others who may be pressuring the older adult to make financial decisions against their will.
- Take Note of Changes in Behavior: Be aware of any changes in behavior displayed by older individuals, such as sudden fearfulness, anxiety, or secretiveness regarding their finances. Perpetrators of financial fraud often employ tactics that isolate vulnerable individuals from their social support networks, allowing them to maintain control over their victims. If an older adult seems to be avoiding family and friends or is hesitant to discuss their financial situation, it may be indicative of elder financial abuse.
- Be Mindful of Any Decline in Personal Care Conditions: You should monitor personal care conditions carefully. If an older person is living in poor conditions, not receiving necessary medical care, or not getting proper nutrition, it could be a sign that their financial resources are not being used for their well-being. If someone has the means to afford food, medication, or necessary care, but they are seemingly being denied access, it could be an indication of financial exploitation.
Methodology
In order to determine the states with the best protection against elder abuse, WalletHub compared the 50 states and the District of Columbia across three key dimensions: 1) Prevalence, 2) Resources and 3) Protection.
We evaluated these dimensions using 16 relevant metrics listed below with their corresponding weights. Each metric was scored on a 100-point scale, with 100 representing the “best protection against elder abuse.”
Finally, we determined each state’s weighted average across all metrics to calculate its overall score and used the resulting scores to rank-order our sample.
Prevalence – Total Points: 40
- Share of Elder-Abuse, Gross-Neglect and Exploitation Complaints: Triple Weight (~24.00 Points)
Note: This metric was calculated by dividing the number of elder-abuse, gross-neglect and exploitation complaints by the number of residents aged 65 and older. “Complaints” include those made to the Office of the State Long-Term Care Ombudsman. - Estimated Elder Fraud Rate: Full Weight (~8.00 Points)
Note: This metric was calculated by dividing the number of elder fraud reports by the number of elderly residents. “Elder fraud”, also called “elder financial abuse” or “elder financial exploitation”, is defined as the misappropriation or abuse of financial control in a relationship where there is an expectation of trust, resulting in harm to the elderly victim. - Elder Fraud Loss Amount per Reported Frauds: Full Weight (~8.00 Points)
Resources – Total Points: 30
- Total Expenditures on Elder-Abuse Prevention per Resident Aged 65 & Older: Full Weight (~10.00 Points)
Note: This metric was calculated by dividing the total dollars spent on elder-abuse prevention by the number of residents aged 65 and older. - Total Expenditures on Legal-Assistance Development per Resident Aged 65 & Older: Full Weight (~10.00 Points)
Note: This metric was calculated by dividing the total dollars spent on legal assistance development by the number of residents aged 65 and older. - Total Long-Term Care Ombudsman Program Funding per Resident Aged 65 & Older: Full Weight (~10.00 Points)
Note: This metric was calculated by dividing the total dollars spent on long-term ombudsman program funding by the number of residents aged 65 and older.
Protection – Total Points: 30
- Financial Elderly-Abuse Laws: Full Weight (~3.00 Points)
Note: This is a binary metric that considers the presence or absence of such legislation. - Eldercare Organizations & Services per Resident Aged 65 & Older: Full Weight (~3.00 Points)
- Presence of Elder-Abuse Forensic Centers: Full Weight (~3.00 Points)
Note: This binary metric considers the presence or absence of Elder Abuse Forensic Centers in a state. - Presence of Elder Abuse Working Groups: Full Weight (~3.00 Points)
Note: An “Elder-Abuse Working Group” is defined by the National Long-Term Care Ombudsman Resource Center as “an entity such as a task force, council, commission, or non-profit organization, convened to address elder abuse issues at the state level.” - Certified Volunteer Ombudsmen per Resident Aged 65 & Older: Full Weight (~3.00 Points)
- Frequency of Assisted-Living Facilities Inspections: Full Weight (~3.00 Points)
- Quality of Nursing Homes: Full Weight (~3.00 Points)
Note: This metric measures the share of certified nursing-home beds rated 4 or 5 stars. - Presence of Laws Allowing Surveillance Cams in Nursing Homes: Full Weight (~3.00 Points)
Note: This binary metric measures the presence or absence of state laws allowing surveillance cameras in nursing homes:
1 – State has laws that allow placement of surveillance cameras in the rooms of nursing home residents;
0.5 – State uses guidelines and programs instead of laws to keep residents safe;
0 – State doesn’t have laws that allow placement of surveillance cameras in the rooms of nursing home residents.
- Presence of Elder Justice Task Forces: Full Weight (~3.00 Points)
Note: This binary metric measures the presence or absence of an Elder Justice Task Force in a state. - Presence of Elder-Abuse Shelters: Full Weight (~3.00 Points)
Note: This binary metrics measures the presence or absence of elder-abuse shelters in a state.
Sources: Data used to create this ranking were collected as of November 22, 2023 from the U.S. Census Bureau, AGing Integrated Database, Administration on Aging - U.S. Department of Health and Human Services, California State Association of Public Administrators, National Ombudsman Resource Center, National Center on Elder Abuse, U.S. Department of Justice, Comparitech, A Place for Mom, Nursing Home Abuse Center and United Health Foundation.
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