Sexual abuse of an elder or dependent adult is any sexual contact or activity without consent — including contact with a person who cannot legally consent because of dementia, disability, or incapacity. It is one of the most serious and most underreported forms of elder abuse, and California’s Elder Abuse and Dependent Adult Civil Protection Act treats it as a form of abuse. Families have the right to hold both the individual abuser and the facility that failed to protect their loved one accountable — and to do so with privacy and dignity.
By Paul H. Kang, Attorney · Los Angeles Bar Association Elder Law Panel Counsel · Last updated 2026
Older adults and dependent adults are especially vulnerable to sexual abuse. Many depend on others for the most intimate aspects of daily care, many cannot communicate clearly because of dementia or disability, and many are isolated from the people who would otherwise notice and speak up. A person who cannot understand or freely agree to sexual activity cannot consent to it, and any sexual contact in that situation is abuse.
Sexual abuse in a care setting can be committed by a staff member, another resident, a visitor, or anyone given access to a vulnerable person. When a facility accepts responsibility for a resident’s care, it also takes on the duty to screen and supervise its staff, to protect residents from one another, and to respond immediately when abuse is suspected. A failure in any of these duties can make the facility legally responsible.
Families are often the first to sense that something is wrong, even before anything is said. A loved one becomes fearful, withdrawn, or agitated around a particular person. There are unexplained injuries or infections. Caregivers are evasive. These signs deserve to be taken seriously.
California’s Elder Abuse and Dependent Adult Civil Protection Act (Welfare and Institutions Code section 15600 and following) treats sexual abuse as a form of physical abuse (section 15610.63) and provides remedies beyond ordinary civil law — including, when the conduct is proven by clear and convincing evidence, the survival of the victim’s own pain and suffering and the recovery of attorney’s fees under section 15657.
Assault by a caregiver or staff member
Sexual contact by someone entrusted with a resident’s personal care, sometimes under the cover of bathing, dressing, or toileting.
Resident-on-resident abuse
Sexual contact initiated by another resident, including a resident with dementia, that the facility failed to supervise or prevent.
Abuse of a person who cannot consent
Any sexual activity with a resident whose dementia, disability, or incapacity means they cannot understand or agree to it.
Abuse by a visitor or outside party
Assault by a visitor, contractor, or other person allowed access without proper supervision.
Unwanted touching and sexual contact
Non-consensual touching of intimate areas, whether or not it goes further.
Coercion and exploitation
Using authority, threats, isolation, or control over a person’s care to pressure a vulnerable adult into sexual activity.
Non-contact abuse
Forcing a person to witness sexual acts or to be photographed in sexual situations.
Failure to report or stop known abuse
Staff or administrators who ignore, conceal, or fail to report suspected abuse, allowing it to continue.
Families who are concerned should take these signs seriously:
New fear, anxiety, or agitation around a specific caregiver, resident, or visitor
Withdrawal, depression, or sudden changes in mood or behavior
Unexplained bruising around the breasts, inner thighs, or genital area
Pain, bleeding, or new difficulty sitting or walking
New or recurrent genital or urinary tract infections, or a sexually transmitted infection
Torn, stained, or bloody undergarments
Reluctance to be alone with — or to be bathed or changed by — a particular person
Trouble sleeping, nightmares, or new resistance to care
Regression or self-soothing behaviors, especially in residents with dementia
A direct or indirect disclosure from your loved one — which should always be believed and taken seriously
Staff who seem evasive or who discourage private visits
Any report from staff of an “incident” involving another resident or an employee
If you suspect sexual abuse, your loved one’s safety and medical care come first. Seek prompt medical attention — a specialized forensic examination can both care for your loved one and preserve evidence — and report to local law enforcement and to California Adult Protective Services; for residents of licensed facilities, the Long-Term Care Ombudsman and the California Department of Public Health should also be notified. Sexual abuse is never the victim’s fault, and a loved one who comes forward deserves to be believed and supported. Preserving clothing, medical records, and a written account of what was observed can be important if a civil case follows.
California’s Elder Abuse Act treats sexual abuse as a serious civil wrong that requires specific proof. To recover, the plaintiffs generally must show:
1. The defendant subjected an elder or dependent adult to sexual contact or assault as defined by Welfare and Institutions Code section 15610.63 — or a facility had care or custody of the victim
2. The victim did not consent, or could not consent because of dementia, disability, or incapacity
3. The abuse harmed the victim — and, for a facility, its failure to screen, supervise, or protect was a substantial factor
4. For the Act’s enhanced remedies, the conduct, or the facility’s ratification or reckless supervision, involved recklessness, oppression, fraud, or malice
These cases are built from medical evidence, facility records, and expert testimony. Records and evidence that matter include:
Medical and forensic examination records, including any sexual-assault forensic (SANE) exam
The facility’s incident reports and internal investigation file
Personnel files and pre-employment background checks for the accused
Staffing schedules and assignments showing who had access
Surveillance footage and visitor logs
Prior complaints and state survey citations against the facility
Communications and witness accounts
Police reports and Adult Protective Services findings
These cases require sensitive, expert handling. Forensic and medical experts interpret examination findings. Geriatric and nursing experts establish what the facility should have done to screen, supervise, and protect. Where the ability to consent is at issue, capacity experts evaluate the victim’s ability to understand and agree. Throughout, the case is handled in a way that protects the victim’s privacy and dignity.
When the elements are met, the victim or their family can recover the victim’s pain and suffering — which can survive the victim’s death under the Elder Abuse Act — attorney’s fees under section 15657, and, where the conduct involved malice, oppression, or fraud, punitive damages.
When the Elder Abuse Act applies to a sexual abuse case, damages may include:
Economic damages — the cost of medical care, counseling and therapy, relocation to a safe facility, and other expenses caused by the abuse
Pain and suffering damages — compensation for the victim’s physical pain, emotional distress, fear, and humiliation, recoverable by the victim if living or by the victim’s heirs if the victim has died. This survival of pain and suffering damages after death is a distinctive feature of California’s Elder Abuse Act.
Attorney’s fees and costs — Welfare and Institutions Code section 15657 authorizes attorney’s fees against defendants found liable for elder abuse by clear and convincing evidence
Punitive damages — additional damages where the conduct involved malice, oppression, or fraud, which is often present in sexual abuse cases
Claims against the facility — separate recovery for negligent hiring, supervision, or retention, and for failing to report or stop known abuse
We handle these cases with discretion and care, and we will explain your options privately during a free consultation.
Any non-consensual sexual contact or activity, including with someone who cannot legally consent because of dementia, disability, or incapacity. California’s Elder Abuse Act (Welfare and Institutions Code section 15610.63) treats sexual assault of an elder or dependent adult as a form of abuse, covering a range of conduct defined in the Penal Code.
Yes. A facility can be liable for the acts of its employees and for its own failures — negligent hiring, inadequate background checks, poor supervision, ignoring prior complaints, or failing to protect residents from one another or to report abuse.
A person with dementia may be unable to consent or to describe what occurred, but that does not prevent a case. These cases are built on medical and forensic evidence, behavioral changes, staffing and access records, and expert testimony — not solely on the victim’s account.
Yes. Your loved one’s safety and medical care come first, and reporting allows a proper investigation. You do not need proof to report a concern to law enforcement or Adult Protective Services, and we can advise you confidentially about next steps.
We handle these matters with discretion and sensitivity, and protecting your loved one’s privacy and dignity is a priority at every stage. Court procedures also allow steps to protect a vulnerable victim’s identity in appropriate cases.
Deadlines apply and vary by claim, so prompt advice matters. We offer a free, confidential consultation, and the Elder Abuse Act’s attorney’s-fee provision can ease the cost of pursuing a case.
Q: What is Elder Abuse and Neglect A: Some examples of elder abuse are when someone hits, slaps, pinches, pushes, kicks, restrains, confines an elder.
