Trusting someone else to care for a loved one—whether it’s your child or an aging parent—is one of the most vulnerable decisions you can make. The reality is that abuse by caregivers is far too common, and it’s often underreported. That’s why doing your homework matters.
This guide will help you take proactive steps to choose safer childcare or eldercare, spot red flags of abuse, and respond if something feels wrong.
Why Careful Vetting Matters
An estimated 6 out of 10 rapes are committed by someone known to the victim:
- 21.4% are committed by intimate partners
- 13.1% are committed by other relatives
- 28.3% are committed by well-known or casual acquaintances
- 31% are committed by strangers
- 2.5% are committed by someone with an unknown relationship to the victim
- 3.7% are committed by an unknown number of perpetrators
Research shows that people are much more likely to be abused by someone they know—such as a caregiver—than a stranger. These statistics are sobering, but you can make informed choices that prioritize your loved one’s safety.
Evaluate Individual Caregivers
Whether you’re hiring a nanny, tutor, or in-home eldercare provider, use the following steps:
- Check references—thoroughly. Talk to past employers or families. Ask how the caregiver handled stress, discipline, and emotional regulation. Was their demeanor professional and respectful? Did the child or elder seem comfortable around them?
- Require a background check. If a candidate declines, that’s a red flag. While no screening method is foolproof—because sexual violence is underreported—background checks can still reveal prior offenses or legal issues.
- Search the National Sex Offender Public Website (NSOPW). This free resource aggregates data from all 50 states, U.S. territories, and tribal lands. Visit NSOPW.gov to search by name and region.
- Investigate their online presence. Social media and public records can reveal concerning behavior or attitudes. Look for anything that conflicts with the responsibilities of caregiving.
- Drop in unannounced. Show up unexpectedly to observe real-time care. Watch how the caregiver interacts with your loved one and whether they follow safety protocols.
Assess Care Centers and Agencies
Choosing a daycare, nursing home, or assisted living facility? Ask tough questions before you sign anything:
- Are they licensed? Confirm that the provider is certified by your state or local jurisdiction. Look up their licensing history and any reported violations.
- How are staff vetted and trained? Ask about education requirements, background checks, abuse prevention training, and ongoing professional development. Do they know how to identify and report abuse?
- What’s the oversight system? How are employees supervised? Are there routine evaluations or performance reviews? High staff turnover can signal internal dysfunction—don’t ignore it.
- What’s the caregiver-to-client ratio? More individualized attention typically means better care and fewer opportunities for abuse to go unnoticed.
- Are the facilities safe and secure? Look for security measures like locked entrances, visitor logs, and clear sightlines. Ask if staff are always present in group spaces. Is there a procedure for reporting concerns?
Know the Signs of Abuse
Even with the best vetting, abuse can happen. That’s why it’s crucial to know what to look for—especially in populations that may not be able to speak up for themselves.
Signs of Sexual Abuse in Older Adults
- Reports or disclosures of sexual assault
- Bruising around breasts or genitals
- Torn, stained, or bloody undergarments
- Unexplained genital bleeding or infections
- Sudden anxiety, withdrawal, or fear of certain staff
Elder survivors may not report due to fear, shame, cognitive impairment, or dependence on their abuser. Others may not be believed due to ageist assumptions.
Signs of Sexual Abuse in Children
Physical:
- Genital pain, swelling, or bleeding
- Difficulty walking or sitting
- Frequent UTIs or yeast infections
Behavioral:
- Sudden fear of a specific person
- Regressive behaviors (thumb sucking, bed-wetting)
- Age-inappropriate sexual behavior or knowledge
- Depression, nightmares, or suicidal thoughts
- Self-harm or running away
Abusers often use secrecy, threats, or grooming tactics to keep children silent. It’s critical to maintain open communication and listen without judgment.
What to Do if You Suspect Abuse
If your loved one is in immediate danger, call 911.
Report elder abuse:
- Contact Adult Protective Services through the National Center on Elder Abuse or use your state’s reporting hotline.
Report child abuse:
- Call the National Child Abuse Hotline at 800.4.A.CHILD (800-422-4453) 24/7.
Speak to someone trained to help:
- Call the National Sexual Assault Hotline at 800.656.HOPE (4673) or chat anonymously at hotlines.rainn.org.
Create a Culture of Safety
- Talk early and often. Normalize conversations about boundaries and consent with your loved ones.
- Empower them to speak up. Teach kids the difference between secrets and surprises. Let elders know they have a right to dignity and safety—even from family members.
- Trust your instincts. If something feels wrong, don’t wait for proof. Ask questions, seek help, and believe your loved one.
Awareness & Action
Safety starts with awareness—and continues with action.
By staying informed, asking the right questions, and remaining vigilant, you can help protect your loved ones from harm and foster a culture of trust, respect, and accountability in caregiving.
Last updated: August 4, 2025