Possible indicators of Physical Abuse
● Cuts, lacerations, puncture wounds
● Bruises, welts, discoloration
● Any injury incompatible with history
● Poor skin condition or poor skin hygiene
● Absence of hair and/or hemorrhaging below scalp
● Dehydration and/or malnourished without illness-related cause
● Loss of weight
● Soiled clothing or bed
● Burns: may be caused by cigarettes, caustics, acids, friction from ropes or chains, or contact with other objects
● Any injury which has not been properly cared for (injuries are sometimes hidden on areas of the body normally covered by clothing)
Possible indicators of Self-Neglect
● Inability to manage personal finances, e.g. hoarding, squandering, giving money away or failure to pay bills
● Inability to manage activities of daily living, including personal care, shopping, meal preparation, housework, etc.
● Suicidal acts, wanderings, refusing medical attention, isolation, substance abuse
● Lack of toilet facilities, utilities or animal infested living quarters (dangerous conditions)
● Rashes, sores, fecal/urine smell, inadequate clothing, malnourished, dehydration, etc.
● Changes in intellectual functioning, e.g. confusion, inappropriate or no response, disorientation to time and place, memory failure, incoherence, etc.
● Not keeping medical appoints for serious illness
Possible indicators of Psychological/Emotional Abuse
● Helplessness
● Hesitation to talk openly
● Implausible stories
● Confusion or disorientation
● Anger
● Fear
● Withdrawal
● Depression
● Denial
● Agitation
Possible indicators of Abuse from the Caregiver
● The elder may not be given the opportunity to speak for him or herself, or see others, without the presence of the caregiver (suspected abuser)
● Attitudes of indifference or anger toward the dependent person, or the obvious absence of assistance
● Family member or caregiver blames the elder (e.g. accusation that incontinence is a deliberate act)
● Aggressive behavior (threats, insults, harassment) by caregiver toward the elder
● Previous history of abuse to others
● Problems with alcohol or drugs
● Inappropriate display of affection by the caregiver
● Flirtations, coyness, etc as possible indicators of inappropriate sexual relationship
● Social isolation of family, or isolation or restriction of activity of the older adult within the family unit by he caregiver
● Conflicting accounts of incidents by family, supporters, or victim
● Unwillingness or reluctance by he caregiver to comply with service providers in planning for care an implementation
● Inappropriate or unwarranted defensiveness by caregiver
Possible indicators of Financial Abuse
● Unusual or inappropriate activity in bank accounts
● Signatures on checks, etc., that do not resemble the older person’s signature, or signed when older person cannot write
● Power of attorney given, or recent changes or creation of will, when the person is incapable of making such decisions
● Unusual concern by caregiver that an excessive amount of money is being expended on the care of the older person
● Numerous unpaid bills, overdue rent, when someone is supposed to be paying the bills for a dependent elder
● Placement in nursing home or residential care facility which is not commensurate with alleged size of estate
● Lack of amenities, such as TV, personal grooming items, appropriate clothing, that the estate can well afford
● Missing personal belongings such as art, silverware, or jewelry
● Deliberate isolation, by a housekeeper, of an older adult from friends and family, resulting in the caregiver alone having total control
What are warning signs of abuse?
The following indicators, by themselves, do not necessarily signify abuse or neglect. However they may be helpful in assessment of abuse.