Elder Abuse Warning Signs

The following indicators, by themselves, do not necessarily signify abuse or neglect. However they may be helpful in assessment of abuse.

Possible indicators of Physical Abuse

• Cuts, lacerations, puncture wounds.
• Bruises, welts, discoloration.
• Any injury incompatible with history.
• Any injury which has not been properly cared for (injuries are sometimes hidden on areas of the body normally covered by clothing).
• 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.
• Burns: may be caused by cigarettes, caustics, acids, friction from ropes or chains, or contact with other objects.
• Soiled clothing or bed.

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 Financial Abuse

• Unusual or inappropriate activity in bank accounts.
• Signatures on checks, etc., that do not resemble the elder and disabled person's signature, or signed when the 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 elder and disabled person.
• Numerous unpaid bills, overdue rent, when someone is supposed to be paying the bills for a dependent elder or disabled person.
• 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 or disabled adult from friends and family, resulting in the caregiver alone having total control.

Possible indicators of Neglect by Caregiver

• Dirt, fecal/urine smell, or other health and safety hazards in elder or disabled adult's living environment.
• Rashes, sores, lice on elder.
• Elder is inadequately clothed.
• Elder or disabled adult is malnourished or dehydrated.
• Elder or disabled adult has an untreated medical condition.

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 appointments for serious illness

Possible indicators of Abuse from the Caregiver

 
• The elder or disabled adult 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 dependant person (e.g. accusation that incontinence is a deliberate act).
• Aggressive behavior (threats, insults, harassment) by caregiver toward the dependant person.
• 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 or disabled adult within the family unit by he caregiver.
• Conflicting accounts of incidents by family, supporters, or victim.
• Unwillingness or reluctance by the caregiver to comply with service providers in planning for care and implementation.
• Inappropriate or unwarranted defensiveness by caregiver.