Potential Indicators of Elder Abuse

Many of the symptoms listed below can occur as a result of medical conditions or medications. The appearance of these symptoms should prompt further investigation to determine and remedy the cause.

Factors that can make an elder particularly vulnerable to abuse include cognitive impairment, being dependent on the caregiver or having a family history of violence or the characteristics of the abusers such as mental illness, substance abuse or legal or financial difficulties. The "oldest-old" -- those who are 80 or older -- are abused and neglected at two to three times their proportion of the entire elderly population.

Physical Abuse

Signs that may indicate that physical abuse is taking place include:
  • Overt signs of physical trauma such as bruises or grip marks around the arms or neck, scratches, cuts, burns or punctures

  • Rope burns or welts on the wrists or ankles or gag marks

  • Repeated unexplained injuries

  • Inconsistent explanation of injuries

  • Refusal to go to the emergency room for treatment or frequent physical-shopping

  • Time lapse between time of “injury or fall” and medical treatment

Sexual Abuse

Signs of possible sexual abuse include:
  • Unexplained vaginal or anal bleeding or trauma to genital area

  • Torn or bloody underwear

  • Bruised breasts

  • Venereal diseases

  • Infections or unusual discharge or smell

  • Signs of psychological abuse may also occur with sexual abuse

Emotional or Psychological Abuse

Signs of psychological abuse may occur along with other types of abuse. These include:
  • Depression, hopelessness, helplessness or thoughts of suicide

  • Uncommunicative and unresponsive

  • Unreasonably anxious (mild to severe), fearful or suspicious

  • Lack of interest in social contacts

  • Chronic physical or mental health problems

  • Evasiveness

  • Confusion or disorientation

  • Agitation

  • Hyper-vigilance

  • Trembling, clinging, cowering or lack of eye contact

Financial Abuse or Exploitation

Signs that someone may be taking advantage financially of a senior include:
  • The older adult is unaware of monthly income

  • Life circumstances don’t match what is known about the individual’s financial assets

  • Large withdrawals from bank accounts, switching accounts, unusual ATM and banking activity

  • Signature on checks don’t match elder’s signature

  • Frequent checks made out to “cash”

  • Bank statements, credit card statements, etc., do not get sent to the older adult

  • Numerous unpaid bills

  • Documents are drawn up for the elder to sign but the elder can not explain or understand the purpose of the papers

  • Caregiver refuses to spend money on the older adult

  • Personal belongings (jewelry, art, furs, papers, credit cards, etc.) are missing

  • Recent acquaintances declare undying affection for the older adult and isolate him or her from friends and family members. Sometimes, the acquaintance promises lifelong care in exchange for the older adult’s deeding all property or assets to the acquaintance/caregiver, etc.

  • Caregiver’s name added to bank account

Neglect

Signs of possible neglect include:
  • Signs of malnourishment (e.g., sunken eyes or loss of weight)

  • Dehydration (extreme thirst)

  • Pressure (bed) sores

  • Chronic health problems -- physical, psychiatric or both

  • Evidence that personal care is neglected or lacking -- unbrushed or washed hair, unbrushed teeth or signs of not bathing

  • Soiled clothing or bedding

Caregiver Behaviors That May Signal Possible Elder Abuse

Certain behaviors on the part of a caregiver may be signs that the caregiver is neglecting or abusing an elder. These signs include:
  • Talks of elder as a burden

  • Keeping the elder from speaking to or seeing friends and family

  • Angry, aggressive or indifferent behavior towards the elder

  • Lack of affection toward the elder

  • Conflicting accounts of incidents

  • Coyness or flirtation. These maybe signs of an inappropriate sexual relationship.

How to Report Abuse

If the abuse occurred in a long-term care facility, report to the nearest Long-Term Care Ombudsman office or the local law enforcement agency AND the appropriate regulatory agency:
  • When reporting abuse in nursing home, report to Department of Public Health Licensing and Certification at (800)228-1019.
  • When reporting abuse in board and care or assisted living facility, contact Community Care Licensing at (818)596-4334 and ask for the 'senior care on duty worker'

If the abuse occurred in the community, contact Adult Protective Services at (213)351-5401.