Elder Abuse, Signs and Indicators

Physical

Behavior

> physical actions
> coercion, bullying
> physical restraint
> locking up in a room
> confining to chair or bed
> hitting, slapping, burning, pushing,
punching, pinching, biting, arm
twisting, cutting, hair pulling.

Signs/Indicators

> carer/relative – overly protective or controlling, conflicting stories, delay in seeking care or reporting an injury, does not leave person unattended, older person described as ‘accident prone’ or having a history of sustaining injuries
> physical – injuries in different stages of healing, broken bones, sprains, or dislocations, abrasions, welts, rashes, blisters, lacerations, swelling, signs of
being restrained, weight loss, hair loss, poor hygiene
> arousal – lack of awareness, drowsiness, vagueness,
confusion, sleepiness
> behavioral – cringing or acting fearful, agitation,
catatonia, frequent requests for care or treatment for
minor conditions, unexplained anger, fear or shutting
down behavior around the carer or relative.

Financial

Behavior

> forgery
> stealing
> forced changes to a will
> unusual transfers of money or
property
> withholding of funds from the older
person
> incurring debts for which the older
person is responsible
> failure of others to repay monies
loaned
> lack of financial information
provided to an older person by
their Power of Attorney

Signs/Indicators

> unpaid bills, inability of the older person to pay for
necessities
> defaulting on payments (e.g. rent, service fees)
> missing documents
> credit cards or personal belongings and unusual
activity in bank accounts
> changes to a will or other documents when appearing
incapable or subject to possible coercion
> confusion regarding assets property and income
> being accompanied by another person when
attending financial institutions or using ATM and the
other person is reluctant to allow a conversation with
the older person regarding transactions
> being overcharged for repairs or services, overdrawn
or depleted accounts.

Physiological

Behavior

> pressuring, intimidating or bullying
> name-calling, degrading or
humiliating
> threatening to harm the person,
other people or pets
> verbal abuse, insults or harsh
commands
> silencing and emotional blackmail
> talking about not coping as a carer
> repeatedly telling an older person
they have dementia, are a burden
or unwanted
> treating the person like a child

Signs/Indicators

Behaviors may fluctuate, and may show improvement
temporarily around some people, reverting back when
abuser returns.
> depression, sadness, tearfulness
> confusion, disorientation
> social isolation and withdrawal
> feeling helpless and ashamed
> insomnia, unexplained paranoia
> fearfulness, intimidation, nervousness, anxiety
> marked passivity, reluctance to make decisions,
> changes in self-esteem, lack of confidence
> anger, frustration
> rocking behavior
> changes in behavior around the abuser
> apathy, listlessness.

Social

Behavior

> restricting, stopping or
discouraging social contact with
others such as family or friends
> preventing, stopping or restricting
activities – either in the
community, or residential aged
care facility
> withholding mail
> prohibiting, preventing access or
not disclosing phone calls
> listening in to calls
> restricting participation in religious
or cultural practices.

Signs/Indicators

> loss of interaction with others
> sadness and grief of people not visiting
> worried or anxious after a particular visit by specific
person(s)
> appears shamed
> low self-esteem, or is very sad
> withdrawn
> passive (not wanting to participate; listless,
uninvolved)
> repeated unanswered phone messages.

Neglect

Behavior

> lack of social, cultural, intellectual
or physical stimulation
> lack of nutrition, accommodation,
clothing, medical or dental care
> lack of safety precautions or
supervision, injuries that have not
been properly cared for
> inappropriate medication
management
> repeated justifications or excuses
for older person’s absence or not
returning messages.

Signs/Indicators

Observations of neglect can be camouflaged by overly
attentive behavior in the company of others. Signs include:
> inadequate nutrition, accommodation, clothing,
> inadequate medical or dental care
> poor personal hygiene and skin integrity, exposure to unsafe, unhealthy, unsanitary conditions
> malnourishment and unexplained weight loss
> hypothermia or overheating
> the person left alone or unattended for long periods.

Sexual

Behavior

> physical actions – rape, sexual
assault, indecent assault, sexual
harassment
> non-physical actions – obscene
language or viewing obscene
material or making obscene phone
calls in the presence of the older
person without their consent.

Signs/Indicators

> physical – unexplained bruising, sexually transmitted diseases, infections, internal injuries, frequent
incontinence, difficulty walking, human bite marks, scratches, bruises, pain on touching, choke marks on
throat, burn marks, injury to face, neck, chest, abdomen, thighs or buttocks, trauma, including
bleeding around the genitals, chest, rectum or mouth, torn or stained clothing
> arousal – lack of awareness, drowsiness, vagueness,
confusion
> behavioral – fearfulness, agitation, disturbed sleep, withdrawal, lack of awareness
> medical – similar to physical
> carer/relative – overly protective or controlling, conflicting stories, attends appointments with older person, does not leave the older person unattended,
requests behavior that may be unusual

Chemical

Behavior

inappropriate use (underuse or
overuse) of prescribed medication
> failure to provide or supervise
medication
> taking prescriptions or dispensed
medications for addiction or
financial gain
> If the carer is a substance abuser,
he/she may be giving drugs or
alcohol to the older person.

Signs/Indicators

> over-sedation, reduced physical or mental activity, grogginess or confusion
> reduced or absent therapeutic response to prescribed treatment may be the result of under- medication, or failure to fill prescriptions
> pills scattered about may be signs of inappropriate use of drugs, medications and/or alcohol
> medical – reports of drug overdose, prescription medication missing or not taken, poor management of medical conditions, repeated accident or
emergency department presentation, frequent falls