Arizona Attorney General

Mark Brnovich

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Types of elder abuse and the warning signs

Elder abuse is not just as simple (and horrible) as hitting an older person. It is carried out in many ways besides physical pain or injury. It is important to know that elder abuse is exhibited in many ways. Many elder abuse victims are subjected to multiple types of abuse.

The following descriptions may not necessarily be proof of abuse, neglect, or exploitation, but may be clues that a problem exists and that a report needs to be made to law enforcement or Adult Protective Services.

Physical Abuse: the intentional infliction of physical pain or injury, injury caused by criminally negligent acts or omissions and/or unlawful imprisonment or use of physical restraints that result in physical pain or impairment

Warning signs:

  • Unexplained bruises, welts, sores, cuts or abrasions in places they would normally not be expected
  • Bruising and other injuries may be in different stages of healing
  • Bruising or other markings reflect the shape of the objects used to inflict the injuries such as electrical cord or belt buckles
  • Bruising on upper arms from shaking
  • Fractures in different stages of healing
  • Cigar and cigarette burns
  • Rope burns on arms/wrists, legs/ankles from improperly tying or bandaging the elderly victim
  • Injury that has not been cared for properly
  • Injury that is inconsistent with explanation for its cause
  • Pain from touching
  • Dehydration or malnutrition without illness-related cause
  • Poor coloration
  • Sunken eyes or cheeks
  • Inappropriate administration of medication
  • Soiled clothing or bed
  • A history of doctor or emergency room "shopping"
  • Lack of personal effects, pleasant living environment, personal items
  • Forced isolation
  • Repeated time lags between the time of any "injury or fall" and medical treatment
  • Fear
  • Non-responsiveness, resignation, ambivalence
  • Contradictory statements, implausible stories
  • Hesitation to talk openly
  • Confusion or disorientation

Sexual Abuse: non-consensual sexual contact of any kind with an older adult

Warning signs:

  • Unexplained genital infections or sexually transmitted diseases
  • Torn or bloody underclothes
  • Difficulty walking or sitting
  • Victim is withdrawn, shameful, anxious and fears touching

Psychological/Emotional Abuse: infliction of mental pain, anguish, or distress through verbal or nonverbal acts such as name calling, insulting, ignoring, threatening, isolating, demeaning and controlling behavior

Warning signs:

  • Fearful of speaking for oneself in the presence of caretaker
  • Trembling, clinging, cowering, lack of eye contact
  • Anxious to please
  • Eating disorders
  • Self medication with alcohol or prescription medications
  • Depression
  • Agitation
  • Withdrawal
  • Anger
  • Low self-esteem

Financial Abuse/Exploitation: the illegal or improper use of an incapacitated or vulnerable adult or his/her resources for another’s profit or advantage

Warning signs:

  • Accompanied by a stranger to the bank who encourages them to withdraw large amounts of cash
  • Accompanied by a family member or other person who seems to coerce them into making transactions
  • Unusual banking activity such as large withdrawals during a short time period, switching from one bank to another, ATM activity by a homebound older adult
  • Older adult not allowed to speak for themselves or make decisions
  • Implausible explanation about what they are doing with their money
  • Concerned or confused about "missing" funds from their accounts
  • Neglect of needs or receiving insufficient care to meet their needs
  • Isolated from others, even family members
  • Unable to remember financial transactions or signing paperwork
  • Frequent expensive gifts from elder to caregiver
  • Older adult's personal belongings, papers and credit cards are missing
  • Numerous unpaid bills
  • A recently written will when person seems incapable of writing will
  • Bank and credit card statements no longer come to the older adult
  • Caregiver's name added to bank account
  • Older adult unaware of monthly income
  • Older adult signs on loan
  • Frequent checks made out to 'cash'
  • Unusual activity in bank account
  • Irregularities on tax return
  • Older adult unaware of reason for appointment with banker or attorney
  • Caregiver's refusal to spend money on older adult
  • Signatures on checks or legal documents that do not resemble older adult's

Neglect: a pattern of conduct without the person’s informed consent resulting in deprivation of food, water, medication, medical services, shelter, cooling, heating or other services necessary to maintain minimum physical or mental health

Warning signs:

  • Bedsores (pressure sores)
  • Unkempt, dirty, body odor, feces on body
  • Clothing is insufficient or inappropriate for the weather
  • Fleas & lice on individual
  • Malnourished & dehydrated
  • Little or no food available
  • Soiled or urine soaked bedding
  • Unsanitary/unsafe living conditions
  • Indications of unusual confinement
  • Improper use of medication
  • Victim appears detached, unresponsive, helpless