Indication of Abuse

Indicators of Abuse, Neglect and
Financial Exploitation of the Elderly

If you have questions, or wish to make a report of elder abuse, neglect, or financial exploitation, call the Crisis Intervention Unit at BayPath Elder Services, Inc., 9:00 a.m. - 5:00 p.m. at (508) 872-1866 or 1-800-287-7284. During non-business hours, call the 24-hour Elder Abuse Hotline at 1-800-922-2275.

Physical Abuse
Sexual Abuse
Emotional Abuse
Neglect
Financial Exploitation
Elder-at-Risk Program
Protective Services Program


Physical Abuse
The non-accidental infliction of serious physical injury by someone with whom the elder has a personal relationship or the threat of serious physical injury when the person has the intent and capacity to carry out the threat. Physical Indicators: Unexplained bruises, lacerations, fractures Frequent falls by elder Hypothermia Behavioral Indicators: Elder Reports to having been hit, slapped, punched, pushed, or threatened with physical harm Elder shows fear Injuries inconsistent with explanation, explanation varies over time Behavioral Indicators: Person alleged to have caused harm Person reports to having hit, slapped, punched, pushed, or threatened to harm the elder Is rough in the moving or turning of the elder Is verbally abusive to the elder Refuses outside intervention despite need Speaks for the elder Is defensive of the quality of care provided to the elder Rationalizes abusive behavior, "Everybody fights sometimes"
Sexual Abuse
Sexual assault, rape, sexual misuse, or sexual exploitation, or threat of sexual abuse when it is believed the individual has the intent and capacity to carry out the threat by a person with whom the elder has a personal relationship. Physical Indicators: Elder Trauma about the genitals, rectum, mouth, breasts Presence of sexually transmitted disease, particularly if the elder is not engaged in consenting sexual activity Injury to face, neck, chest, abdomen, thighs, buttocks Behavioral Indicators: Elder Post-Traumatic Stress Disorder Fear, anxiety, mistrust Shame, humiliation Strong ambivalent feelings regarding the beloved person alleged to have caused harm Extreme upset when bathed, toileted, changed Behavioral Indicators: Person alleged to have caused harm Alcoholism or other drug addiction Reluctance to allow others access to the elder Statements indicating view of the elder as (sexual) property Husband physically abusive towards wife History of sexual offending (Indicators of sexual abuse are taken from Sexual Abuse Workshop by Holly Ramsey-Klawsnik, Ph.D.)
Emotional Abuse
The non-accidental infliction of serious emotional injury by someone with whom the elder has a personal relationship. Behavioral Indicators: Elder Appears intimidated or fearful Maintains minimal eye contact Exhibits changes in sleeping or eating habits Reports being yelled at or threatened Appears worried, easily upset Shows depressed affect Behavioral Indicators: Person alleged to have caused harm Insults, yells, or swears at elder Threatens to harm elder or place in nursing home against elder's wishes Does not allow elder to have contact with others
Neglect
Failure or refusal of a caregiver to provide basic necessities which results in serious physical harm to the elder or imminent physical harm to the elder. The caregiver is defined as the person(s) (family member, friend, neighbor, conservator, or legal guardian) responsible for the care of the elderly person. This person must be providing substantial care which enables the elder to remain safely in the community. Note that self-neglect, which indicates there is no caregiver, is not reportable to Protective Services. These elders may be appropriate for the Elder-at-Risk Program at BayPath. Physical Indicators: Elder has poor personal hygiene: dirty, urine or feces smell, or presence of urine or feces Bedsores: dirty, uncared for, infected Dehydration Weight loss/malnutrition/no evidence of appropriate food in the house Changes in physical status due to lack of medication (i.e., cardiac medications, insulin, or tranquilizers) Evidence of sores or trauma requiring medical attention Lack of medical compliance Unsafe living conditions Behavioral Indicators: Elder Increased lethargy Changes in mental status Seems afraid of caregiver Will eat or drink when food or liquids are offered from people other than the caregiver Makes excuses for caregiver as to why care is not being provided Expresses feelings of not wanting to or no reason to live Denial of problem despite evidence Unrealistic expectation that problem will go away Behavioral Indicators: Caregiver Expresses inability to care for the elder Refuses to acknowledge care required by the elder Caregiver speaks for elder Expresses excessive concern about the elder's behavior, dementia, or disruption of lifestyle Rationalizes behavior, "I have my own life to live and I can't do everything"
Financial Exploitation
An act or omission by a person without the informed consent of the elder which causes a substantial monetary or property loss to the elder or gain to the other person. The elder must have a personal relationship with the other person such as a family member, friend, neighbor, or fiduciary. Indicators: Unusual or inappropriate activity in elder's bank accounts Care of the elder not commensurate with the size of the estate Implausible explanations about the finances of the elder Elder is unaware of or does not understand financial arrangements that have been made (Indicators of exploitation from Financial Abuse by Lois Trapp)

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