Possible indicators of ph

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ysical abuse

• cuts, lacerations, puncture wounds
• bruises, welts, discolouration
• 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
• fear
• hesitation to talk openly
• withdrawal
• implausible stories
• depression
• confusion or disorientation
• denial
• anger
• agitation

Indicators of possible financial abuse

• unusual or inappropriate activity in bank accounts
• signatures of cheques, etc., that do not resemble the older person's signature, or signed when older 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 older person
• numerous unpaid bills, overdue rent, when someone is supposed to be paying the bills for a dependent elder
• 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 jewellery
• deliberate isolation, by a housekeeper, of an older adult from friends and family, resulting in the caregiver alone having total control

Elders may be financially exploited if they are:

• accompanied by a stranger who encourages them to withdraw a large amount of cash
• accompanied by a family member or other person who seems to coerce them into making transactions
• not allowed to speak for themselves or make decisions
• with an acquaintance who appears too interested in their financial status
• nervous or afraid of the person accompanying them
• giving implausible explanations about what they are doing with their money
• concerned or confused about 'missing funds' in their accounts
• unable to remember financial transactions or signing paperwork
• fearful that they will be evicted or institutionalised if money is not given to a caregiver
• neglected or receiving insufficient care for their needs or financial status
• isolated from other family members or supports by a family member of acquaintance

Symptoms of financial exploitation - suspicious banking activity

• unusual volume of banking activity
• frequent account changes from one branch/bank to another
• change in pattern of withdrawals (e.g. several in one day) or unusually large amounts
• large withdrawals or transfers from recently opened joint accounts
• banking activity inconsistent with customer's usual habits
• large withdrawal from previously inactive account or savings account
• frequent withdrawals made through ATMs, especially if elder is physically frail and had not used ATM previously
• regular rent or utility payments by cheque cease abruptly
• stable, single beneficiary trusts are revoked
• distribution provisions are altered to require payments to third parties
• suspicious signatures on cheques or other documents, like credit card applications
• elder's signature appears forged
• cheques /withdrawal slips made out in one handwriting, elder's signature appears correct
• sudden increases in incurred debt when elder appears unaware of transactions
• bank loans obtained
• large credit card or reserve credit debts
• second mortgages obtained
• a fiduciary or other begins handling the elder's affairs, withdrawing funds with no apparent benefit to the elder
• bank statements and cancelled cheques are no longer sent to the elder's home
• implausible reasons for banking activity are given either by the elder or the person accompanying him/her

Possible indicators of neglect by caregiver

• dirt, faecal/urine smell, or other health and safety hazards in elder's living environment
• rashes, sores, lice on elder
• elder is inadequately clothed
• elder is malnourished or dehydrated
• elder 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 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 elder (e.g. accusation that incontinence is a deliberate act)
• aggressive behaviour (threats, insults, harassment) by caregiver toward the elder
• previous history of abuse of 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 adult within the family unit by the caregiver
• conflicting accounts of incidents by family, supporters, or victim
• unwillingness or reluctance by the caregiver to comply with caregiver to comply with service providers in planning for care and implementation
• inappropriate or unwarranted defensiveness by caregiver

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