• Unexplained signs of injury such as bruises, welts, or scars, especially if they appear symmetrically on two sides of the body
• Broken bones, sprains, or dislocations
• Report of drug overdose or apparent failure to take medication regularly (a prescription has more remaining than it should)
• Broken eyeglasses or frames
• Signs of being restrained, such as rope marks on wrists • Caregiver’s refusal to allow the elder to be seen alone

In addition to the general signs above, indications of emotional elder abuse include:

• Threatening, belittling, or controlling caregiver behavior that is witnessed
• Behavior from the elder that mimics dementia, such as rocking, sucking, or mumbling to oneself

• Bruises around breasts or genitals
• Unexplained venereal disease or genital infections
• Unexplained vaginal or anal bleeding
• Torn, stained, or bloody underclothing

• Unusual weight loss, malnutrition, dehydration
• Untreated physical problems, such as bed sores
• Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
• Being left dirty or unbathed
• Unsuitable clothing or covering for the weather
• Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards)
• Desertion of the elder at a public place

• Significant withdrawals from the elder’s accounts
• Sudden changes in the elder’s financial condition • Items or cash missing from the senior’s household
• Suspicious changes in wills, power of attorney, titles, and policies
• Addition of names to the senior’s signature card
• Unpaid bills or lack of medical care, although the elder has enough money to pay for them
• Unnecessary services, goods, or subscriptions

• Duplicate billings for the same medical service or device
• Evidence of overmedication or under-medication
• Evidence of inadequate care when bills are paid in full
• Problems with the care facility:
  • Poorly trained, poorly paid, or insufficient staff
  • Crowding
  • Inadequate responses to questions about care