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Recognize the Warning Signs

Common Warning Signs of Abuse, Neglect and Exploitation
http://vajp.org/wp-content/uploads/2013/06/Common-Warning-Signs.pdf | http://vajp.org/wp-content/uploads/2013/06/Common-Warning-Signs-2.pdf

What are the Signs of Financial Exploitation?

  • Recent changes in property titles, deeds, refinances mortgages, Power of Attorney documents, wills, trusts, or other related documents
  • Sudden changes in bank accounts or banking practice, including an unexplained withdrawal of large sums of money
  • Substandard care being provided or bills unpaid despite the availability of adequate financial resource
  • Frequent checks for cash are written to a caregiver or financial professional
  • The vulnerable adults is reluctant to talk about once-routine topics
  • Large, frequent gifts are made to a caregiver
  • A caregiver is evasive or expressive excessive interests about financial arrangements
  • The vulnerable adult is unaware of or does not understand financial arrangements that have been made for him or her
  • Sudden appearance of previously uninvolved relatives claiming rights to a vulnerable adult’s possessions
  • A report by the vulnerable adult of exploitation


What are the Signs of Neglect?

  • Physical Indicators
    • Poor personal hygiene including soiled clothing, dirty nails and skin, matted or lice infested hair, odors, and the presence of feces or urine
    • Unclothed, or improperly clothed for weather
    • Skin rashes
    • Sunken area under the eyes and around the cheek bones
    • Dehydration, evidence by low urinary output, dry fragile skin, dry sore moth, apathy, lack of energy, and mental confusion
    • Unusual weight loss or malnutrition
    • Untreated medical or mental conditions including infections, soiled bandages, and unattended fractures, bed sores
    • Absence of needed dentures, eyeglasses, hearing aids, walkers, wheelchairs, braces, or commodes
    • Exacerbation of chronic diseases despite a care plan
    • Worsening dementia
    • Left alone or locked up for extended periods of time
    • Pressure Ulcers: Pressure ulcers occur due to pressure reducing blood flow to an area of skin until the tissue dies. They may also be commonly referred to a bedsores or pressure sores. They most commonly occur on bony prominences. Although pressure ulcers/sores may occur despite good care, warning signs indicating abuse or neglect include:
      • Unusual location (not bony prominences)
      • Stinking wound
      • Multiple locations and on more than one plane of the body
      • Non obvious attempt at care/treating, especially for deeper wounds (e.g. a lot of dead tissue or debris)
      • Behavioral indicators
        • Observed in the caregiver/abuser
          • Expresses anger, frustration, or exhaustion
          • Isolates the elder from the outside world, friends, or relatives
          • Obviously lacks care giving skills
          • Is unreasonably critical and/or dissatisfied with social and health care providers and changes providers frequently
          • Refuses to apply for economic aid or services for the elder and resists outside help
  • Observed in the vulnerable adult
    • Is emotionally numb, withdrawn, or detached
    • Exhibits regressive behavior
    • Exhibits self-destructive behavior
    • Exhibits fear toward the caregiver
    • Expresses unrealistic expectations about their care (e.g., claiming that their care is adequate when it is not or insisting that the situation will improve)
    • Signs of Self-Neglect
      • Hoarding
      • Failure to take essential medications or refusal to seek medical treatment for serious illness or injuries
      • Unsafe living conditions, including leaving a burning stove unattended, no heat, no running water, faulty electrical wiring or other fire hazards.
      • Poor hygiene
      • Not wearing suitable clothing for the weather
      • Confusion
      • Inability to attend to housekeeping
      • Dehydration

    What are the Signs of Physical Abuse?

    • Physical Indicators
      • Sprains, dislocations, fractures or broken bones
      • Burns from cigarettes, appliances, or hot water
      • Abrasions on arms, legs, or torso that resemble rope or strap marks
      • Internal injuries evidenced by pain, difficulty with normal functioning of organs, and bleeding from body orifices
      • Bruises. The following types of bruises are rarely accidental:
        • Bilateral bruising to the arms (may indicate that the person has been shaken, grabbed, or restrained)
        • Bilateral bruising of the inner thighs (may indicate sexual abuse)
        • “Wrap around” bruises that encircle an older person’s arms, legs, or torso (may indicate that the person has been physically restrained)
        • Multicolored bruises (indicating that they were sustained over time)
    • Injuries healing through “secondary intention” (indicating that they did not receive appropriate care
    • Signs of traumatic hair and tooth loss
    • Broken eyeglasses/frames, or any physical signs of being punished or restrained
    • A vulnerable adult’s own report of being hit, slapped, kicked, or mistreated
    • Report of drug overdose or apparent failure to take medication regularly (a prescription has more or less remaining than it should)
    • Behavioral Indicators
          • Injuries are unexplained or explanations are implausible (they do not “fit” with the injuries observed)
          • Family members provide different explanations of how injuries were sustained
          • A history of similar injuries, and/or numerous or suspicious hospitalizations
          • Victims are brought to different medical facilities for treatment to prevent medical practitioners from observing a pattern of abuse
          • Delay between onset of injury and seeking medical care

    The caregiver refuses to allow visitors to see a vulnerable adult alone

    What are the Signs of Sexual Abuse?

    Physical Indicators

    • Genital or anal pain, irritation, or bleeding
    • Bruises on external genitalia or inner thighs
    • Difficulty walking or sitting
    • Torn, stained, or bloody underclothing
    • Sudden exacerbation of existing illnesses
    • Sexually transmitted diseases
    • A vulnerable adults report of being sexually assaulted or raped

    Behavior Indicators

    • Inappropriate sex-role relationship between vulnerable adult and caregiver
    • Inappropriate, unusual, or aggressive sexual behavior
    • Post-Traumatic Stress Disorder (PTSD)
    • Extreme agitation
    • Panic attacks
    • Sleep disturbances, such as insomnia

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