What Are The Warning Signs of Abuse and Neglect?

Abuse and neglect in long-term care facilities for the elderly is usually difficult to notice.  Studies from the National Institute on Aging (NIA) indicate that as many as 1 in 10 elders experience some form of abuse each year, and figures from the World Health Organization (WHO) show that on average just 1 out of 24 cases of abuse are reported each year.

Some elders can also be at a greater risk of elder abuse based on a number of factors.  These include mental capacity, age, gender, and whether the elder resides in a community setting.  Multiple studies have corroborated that older adults with diminished psychosocial capacities, such as a diagnosis of a cognitive condition such as dementia or Alzheimer’s disease, increases the risk that the elder will be a victim of abuse, as these elders are likely unable to report the abuse or protect themselves.  The WHO and the Department of Health and Human Services additionally report that elders that are isolated, as well as elderly women, are also at a greater risk of abuse.

Although not all injuries that occur in nursing homes and assisted living facilities amount to abuse or neglect, it is important to be on the lookout for red flags and warning signs to abuse to better protect your loved ones during their residency.

Common Red Flags

The primary indicator of elder abuse or neglect is the unusual or abrupt unexpected change to your loved one’s physical, mental, or financial condition.  Signs of physical abuse and neglect are arguably the most noticeable, with common signs including:

  • Strange or unexpected physical injuries, such as skin tears, welts or bruises, scrapes, burns, or cuts to the body
  • Unexplained head injuries or concussions
  • Broken or fractured bones
  • Being left alone for extended periods without supervision
  • Poor hygiene and/or unsafe living conditions
  • Pressure marks or sores
  • Extreme unexplained weight loss or malnutrition
  • Dehydration
  • Missing personal items, such as glasses, hearing aids, and medications

It is important to stay vigilant and frequently check in with your loved one, as sadly, it is sometimes the case that facilities will go to great lengths to attempt to conceal or cover up the injuries your loved one may have suffered.  It is as essential to also keep a watchful eye on those caregivers tending to your loved one, as often the abuse or neglect comes from the direct caregiver.

Additionally, and although it may be rare, sexual abuse does occur in the elderly long-term care setting. This type of abuse can be committed by facility staff, but it also may result from unsupervised residents or even individuals who enter the facility unauthorized.  The following red flags may indicate sexual abuse:

  • Unexplained injuries on or near the genital area, including bruising, bleeding, pain, or irritation
  • Contraction of a sexually-transmitted infection
  • Acting fearful, angry, and/or depressed around certain individuals
  • Inappropriate interactions with staff, other residents, or other individuals

In addition to these physical manifestations, there are also a number of mental or behavioral indicators abuse and neglect, which can include:

  • Radical and sudden changes in mood, including acting confused, anxious, fearful, angry, and/or depressed
  • Withdrawal and isolating oneself from social activities, including with family and friends
  • Unexplained lethargy or exhaustion

It is significant to notice your loved one’s mental well-being during their transition to long-term care.  It may be the case that a sudden unexpected change in their mood is evidence of abuse or neglect.

Lastly, unlike physical abuse and neglect, financial abuse may go undetected as indicators of this type of abuse are not easily noticed.  Red flags to look out for in the context of financial abuse include:

  • Unexpected or unexplained transactions of large sums of money
  • Sudden executions of legal documents on behalf of the elder, such as a power of attorney, marriage certificate, and transferring of property
  • Inaccessibility of financial and legal records

In addition to checking in on the physical and mental well-being of your loved one, it is also important to monitor your loved one’s financial accounts and investigate any suspicious transactions.  Strange or unexpected actions involving your loved one’s finances could be evidence of financial elder abuse.


Indicators of elder abuse and neglect are different in each case, and some elders may be subjected to more than one type. In order to protect your loved one, it is important to keep a watchful eye and report any of these indicators of abuse as soon as possible.

If you suspect that your loved one is in immediate danger, call 911 or the local law enforcement authorities immediately.  You may also consider contacting Adult Protective Services or the appropriate governing state agency as soon as possible.

If you believe that a loved one is a victim of abuse or neglect, you may also consider contacting an elder abuse attorney for a consultation.  Yeroushalmi Law is dedicated to holding nursing homes accountable when patient injury results from abuse and neglect. Call us today for a no-cost consultation.


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