Elder Abuse

If you identify that a client is in a high risk care situation, you should ask gently but directly about abuse. While this is difficult for both of you, clients and even abusers are frequently willing to respond to direct questions. The following are clues to possible elder abuse:

Physical Abuse

  • Apparent fear or intimidation
  • Client doesn’t talk in presence of caregiver
  • Lack of eye contact between client and caregiver or with care manager
  • Over use of physical restraint
  • Constant heavy sedation
  • Physical injuries which cannot be adequately explained


  • Ongoing lack of food or drink
  • Isolation
  • Injuries or episodes (e.g. getting lost) due to lack of supervision
  • Inadequate personal care in a dependent client
  • Urine burns or skin breakdown
  • Frequent urinary tract infections or fecal impaction
  • Caregiver non-compliant with client’s medications or medical care
  • Excessive delay in seeking needed medical care
  • Episodes of dehydration

Financial Abuse

  • Discrepancies between a person’s financial assets and their standard of living
  • A person repeatedly says they cannot afford something

Many cases of elder abuse have gone unreported because no one ever asked directly. Tailor questions for your client or the caregiver based on the circumstances you witness, and follow-up with questions about when and who, if appropriate and possible.