Clinical Manifestations

Certain behavioral and physical signs should raise suspicion for elder abuse. Behavioral signs in the caregiver include answering for the patient, insisting on being present for the entire visit, failing to offer assistance, and displaying indifference or anger. Behavioral signs in the elderly patient include poor eye contact, hesitation to talk openly, or fearfulness toward the caregiver. Other indicators of possible abuse include confusion, paranoia, anxiety, anger, and low self-esteem. Physical signs that may signal neglect include poor hygiene, malnutrition, dehydration, pressure ulcers, and injuries (Table 4-7). Medication nonadherence may also be a warning sign for abuse.

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