The Ultimate 200-Point Checklist to Identify Elder Abuse.

A Guide for Families, Caregivers, and Advocates

Elder abuse is often a silent epidemic—one that hides behind closed doors, subtle behaviors, or seemingly harmless oversights. It affects millions of seniors every year and comes in many forms: physical, emotional, financial, sexual, and neglect. Understanding the signs of elder abuse early is critical for prevention and protection. Whether the abuse occurs at home, in a facility, or under the care of a trusted individual, it often goes unnoticed until serious harm is done.

At Hackard Law, we believe in empowering families with the tools they need to recognize the signs of abuse early. This 200-point checklist is designed for families, social workers, caregivers, and legal advocates to identify red flags and take swift action. While not every item alone proves abuse, the presence of multiple signs of elder abuse may warrant closer investigation or professional help.While not every item alone proves abuse, the presence of multiple signs may warrant closer investigation or professional help.

🔎 PHYSICAL ABUSE (SIGNS ON THE BODY AND BEHAVIOR)

1. Unexplained bruises
2. Frequent “accidental” injuries
3. Burns or scalds
4. Welts in the shape of objects (belts, cords)
5. Multiple fractures at various stages of healing
6. Fingerprint bruising
7. Black eyes
8. Rope marks or restraints
9. Fear of physical contact
10. Flinching when approached
11. Refusal to undress in front of others
12. Sudden hearing loss or complaints
13. Eye injuries
14. Bite marks
15. Lacerations without explanation
16. Unusual hair loss (from pulling)
17. Infections or untreated wounds
18. Loss of appetite due to injury
19. Limping or trouble walking
20. Missed doctor appointments for injury treatment

💰 FINANCIAL ABUSE (MISUSE OF MONEY OR ASSETS)

1. Sudden bank account changes
2. Unexplained ATM withdrawals
3. Forged signatures on checks
4. Missing valuables or heirlooms
5. New “best friend” helping manage finances
6. Pressure to sign financial documents
7. Unpaid bills despite having adequate income
8. Legal documents with unusual changes
9. New joint accounts with non-family members
10. Transfer of property or deed under duress
11. Changes in power of attorney without explanation
12. Lack of basic needs (food, heat) despite resources
13. Discrepancies in spending habits
14. A caregiver or relative with new wealth
15. Isolation from family members after inheritance change
16. Threats linked to money or inheritance
17. Exploitation through scams or fraud
18. Suspicious signatures on legal papers
19. Elderly person appears confused about finances
20. Closed or inaccessible financial records

Understanding the legal avenues available is crucial when addressing financial exploitation. For a comprehensive guide on protecting your loved ones from estate exploitation, refer to Hackard Law’s Estate Exploitation: How to Protect Your Loved Ones

🗣️ EMOTIONAL & PSYCHOLOGICAL ABUSE (VERBAL OR NONVERBAL MISTREATMENT)

1. Yelling or shouting in front of the elder
2. Belittling or humiliating speech
3. Threats to withdraw care
4. Constant criticism or scapegoating
5. Manipulation or guilt-tripping
6. Controlling who the elder sees or talks to
7. Silent treatment
8. Withholding affection as punishment
9. Treating the elder like a child
10. Fear of specific individuals
11. Sudden onset of depression
12. Increased anxiety or panic
13. Self-harming behavior
14. Rocking, mumbling, or repetitive behaviors
15. Statements of worthlessness
16. Suicidal talk or hopelessness
17. Over-apologizing
18. Crying without explanation
19. Hypervigilance
20. Sudden changes in personality

❌ NEGLECT (FAILURE TO PROVIDE NECESSARY CARE)

1. Dehydration or malnutrition
2. Poor hygiene (unbathed, dirty clothes)
3. Bedsores
4. Unchanged soiled clothing or bedding
5. Lack of necessary medical aids (glasses, hearing aids)
6. Missed medical appointments
7. Unsafe living conditions (clutter, fire hazards)
8. Lack of heat or air conditioning
9. Expired or missing medications
10. Infections or untreated health issues
11. Skin rashes or infestations
12. Poor dental hygiene
13. Wearing inappropriate clothing for the season
14. Unwashed hair or foul odors
15. Dirty or unsafe home environment
16. Rotten or insufficient food in the home
17. Isolation or abandonment
18. Failure to supervise someone with dementia
19. Inaccessible bathroom facilities
20. Refusal to let others provide help

🚨 SEXUAL ABUSE (UNWANTED TOUCHING OR BEHAVIOR)

1. Bruising around breasts or genitals
2. Torn or bloody undergarments
3. Sexually transmitted infections
4. Vaginal or anal bleeding
5. Sudden withdrawal from social contact
6. Fear of specific people or settings
7. Inappropriate comments by caregiver
8. Unexplained behavioral regression
9. Discomfort with physical exams
10. Attempt to run away or hide
11. Reports of assault (even if inconsistent)
12. Clutching or guarding genital area
13. Incontinence without medical reason
14. Sexual references beyond elder’s norm
15. Reluctance to be alone with specific individual
16. Refusal of care or hygiene assistance
17. Sudden obsession with personal safety
18. Frequent urinary tract infections
19. Fear or confusion during touch
20. Sexualized behavior out of character

👩‍⚖️ LEGAL & DOCUMENTARY RED FLAGS

1. Sudden changes to estate plans
2. Revocation of power of attorney under pressure
3. Conflicting versions of wills or trusts
4. Unavailable or missing legal documents
5. Legal paperwork signed under suspicious circumstances
6. Involvement of unqualified notaries or witnesses
7. Newly appointed legal representatives with no connection to the elder
8. Pre-signed blank forms
9. Signing without reading or understanding
10. Language barriers exploited during signing
11. No copy of estate plan available to family
12. Documents created in secrecy
13. Misinformation provided to the elder before signing
14. Family kept in the dark about legal decisions
15. Unrecorded real estate transfers
16. Changes to life insurance beneficiaries
17. Trusts with unexpected terms
18. Duplicate legal forms with altered content
19. Dismissive responses to legal questions
20. No clear reason for recent changes

🏠 SIGNS IN CARE FACILITIES OR AT HOME

1. Staff reluctance to answer questions
2. Elder seems overly medicated or sedated
3. High staff turnover
4. Complaints from other residents
5. Lack of supervision
6. Missing personal items
7. Dirty living space
8. Elder not participating in activities
9. Staff ignoring elder’s basic needs
10. Doors locked or restricted access
11. Elder left unattended for long periods
12. Inconsistent reporting of incidents
13. Hostility from staff when questioned
14. Understaffed facility
15. Elder’s complaints dismissed by staff
16. Lack of privacy or dignity
17. Improper use of restraints
18. Delay in medical treatment
19. Mismatched medical records and observations
20. Overuse of antipsychotic drugs

🧠 COGNITIVE DECLINE AND ABUSE VULNERABILITY

1. Elder diagnosed with dementia or Alzheimer’s
2. Frequent memory loss or confusion
3. Paranoia or delusions
4. Forgetting financial arrangements
5. Repeating same questions
6. Disorientation in familiar surroundings
7. Wandering or getting lost
8. Inability to identify family
9. Hallucinations
10. Trouble following conversations
11. Easily manipulated or persuaded
12. Inability to report abuse
13. Fear of not being believed
14. Loss of judgment
15. Suspicious caregivers discouraging interaction
16. Caregiver answers all questions for elder
17. Elder appears coached
18. Contradictory statements about recent events
19. Cognitive test results not shared with family
20. Confusion over identity of caregiver

💬 VERBAL DISCLOSURES & HINTS

1. Elder states “they’re taking my money”
2. “They hit me”
3. “I’m scared”
4. “I’m not allowed to leave”
5. “I don’t know what happened to my things”
6. “They said I’ll be punished if I tell”
7. “I’m a burden”
8. “I don’t want to live anymore”
9. “They said not to tell you”
10. “They yell at me”
11. “I don’t feel safe”
12. “I don’t understand what I signed”
13. “They keep changing the rules”
14. “They never listen to me”
15. “They treat me like I’m stupid”
16. “They make me feel bad for needing help”
17. “They took my phone”
18. “They won’t let me call anyone”
19. “They told me I’m crazy”
20. “They say no one cares”

🧩 BEHAVIORAL PATTERNS TO MONITOR IN CAREGIVERS

Monitoring caregivers closely is essential, especially when multiple signs of elder abuse are present across different categories.

1. Defensive or hostile attitude
2. Isolating the elder from others
3. Speaking for the elder in all matters
4. Constantly supervising conversations
5. Overly controlling behavior
6. Signs of substance abuse
7. History of criminal behavior
8. Unexplained affluence
9. Discouraging visitors or phone calls
10. Inconsistent stories
11. Frequent absences or neglect
12. High-stress responses to questions
13. Lack of concern for elder’s wellbeing
14. Overuse of medication
15. Refusal to provide financial records
16. Prior reports of abuse
17. Denying access to basic resources
18. Using fear to influence decisions
19. Telling others “you don’t need to worry”
20. Expressing resentment toward the elder

Recognize, Respond, and Protect: A Call to Action

Elder abuse can be subtle, manipulative, and dangerous. The more we understand the signs of elder abuse, the better we can protect our loved ones and hold wrongdoers accountable. This checklist isn’t just a reference—it’s a call to action. If you recognize multiple red flags, don’t dismiss them. Trust your instincts, gather documentation, and contact a trusted elder law attorney immediately.

At Hackard Law, we’re committed to advocating for vulnerable seniors and their families. If you suspect abuse or exploitation, let us help you uncover the truth and fight for justice.

Contact us for a confidential consultation.