Family members are often the first to recognize elder neglect or abuse.

Neglect
Signs and symptoms of neglect include but are not limited to:

• dehydration, malnutrition, untreated bed sores, and poor personal hygiene
• unattended or untreated health problems
• hazardous or unsafe living condition/arrangements (e.g., improper wiring, no heat, or no running water)
• unsanitary and unclean living conditions (e.g. dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing)
• an elder's report of being mistreated

Physical Abuse
Signs and symptoms of physical abuse include but are not limited to:

• bruises, black eyes, welts, lacerations, and rope marks
• bone fractures, broken bones, and skull fractures
• open wounds, cuts, punctures, untreated injuries in various stages of healing
• sprains, dislocations, and internal injuries/bleeding
• broken eyeglasses/frames, physical signs of being subjected to punishment, and signs of being restrained
• laboratory findings of medication overdose or under utilization of prescribed drugs
• an elder's report of being hit, slapped, kicked, or mistreated
• an elder's sudden change in behavior
• caregiver's refusal to allow visitors to see an elder alone