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Home and Community Based Services Manual

8.00 Appendix 1 Abuse, Neglect and Exploitation Indicators

Home and Community Based Services Manual


8.00 Appendix 1 Abuse, Neglect and Exploitation Indicators

The following list contains typical indicators of abuse, neglect, and exploitation (ANE) for the reported adult (RA). This list, while not all inclusive, should serve as a guide for making a report of ANE.

ABUSE

  • PHYSICAL INDICATORS:
    • Unexplained bruises and welts
    • Bruises in the shape of an object
    • Unexplained fractures
    • Unexplained burns
    • Unexplained lacerations or abrasions
    • Broken bones
    • Injuries on the neck, bottom of feet or genitals
  • SEXUAL INDICATORS:
    • Sudden interest in sexual issues
    • Questions regarding pregnancy
    • Bruising on breasts or genital area
    • Acting out inappropriately in a sexual manner

NEGLECT

  • ENVIRONMENTAL:
    • Excessive garbage in home
    • Inadequate/exposed wiring
    • Rodent or insect infestation
    • Inadequate/unsafe structure such as holes in walls or ceiling of home
    • Inadequate/ no food in home
    • Inadequate/no utilities or shut-off notices for utilities
    • Inadequate/no plumbing or running water
  • PHYSICAL:
    • Inadequate/lack of personal hygiene: not clean, has bad odor, hair matted or tangled
    • Soiled clothing/bedding or same clothing all the time
  • MEDICAL:
    • Inadequate/lack of essentials: eyeglasses; hearing aid; teeth; walker; crutches; wheelchair; and/or other prosthetic devices.
    • Excessive number of old medicine bottles with outdated prescriptions
    • Inadequate/lack of medical care
    • Malnourishment and/or dehydration
    • Unhealed sores/untreated injuries
    • Untreated infections/conditions

EXPLOITATION

  • Eviction notices
  • Disparity between income/assets and lifestyle
  • Sudden or numerous changes to wills or powers of attorney
  • Property or money missing
  • Sudden change in banking practices
  • Unexplained/unauthorized bank withdrawals
  • Sudden lack of money or inability to purchase essentials
  • Unpaid bills

BEHAVIORAL INDICATORS

  • Destructive behaviors unusual to the reported adult
  • Yells obscenities at others
  • Assaults others
  • Tears up belongings of others or themselves
  • Threatens self-harm or suicide
  • Refuses needed life-sustaining services (medical care)
  • Inappropriately displays rage in public
  • Steals without an apparent need for the things stolen
  • New onset of depression or apathy
  • Anger
  • Withdrawal - stops talking to others, pulls away from usual social pursuits

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