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- Excessive number of old medicine bottles with outdated prescriptions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