Warning Signs of Elder Abuse

Frequent arguments or tension between the caregiver & the older adult

Changes in personality or behavior in the senior

Signs of physical abuse include:

Unexplained signs of injury such as bruises, welts, or scars, especially occurring symmetrically on both sides of the body
Broken bones, sprains, or dislocations
Report of drug overdose or apparent failure to take medication regularly (a prescription has more remaining than it should)
Broken eyeglasses or frames
Signs of being restrained, such as rope marks on wrists
Restricted access to the senior by caregiver

Signs of emotional abuse

Threatening, insulting, or controlling behavior by the caregiver witnessed by others
Behavior from the senior that mimics dementia, such as rocking, sucking, or mumbling to oneself

Sexual abuse

Bruises around breasts or genitals
Unexplained venereal disease or genital infections
Unexplained vaginal or anal bleeding
Torn, stained, or bloody underclothing

Neglect by caregivers or self-neglect

Unusual weight loss, malnutrition, dehydration
Untreated physical problems, such as bed sores
Unsanitary living conditions: dirt, bugs, soiled bedding and clothes
Being left dirty or unbathed
Unsuitable clothing or covering for the weather
Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards)
Desertion of the elder at a public place

Financial exploitation

Significant withdrawals from the elder’s accounts
Sudden changes in the elder’s financial condition
Items or cash missing from the senior’s household
Suspicious changes in wills, power of attorney, titles, and policies
Addition of names to the senior’s signature card
Unpaid bills or lack of medical care, although the elder has enough money to pay for them
Financial activity the senior couldn’t have done, such as an ATM withdrawal when the account holder is bedridden
Unnecessary services, goods, or subscriptions

Healthcare fraud and abuse

Duplicate billings for the same medical service or device
Evidence of over-medication or under-medication
Evidence of inadequate care when bills are paid in full
Problems with the care facility: poorly trained, poorly paid, or insufficient staff; crowding; inadequate responses to questions about care

If you see an older adult being abused or neglected:

Don’t hesitate to report the situation.

Don’t assume that someone else will take care of it or that the person being abused is capable of getting help if he or she really needs it.

To report abuse, neglect, or exploitation of an older person call 1.888.APS.TENN or 1.888.277.8366.


Tennessee Adult Protective Services

Tennessee Adult Protective Services (APS) also offers an online service for reporting suspicions of non-emergency abuse, neglect or exploitation of adults when the suspected abuse, neglect or exploitation took place in Tennessee.

If you believe the allegation you are reporting requires action in less than 24 hours, please contact the Adult Protective Services intake hotline at 1-888-APS-TENN (1-888-277-8366) or dial 911 if the situation is life-threatening.

If you are an elder who is being abused, neglected, or exploited:

  • Tell at least one person.
  • Tell your doctor, a friend, or a family member whom you trust.
  • Call 1-888-277-2366

COA taking action on elder abuse in Tennessee

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In order to learn more about what is presently being done to help the victims  of elder abuse and to develop solutions to any gaps, COA established in 2013 a work group around this topic.

Excellent participation and input continues to be shared from groups such as Adult Protective Services (APS), YWCA, You Have the Power, Metro Nashville Police Department, Securities Division of the TN Dept. of Commerce and Insurance, TN Vulnerable Adult Coalition (TVAC), TN State Ombudsman, FiftyForward, TN Commission on Aging and Disability, Legal Aid Society, Park Manor, Sexual Assault Center, Life Links, Metro Social Services and the Greater Nashville Regional Council.

The committee began by reviewing existing initiatives and their sustainability as well as learning of gaps and problems from those closest to the issue.

• Unfortunately, we learned that Tennessee is one of the few states where APS can only investigate financial exploitation if the action included a government-issued check.
• APS can only answer calls during workdays. Someone reporting a suspicion of abuse on a weekend will not receive a follow-up until Monday.

• Middle TN is without an affiliate organization as a member of TVAC. COA was asked to be the affiliate and we have applied for this position.

• The Tennessean published an opinion piece from the COA Executive Director on World Elder Abuse Awareness Day.

• The committee is helping APS re-design their internet referral forms by testing the process and providing feedback

• COA is working with a national foundation and other groups across the state to develop a network of emergency shelters for seniors who need help with activities of daily living, such as bathing and dressing. No shelter in our area can presently accommodate these frail seniors.

• To raise awareness among medical and law enforcement professionals, a sub-group is working on a special handout that presents the signs of elder abuse and what these professionals should do when they suspect abuse.

• COA is also working with banking personnel regarding training on the signs of financial exploitation and how to address suspicions.

COA realizes that this is a serious and far-reaching issue with no easy answers. We are committed to doing all that we can in terms of advocacy, materials and outreach to ensure the safety of our most vulnerable older adults.