Help the person in your care identify a trusted person who can be called on for help. The Adult Protective Services Agency—a component of the human service agency in most states—is typically responsible for investigating reports of domestic elder abuse and providing families with help and guidance. Other professionals who may be able to help include doctors or nurses, police officers, lawyers, and social workers.

If you suspect elder abuse in an institutional setting, such as a nursing home, report concerns to your state long-term-care ombudsman.

Each state has such an ombudsman program to investigate and address nursing- home complaints. The National Center on Elder Abuse Web site maintains a list of phone numbers, by state, which you can call for assistance if you suspect domestic or institutional elder abuse. Visit www.elderabusecenter.org. If someone you care about is in imminent danger, call 911, police, or hospital emergency NOW.

Out-of-State Calls

If your concern is for someone who lives in another state, call the Elder Care Locator [(800) 677-1116] for the in-state phone number. The people who staff the locator can help you to find assistance. All these hotlines are free and anonymous.

Signs of Elder Abuse

Knowing the signs and symptoms of abuse can help you determine if there is a problem.

Signs and symptoms may include:

• Physical injury—bruises, cuts, burns or rope marks, broken bones or sprains that can't be explained.
• Emotional abuse—feeling of helplessness, a hesitation to talk openly, fear, withdrawal, depression, feelings of denial or agitation.
• Lack of physical care—malnourishment, weight loss, poor hygiene, as well as bedsores, soiled bedding, unmet medical needs.
• Unusual behaviors—changes in the person's behavior or emotional state such as withdrawal, fear, or anxiety, apathy.
• Changes in living arrangements.
• Unexplained changes such as the appearance of previously uninvolved relatives or newly met strangers moving in.
• Financial changes—missing money or valuables, unexplained financial transactions, unpaid bills despite available funds, and sudden transfer of assets.

Be alert to the senior's comments about being taken advantage of.

NOTE As many as 1.2 million seniors have been abused at some point in their lives. Those most at risk of being abused are people who suffer from dementia. Source: American Geriatrics Society.