How to Recognize Abuse?

Any Horizon NJ Health member has the right to receive care without facing abuse. Caregivers and professionals, including care providers, are required to report suspected abuse or neglect of any person, including:

Children or adults who resides in a community setting; and
Elderly adults living in nursing homes or other long-term care facilities

Types of abuse:

Physical Abuse – physical pain or injury caused by slapping, bruising, or restraining by physical or chemical means
Sexual Abuse – non-consensual sexual contact of any kind
Neglect – failure to provide food, shelter, health care, or protection
Exploitation – illegally taking, misuse, or concealment of funds, property, or assets for someone else's benefit
Emotional Abuse –mental pain, anguish, or distress caused by verbal or nonverbal acts
Abandonment – desertion of a vulnerable person by anyone who has responsibility for that person
Self-neglect –failure of a senior to perform everyday self-care tasks that threatens his/her own health or safety

If you think your loved one is the subject of abuse or neglect, report it immediately. How to report abuse?

Elder Abuse

The federal Administration on Aging has provides a list of signs to look for in possible cases of elder abuse. While one sign does not necessarily mean there is abuse, there are some telltale signs that there could be a problem:

Physical abuse – bruises, pressure marks, broken bones, abrasions, and burns
Emotional abuse – unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression
Sexual abuse – bruises around the breasts or genital area
Exploitation – sudden changes in financial situations
Neglect – bedsores, unattended medical needs, poor hygiene, and unusual weight loss
Emotional abuse – behavior such as belittling, threats and other uses of power and control

Child Abuse

The New Jersey Department of Children and Families provides a list of signs to look for in possible cases of child abuse and neglect.

Physical Abuse

Physical Indicators	Behavioral Indicators
Unexplained bruises and welts: On face, lips, mouth On torso, back, buttocks, thighs In various stages of healing Cluster, forming regular patterns Reflecting shape of article used to inflict (electric cord, belt buckle) On several different surface areas Regularly appear after absence, weekend or vacation Unexplained burns: Cigar, cigarette burns, especially on soles, palms, back or buttocks Immersion burns (sock-like, glove-like doughnut shaped on buttocks or genitalia) Patterned like electric burner, iron, etc. Rope burns on arms, legs, neck or torso Unexplained fractures: To skull, nose, facial structure In various stages of healing Multiple or spiral fractures Unexplained laceration or abrasions: To mouth, lips, gums, eyes To external genitalia	Wary of adult contacts Apprehensive when other children cry Frightened of parents Afraid to go home Reports injury by parents Behavioral extremes: Aggressiveness Withdrawal

Physical Indicators

Behavioral Indicators

Unexplained bruises and welts:

On face, lips, mouth
On torso, back, buttocks, thighs
In various stages of healing
Cluster, forming regular patterns
Reflecting shape of article used to inflict (electric cord, belt buckle)
On several different surface areas
Regularly appear after absence, weekend or vacation

Unexplained burns:

Cigar, cigarette burns, especially on soles, palms, back or buttocks
Immersion burns (sock-like, glove-like doughnut shaped on buttocks or genitalia)
Patterned like electric burner, iron, etc.
Rope burns on arms, legs, neck or torso

Unexplained fractures:

To skull, nose, facial structure
In various stages of healing
Multiple or spiral fractures

Unexplained laceration or abrasions:

To mouth, lips, gums, eyes
To external genitalia

Wary of adult contacts
Apprehensive when other children cry
Frightened of parents
Afraid to go home
Reports injury by parents
Behavioral extremes:
- Aggressiveness
- Withdrawal

Physical Neglect

Physical Indicators	Behavioral Indicators
Consistent hunger, poor hygiene, inappropriate dress Consistent lack of supervision, especially in dangerous activities or long periods Constant fatigue or listlessness Unattended physical problems or medical needs Abandonment Venereal disease, especially in pre-teens Pregnancy	Begging, stealing food Extended stays at school (early arrival and late departure) Constantly falling asleep in class Alcohol or drug abuse Delinquency (e.g. thefts) States there is no caregiver

Sexual Abuse

Physical Indicators	Behavioral Indicators
Difficulty in walking or sitting Torn, stained or bloody underclothing Pain or itching in genital area Bruises or bleeding in external genitalia, vaginal or anal areas Venereal disease, especially in pre-teens Pregnancy	Unwilling to change for gym or participate in PE Withdrawn, fantasy or infantile behavior Bizarre, sophisticated or unusual sexual behavior or knowledge Poor peer relationships Delinquent or run away Reports sexual assault by caregiver

Emotional Maltreatment

Physical Indicators	Behavioral Indicators
Habit disorders (sucking, biting, rocking) Conduct disorders (antisocial, destructible) Neurotic traits (sleep disorders, speech disorders, inhibition of play)	Behavior extremes: Compliant, passive Aggressive, demanding Inappropriately adult Inappropriately infant

Be alert. The suffering that results from abuse and neglect is often silent. If you notice changes in personality or behavior, you should start asking what’s going on. Remember, it is not your role to verify that abuse is happening, only to alert others of your suspicions.

How to Recognize Abuse? - Horizon NJ Health