The intentional use of physical force that causes injury, pain, or impairment. This includes hitting, pushing, improper use of physical restraints, and rough handling during transfers or personal care.

• Unexplained bruising, especially in clustered or patterned shapes
• Rough handling during bathing, dressing, or repositioning
• Improper or unauthorized use of physical restraints
• Injuries inconsistent with the explanation given

Any act that causes mental anguish, fear, or distress through verbal or nonverbal conduct. This includes intimidation, humiliation, threats, isolation, and treating a resident as though they cannot understand or make decisions.

• Yelling, name-calling, or belittling comments from staff
• Threats of punishment, abandonment, or restraint
• Deliberately isolating a resident from other residents or visitors
• Ignoring or talking over a resident as though they are not present

Any non-consensual sexual contact of any kind with a resident, including someone who is unable to give consent due to cognitive impairment. This is a crime, not just a regulatory violation, and should be reported to law enforcement in addition to APS and the Ombudsman.

• Unexplained genital injuries, bruising, or bleeding
• Torn, stained, or missing undergarments
• A new sexually transmitted infection with no prior history
• Extreme distress during bathing, toileting, or personal care

The illegal or improper use of a resident’s funds, property, or assets for someone else’s benefit. This ranges from petty theft of personal belongings to large-scale fraud involving powers of attorney, wills, and bank accounts.

• Unexplained withdrawals or transfers from bank accounts
• New power of attorney granted to a caregiver or recent acquaintance
• Changes to a will or beneficiary designation without family knowledge
• Missing personal belongings or unpaid bills despite adequate funds

The failure of a caregiver or facility to provide the goods and services necessary to avoid physical harm, pain, mental anguish, or emotional distress. Neglect is an act of omission, not action, and intent is not required to establish it. This is the most common form of harm in institutional settings.

• Untreated bedsores, malnutrition, or dehydration
• Missed medications or delayed medical attention
• Unsanitary conditions, soiled bedding, or poor hygiene
• Understaffing that prevents basic care from being delivered consistently

When an older adult’s own actions or inactions threaten their own health or safety. This category is different from the others because there is no outside perpetrator. It typically applies to older adults living independently, though it can also describe a resident who refuses care or assistance within a facility.

• Refusing necessary medical care, medication, or food
• Living in unsafe or unsanitary conditions by choice
• Failing to manage finances, resulting in unpaid bills or utility shutoffs
• Withdrawal from social contact that leaves no one checking in

The desertion of an older adult by a person who has assumed responsibility for their care, or by a facility that has physical custody of them. This includes a caregiver who simply stops showing up, or a facility that discharges a resident without a safe, appropriate plan in place.

• A hired or family caregiver who stops providing care without notice
• Discharge or eviction from a facility without a documented safe placement
• A resident left at a hospital, another facility, or a public location with no plan for pickup
• Sudden, unexplained absence of a caregiver a resident depends on

The use of any medication, most often an antipsychotic, to manage a resident’s behavior or restrict their movement in a way that is not required to treat a diagnosed medical condition. Federal regulation prohibits this practice, but it remains widespread in long-term care specifically because it is easy to disguise inside routine documentation.

• Over-sedation or unusual drowsiness with no corresponding diagnosis
• A resident unable to participate in meals, therapy, or family visits due to sedation
• Antipsychotic medication started with no documented clinical justification
• A newly added or retroactive schizophrenia diagnosis that does not match the resident’s history, since residents with that diagnosis are excluded from federal antipsychotic-use tracking

The use of phones, tablets, video calls, smart devices, or the internet to isolate, monitor, control, or exploit an older adult. This category did not exist in older definitions of elder abuse, but it has become common as care facilities and daily life have grown more dependent on technology.

• Repeatedly blocking, delaying, or canceling video calls with a vague excuse like a “broken tablet”
• Confiscating or restricting a resident’s phone as a convenience or punishment
• A resident who seems coached, scripted, or supervised during calls with family
• Unusual online purchases, subscriptions, or money transfers the resident does not recall making
• A new “online friend” or romantic contact pressuring the resident for money or gift cards
• Facility staff photographing or posting a resident on social media without consent