For more detailed information about abuse and neglect see: Oregon Administrative Rule 411-020-0002
Physical abuse is any physical injury to an adult caused by other than accidental means that may result in bodily injury, physical pain, or impairment.
Warning signs of physical abuse:
- Cuts, lacerations, punctures, wounds
- Bruises, welts, discolorations, grip marks
- Any unexplained injury that doesn't fit with the given explanation of the injury
- Any injury incompatible with the person's history of unexplained injuries
- Any injury which has not been properly cared for (sometimes injuries are hidden on areas of the body normally covered by clothing)
- Dehydration and/or malnourishment without illness-related cause
- Unexplained loss of weight
- Burns, possibly caused by cigarettes, caustics, acids or friction from ropes or chains
Neglect is the failure of an individual who is responsible to make a reasonable effort to protect an adult from abuse or to provide the care, supervision, or services necessary to maintain the physical health and emotional well-being of an adult that creates a risk of serious harm or results in physical harm, significant emotional harm or unreasonable discomfort, or serious loss of personal dignity.
NOTE: An elderly person who in good faith is voluntarily under treatment solely by spiritual means through prayer in accordance with the tenets and practices of a recognized church or religious denomination by a duly accredited practitioner shall, for this reason alone, not be considered subjected to abuse by reason of neglect as defined in Oregon Administrative Rule 411-020-0002.
Warning signs of neglect:
- Dirt, fecal/urine smell or other health and safety hazards in adult's living environment
- Leaving an adult in an unsafe or isolated place
- Rashes, sores, lice on the adult
- Malnourishment or dehydration and/or sudden weight loss
- Untreated medical condition
- Soiled clothing or bed linens
- Poor skin condition or poor skin hygiene
Self-neglect is the inability of a person to understand the consequences of his or her actions or inaction when that inability leads to or may lead to harm or endangerment to self or others.
Abandonment is desertion or willfully leaving an adult alone by a caregiver that would place the adult in serious risk of harm. It is a specific form of neglect.
Warning signs of abandonment:
- The desertion at a public location
- A person's own report of being abandoned
Verbal or emotional abuse
Verbal or emotional abuse includes threatening significant physical harm or threatening or causing significant emotional harm to an adult through the use of: derogatory or inappropriate names, insults, verbal assaults, profanity, or ridicule; or harassment, coercion, threats, intimidation, humiliation, mental cruelty, or inappropriate sexual comments.
Warning signs of verbal or emotional abuse:
- Humiliating, insulting, or threatening language directed at the person
- Being emotionally upset or agitated
- Being extremely withdrawn and non-communicative or non-responsive
- Unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking)
- An adult's report of being verbally or emotionally mistreated
- Wrongfully taking, by means including but not limited to deceit, trickery, subterfuge, coercion, harassment, duress, fraud, or undue influence, the assets, funds, property, or medications belonging to or intended for the use of an adult
- Alarming an adult by conveying a threat to wrongfully take or appropriate money or property of the adult if the adult would reasonably believe that the threat conveyed would be carried out
- Misappropriating or misusing any money from any account held jointly or singly by an adult
- Failing to use income or assets of an adult for the benefit, support, and maintenance of the adult.
Warning signs of financial exploitation:
- Unusual or inappropriate activity surrounding investment properties or in bank accounts, including the use of ATM cards, to make large or repeated withdrawals
- Signatures on checks, etc. that do not resemble the person's signature, or signatures when the person cannot write
- Power of attorney given, or recent changes in or creation of a will or trust, when the person is incapable of making such decisions
- Unpaid bills, overdue rent, utility shut-off notices
- Excessive spending by a caregiver on himself for new clothing, jewelry, automobiles
- Lack of spending on the care of the person, including personal grooming items
- Missing personal belongings, such as art, silverware or jewelry
- Recent sale of assets and properties
The Attorney General's office also has a consumer hotline for financial fraud issues.
- Sexual contact with a non-consenting adult or with an adult considered incapable of consenting to a sexual act. Failure to object does not mean an expression of consent.
- Sexual harassment or sexual exploitation of an adult, exposing an adult to, or making an adult the subject of sexually explicit material or language.
- Any sexual contact between an employee or volunteer of a facility or a caregiver and an adult served by the facility or caregiver, unless a pre-existing relationship existed. Sexual abuse does not include consensual sexual contact between an adult and a caregiver who is the spouse or domestic partner of the adult.
Warning signs of sexual abuse:
- Unexplained vaginal or anal bleeding
- Torn or bloody underwear
- Bruised breasts
- Venereal diseases or vaginal infections
- Sudden changes in the emotional or psychological state of the person
- Abrupt changes in responses or behavior around certain people
- The person discloses that they've been abused
Confinement, isolation or restriction of an adult to his or her room or a specific area; or placing restrictions on an adult's ability to associate, interact, or communicate with other individuals.
NOTE: In a facility, emergency or short-term, monitored separation from other residents may be permitted if used for a limited period of time when: used as part of the care plan after other interventions have been attempted; used as a de-escalating intervention until the facility can evaluate the behavior and develop care plan interventions to meet the resident's needs; or the resident needs to be secluded from certain areas of the facility when their presence in that specified area would pose a risk to health or safety.
Warning signs of involuntary seclusion:
- An adult's report of not being allowed to see or talk with people who they would reasonably see or talk to
- Kept away from where others can go
- Not allowed to use the telephone
- Not allowed to receive or send mail
A wrongful use of a physical or chemical restraint includes situations where:
- A licensed health professional has not conducted a thorough assessment prior to implementing a licensed physician's prescription for restraint;
- Less restrictive alternatives have not been evaluated prior to the use of the restraint; or
- The restraint is used for convenience or discipline.
NOTE: Physical restraints may be permitted if used when a resident's actions present an imminent danger to self or others and only until immediate action is taken by medical, emergency, or police personnel.
Warning signs of physical or chemical restraint:
- Being sedated
- Going to bed at an unusually early time or uncharacteristically early bedtime
- Bruises or remarks on both wrists, both ankles, or a strip-like mark or bruise across the chest
- An adult's report of being tied up or sedated or not allowed to move