• Is anxious, withdrawn, agitated, evasive, depressed or suicidal.
  • Shows fear of caregiver; behaviour changes when caregiver enters/leaves room.
  • Is frail or cognitively impaired and presenting for emergency treatment alone or without regular caregiver.


  • Sudden/unexpected change in social habits.
  • Sudden/unexpected change in residence or living arrangements.
  • Unexplained or sudden inability to pay bills, account withdrawals, changes in the will or Power of Attorney, or disappearance of possessions.
  • Refusal to spend money without consulting caregiver.
  • Claims of being “accident-prone”.
  • Missed/cancelled appointments, especially medical appointments.

Health/Well Being

  • Sudden/unexpected decline in health or cognitive ability.
  • Decline in personal hygiene; skin ulcers.
  • Dehydration or malnutrition; sudden/rapid weight loss.
  • Signs of over/under-medication.
  • Suspicious injuries: bruising in various stages of healing; on the face or eye area, the inner part of the thighs or arms, or around the wrists or ankles.
  • Sexually-transmitted disease; itching, pain or bleeding in genital area; difficulty sitting or walking.
  • Unexplained delay in seeking treatment.
  • Denial in view of obvious injury.
  • Previous reports of similar injury.
  • Explanation of injury or condition: inappropriate to type/degree; vague or bizarre; conflicting explanations from elder and caregiver.


  • Poor living conditions in comparison to assets.
  • Inappropriate or inadequate clothing.
  • Lack of food.
  • Lack of required medical aids, functional aids, or medications.
  • Evidence of locks or restraints.
  • Living in worse conditions than others in the home.
  • Involuntary separation from others in the home, friends or other family members.

CAREGIVER (Family, Friend, Paid Caregiver)

  • Is verbally aggressive, insulting or threatening toward elder.
  • Shows unusual amount of concern over elder (either too little or too much)
  • Speaks for elder; does not permit the elder’s involvement in making decisions.
  • Is reluctant to leave elder alone with professional.