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 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.