Name *

First Name

Last Name

Family members are reported to commit over 90% of reported cases of elder abuse. *

TRUE

FALSE

Forms of abuse are: Physical, emotional, neglect, financial abuse, isolation, abandonment, sexual, and self neglect. *

TRUE

FALSE

Signs of abuse to report: *

BRUISING OR WELTS ON THE BODY

FINGERPRINTS OR HANDPRINTS VISIBLE ON THE BODY

TORN, STAINED, OR BLOODY CLOTHING

MALNUTRITION

ALL OF THE ABOVE

Should you report if the client tells you they are afraid of a family member or another caregiver? *

YES

NO

Signs of financial exploitation can include: *

UNPAID BILLS OR UTILITIES TURNED OFF

CHECKS WRITTEN OUT TO "CASH"

NEW RELATIVE IN THE HOME

INCREASED PHONE CALLS

ALL OF THE ABOVE