# Elder Abuse Recognition in Nursing > Nursing notes on elder abuse recognition: five abuse types, EASI screening, warning signs, mandatory reporting and the Parents and Senior Citizens Act 2007. - Canonical URL: https://prepelephant.com/topics/allied/nursing/elder-abuse-nursing-recognition - Exam / course: Allied Health · Subject: Nursing - Publisher: PrepElephant (https://prepelephant.com) — Prepared and reviewed by the PrepElephant Academic Review Team - First published: 2026-10-02 - Last updated: 2026-10-02 - How to cite: "Elder Abuse Recognition in Nursing", PrepElephant, https://prepelephant.com/topics/allied/nursing/elder-abuse-nursing-recognition ## Direct answer Bruises in various stages of healing on the inner arms, a sudden "helper" who answers every question, missed appointments, weight loss, and fear in the room — elder abuse announces itself in patterns, and geriatric nurses are trained to read them across five recognised types: physical, psychological or emotional, sexual, financial or material exploitation, and neglect (with abandonment added in Indian classifications). Structured screening tools such as the Elder Abuse Suspicion Index (EASI) — six brief questions usable in any outpatient setting — move suspicion toward disclosure, always asked with the caregiver out of the room. India's legal backbone is the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, which obliges children and heirs to maintain parents and makes abandonment punishable (imprisonment up to three months and/or fine), backed by the national toll-free Elder Line 14567. ## What you must remember - **Five types to recite:** physical (hitting, restraining, force-feeding), psychological (threats, humiliation, isolation, silent treatment), sexual, financial or material (property transfer, pension capture, withholding money), and neglect (failure to provide food, medicines, hygiene, or medical care) — plus abandonment as a distinct Indian legal category. - **Screening with EASI:** six questions covering overall abuse, possible physical/psychological mistreatment, financial exploitation, and who helps the older person — designed to be answered without the caregiver present; the Hwalek-Sengstock screen is the older alternative. - **Physical indicators:** bruises at unusual sites (inner arms, thighs, back, neck rather than over shins), injuries in different healing stages, burns in glove or stocking patterns, rope marks, pressure sores, malnutrition, dehydration and poor hygiene. - **Behavioural and relational red flags:** the older person becomes withdrawn or fearful, defers all answers to one caregiver, gives implausible injury stories, is "never allowed" to speak alone; the caregiver refuses visitors, shows financial control, or expresses burnout with hostility. - **Indian law:** Maintenance and Welfare of Parents and Senior Citizens Act 2007 — adult children legally bound to maintain parents and grandparents; maintenance claims go to a tribunal; abandonment punishable with imprisonment up to three months and/or fine. - **Reporting pathway in India:** welfare officers, police, the Maintenance Tribunal under the Act, and the national Elder Line 14567; helpline data consistently identify son and daughter-in-law as the commonest alleged abusers in Indian studies. - **Documentation:** verbatim quotes, body maps with injury ages, photographs with consent where policy allows, and the reason suspicion arose — written contemporaneously. ## A suspicious admission worked through An 82-year-old widow admitted with a "fall" has a spiral fracture of the humerus, bruises on both inner upper arms in different colours, an infected pressure area, and a daughter-in-law who stays in the cubicle answering every question. The nurse arranges the examination with the relative politely occupied elsewhere, then asks the EASI questions gently: "Do you feel safe at home?" "Has anyone hurt you or made you uncomfortable?" The woman cries and discloses being locked in a room when the family goes out and her pension collected by her son. The nurse documents her words verbatim, maps and dates the bruises, records weight and pressure-ulcer staging, and — without confrontation — informs the medical officer and social worker. The plan: treatment, nutrition, a safety assessment, contact with the Elder Line, and a maintenance-tribunal referral explained at her pace. Confronting the family is not the nurse's task; preserving evidence, ensuring safety, and activating the legal pathway is. ## Where students and wards slip Exams ask for the five types of abuse and their indicators, and candidates routinely forget financial exploitation — yet pension and property capture is among the most frequently reported forms in Indian elder-helpline data. The second slip is screening etiquette: asking "Is anyone hurting you?" while the suspected abuser holds the patient's arm guarantees a negative answer — the tool is useless without a private interview. Viva probes include differentiating abuse injuries from senile purpura (flat, on forearms and hands, painless, patternless) and distinguishing neglect from poverty (neglect is failure by a capable, resourced caregiver). Indian framing earns marks: quote the 2007 Act's maintenance obligation and abandonment punishment, the 14567 Elder Line, and the fact that reported prevalence in Indian studies varies widely — an honest hedge against invented statistics. ## Frequently asked questions ### What are the recognised types of elder abuse? Physical, psychological or emotional, sexual, financial or material exploitation, and neglect — abandonment is a distinct category under Indian law. ### What is the EASI tool and when is it used? The Elder Abuse Suspicion Index — six brief questions screening for abuse in outpatient and ward settings, administered only without the caregiver present. ### Which injury patterns point to abuse rather than ageing? Bruises on inner arms, thighs, neck or back (not over bony shins), injuries in multiple healing stages, patterned burns, spiral fractures, and pressure sores with malnutrition in a supposedly cared-for elder. ### What does the Maintenance and Welfare of Parents and Senior Citizens Act 2007 provide? A legal duty on children and heirs to maintain parents and grandparents, a maintenance tribunal for claims, and punishment — imprisonment up to three months and/or fine — for abandonment of a senior citizen. ### How should a nurse act on suspected elder abuse in India? Interview privately, document contemporaneously with body maps and verbatim quotes, inform the medical officer and social worker, and use the Elder Line 14567 and maintenance tribunal while ensuring safety.