Because staff will not report themselves, families are usually the first to notice that something is wrong. Physical warning signs include bedsores or pressure ulcers, unexplained bruises, cuts, or fractures, sudden weight loss or signs of dehydration, poor hygiene, and a soiled or unsafe room.
Behavioral and emotional signs matter too: a resident who becomes withdrawn, fearful, or agitated, who is reluctant to speak around certain staff, or who seems over-sedated. Financial red flags — missing money or belongings, unexplained transfers, or sudden changes to accounts or a will — can signal financial exploitation.
Also pay attention to the facility itself: understaffing, unanswered call lights, staff who discourage visits or private time, and resistance to sharing records are all concerning. If you see these signs, ensure your loved one's safety, report it, document what you observe, and consider a review.