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People who physically abuse vulnerable adults are more likely to be unmarried, to live with their victims and to be unemployed. Some perpetrators have alcohol or substance abuse problems and some are caregivers for those they abuse.

Indicators of physical abuse include bruises, sprains, dislocations, fractures or broken bones, burns from cigarettes, appliances, or hot water. abrasions on arms, legs, or torso, which resemble rope or strap marks.

Some indicators are less obvious, internal injuries may be evidenced by pain or difficulty with the normal functioning of organs, and bleeding from the ears, mouth, or other body orifices.

Some types of bruises are rarely accidental bilateral bruising to the arms may indicate that the person has been shaken, grabbed, or physically restrained. Bilateral bruising to the inside of the inner thighs may indicate sexual abuse. Bruises that wrap around or encircle an older person’s torso arms or legs may indicate that the person has been physically restrained. Multi-coloured bruises can indicate that they were sustained over time, injuries healing through secondary intention can indicate that they did not receive the appropriate care.  Signs of traumatic hair and tooth loss are also indications of physical abuse.

Non-accidental injuries are suspected when –

  • Injuries are to both sides of the body
  • Soft tissue injuries
  • Injuries with a particular pattern, that don’t fit the explanation given
  • Delays in presentation
  • Signs of untreated injuries


Behavioural Indicators of physical abuse include:-

  • Unexplained injuries or implausible explanations that do not fit with the injuries seen.
  • Family members providing different explanations of how the injuries were sustained
  • Where there is a history of similar injuries and or numerous or suspicious hospitalisations
  • Victims being brought to different medical facilities for treatment to prevent medical practitioners from observing a pattern of abuse
  • And a delay in seeking medical care for injuries.