Screen Caregivers

Being empathetic to caregiver stress and identifying specific problems and possible remedies can help avoid abuse. Be neutral and nonjudgmental when you ask how they are coping. Also, keep in mind that unintentional mistreatment may result from ignorance, inexperience, or lack of ability to provide proper care. Caregivers who are overwhelmed may appreciate your intervention with APS as a way to formally receive support, such as respite care.

Communicate and Document a Care Plan

A written and updated care plan with copies to all involved helps prevent inadvertent neglect, and shows you have been proactive. This plan can include monitoring of nutrition, hydration, skin care, hygiene, patient safety (such as fall prevention), medications, and any unique needs.

Educating caregivers about abuse reporting laws, and knowledge that there are expectations and oversight by a healthcare provider, may deter intentional abuse and neglect.

Special Vulnerability

Elders and dependent adults in certain circumstances have special vulnerability to abuse. Present or new onset of cognitive impairment, cancer diagnosis and treatment, and end of life are all particularly stressful times for patients and caregivers. Patients in these circumstances may also have a strong desire to stay in their usual surroundings, and abusers may threaten that the only option is institutionalization "if they tell" about abuse.

Discussing anticipated medical and behavioral problems during the course of the above situations ahead of time can improve caregiver coping, and lessen chances for abuse.


Inpatient referrals can be obtained 7 days a week (723-6701), with however limited outpatient care. Physical, occupational, and speech and language therapists can help assess and treat:

  • gait problems
  • speech or swallowing problems
  • ability to care for self
  • general strengthening
  • neuromuscular re-education

They can also fit and order walkers, crutches, or wheelchairs.


Obtain nutritional assessments for suspected inadequate diet from the Department of Clinical Nutrition 723-5440. Note that some types of insurance, including Medicare, may not cover this service unless patient has a medical condition such as diabetes.