•Multiple injury sites or bruises or welts that have a regular pattern resembling the shape of an article which might have been used to inflict the injury.
•Burns that appear to be from a cigar or cigarette.
•Injuries to the head, neck, check, breasts, or abdomen, contusions, abrasions such as rope burns or lacerations especially on the wrist, ankle, torso, or extremities.
•Fractures, many times at different stages of healing, to the skull, ribs, or long bones, injuries to abdomen, kidney, bladder, or pancreas, intestinal perforation, ruptured liver, spleen, or blood vessels, spontaneous abortions resulting from injury to the abdomen, or intramural hematoma of the duodenum or proximal jejunum.
•Chronic diseases, such as asthma, seizures, or arthritis.
•Medical problems indicating chronic or psychogenic pain.
•Symptoms of suffocation or chemical abuse.
•Improbable explanation of injuries or major inconsistencies between elder or dependent adult and caregiver’s injury etiology description.
•Changes in the elder or dependent adult’s behavior when the caregiver enters or leaves the room.
•Appearance of fright, shame, embarrassment, depression, agitation, stress, inability to cope, panic attacks, feelings of isolation, withdrawal, or homicidal or suicidal tendencies.
•Frequent use of prescribed tranquilizers or pain medications.
•Risk factors such as caregiver substance abuse or historical family violence.