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• In situations of physical abuse, victims and abusers often live together. 
• When abuse is by a spouse, it may continue from earlier in life, or it may begin in old age.  
• Abusers are likely to have mental or substance abuse problems. 
• Abusive offspring are often dependent on victims for money or a place to live.  
• Some victims of physical abuse may appear relatively independent but may have emotional problems.  
• Very often medical personnel are the first to discover evidence of abuse during a normal check-up.

Physical indicators

• Bruises or welts. 
• Burns from cigarettes, appliances or hot water.  
• Abrasions on arms, legs or torso that resemble rope or strap marks that may indicate inappropriate restraint.  
• Fractures, sprains, lacerations or abrasions.  
• Injuries caused by biting, cutting, poking, punching, whipping or twisting limbs. 
• Disorientation, stupor or other effects of over medication.  
• Internal injuries may be evidenced by unexplained reported pain, difficulty with normal functioning of organs or bleeding from body orifices.  
• History of similar injuries and/or numerous or suspicious hospitalizations.

Behavioral indicators

The victim may:

• Be easily frightened or fearful.  
• Exhibit denial.  
• Be agitated or trembling.  
• Be hesitant to talk openly. 
• Offer implausible stories.  
• Make contradictory statements.  
• Often recant accusations.  
• Be willing to assume responsibility for whatever precipitated the police call or other form of intervention (i.e., a neighbor stopping by to check on loud noises or cries).

The Abuser may:

• Conceal the victim’s injuries (i.e., bring the victim to a different medical facility for treatment each time there is an injury).  
• Offer inconsistent or implausible explanations for the victim’s injuries.  
• Threaten the person with physical abuse, withdrawal of care, loss of relationships, desertion, or nursing home placement.  
• In cases where abuse is by offspring, the abuser is likely to have mental health or substance abuse problems.  
• Be obstructive to investigation. He or she may speak for the person, dominate the interview, refuse to allow the person to be interviewed along, try to divert the interviewer from the subject or act defensively.  
• Handle the person roughly or in a manner that is threatening, manipulative, sexually suggestive or insulting.  
• Be unreasonably critical of and/or dissatisfied with social and health care providers and changes frequently.

It is often difficult to distinguish between injuries that were abusively inflicted and those that were the result of an accident, health condition or medication. For this reason, it is important to become a keen listener and observer so you can explore and evaluate explanations and interpretations of physical indicators of abuse. The behaviors of victims and abusers, as well as the interaction between them, can provide valuable clues.