FLORENCE, Wis. — From a distance, it can be hard to assess the quality of your family member’s caregivers. Ideally, if there is a primary caregiver on site, he or she can keep tabs on how things are going.

Perhaps you already have identified friends or neighbors who can stop in unannounced to be your eyes and ears. Sometimes, a geriatric care manager can help.

You can stay in touch with your family member by phone and take note of any comments or mood changes that might indicate neglect or mistreatment. These can happen in any setting, at any socioeconomic level. Abuse can take many forms, including domestic violence, emotional abuse, financial abuse, theft, and neglect.

Sometimes the abuser is a hired caregiver, but he or she also can be someone familiar. Stress can take a toll when adult children are caring for aging parents, or when an older person is caring for an aging spouse or sibling. In some families, abuse continues a long-standing family pattern. In others, the older adult’s need for constant care can cause a caregiver to lash out verbally or physically. In some cases, especially in the middle to late stages of Alzheimer’s disease, the older adult may become difficult to manage and physically aggressive, causing harm to the caregiver. This might cause a caregiver to respond angrily.

But no matter who is the abuser or what is the cause, abuse and neglect are never acceptable responses. If you feel your family member is in physical danger, contact the authorities right away. If you suspect abuse but do not feel there is an immediate risk, talk to someone who can act on your behalf: your parent’s doctor, for example, or your contact at a home health agency.

Signs of self-neglect

Self-neglect describes situations in which older people put themselves at high risk. People who neglect themselves may have a disorder that impairs their judgment or memory. They may have a chronic disease. Knowing where to draw the line between a person’s right to independence and self-neglect can be hard. Here are some signs that may mean it’s time to intervene, although they can be hard to recognize during a short visit —

— Hoarding;

— Failure to take essential medications or refusal to seek medical treatment for serious illness;

— Leaving a burning stove unattended;

— Poor hygiene;

— Not wearing suitable clothing for the weather;

— Confusion;

— Inability to attend to housekeeping;

— Dehydration.

Those who think they may see these signs should call the Florence County Human Services Department at 715-528-3296 or the Florence County Sheriff’s Department at 715-528-3346 or 911 about their concerns. A caller may ask to keep their name confidential from the older person who is the subject of the concern. State laws provide protection from liability for anyone who reports elder abuse in good faith.

The Florence County Sheriff’s Department and Florence County Human Services Department will assess and discuss the safety of the situation. Information is provided about options and services through Human Services and the Aging and Disability Resource Center, or ADRC.

When abuse occurs in a nursing home, community-bases residential facility or by a licensed home health agency, you may call the Wisconsin Department of Health and Family Services 1-800-642-6552.

For informal intervention regarding quality of care issues, contact the Ombudsman Program at the Board of Aging and Long-Term Care at 1-800-815-0015.

For more information on elder abuse, or information on aging or living with a disability, contact the ADRC of Florence County at 715-528-4890, or stop at the office in the lower level of the Florence County courthouse, 501 Lake Ave. in Florence from 8:30 a.m. to 4 p.m. weekdays; or go to www.florencecountywi.com and click on Aging and Disability Resource Center.