Which pattern of bruising is most suggestive of possible abuse in older adults?

Bruising on both ears and both sides of the neck is particularly suggestive of potential abuse in older adults. This pattern raises concerns because these areas are not typical locations for accidental bruises, as they are usually protected and not easily subject to trauma in the course of normal daily activities. When bruising occurs in these areas, it can raise red flags for physical assault, especially if the bruising is bilateral, indicating a possible pattern of forceful handling or striking.

In contexts where older adults may experience falls or other injuries, bruising on the lower arms and legs, although common in aging individuals due to falls, typically results from accidental events rather than abuse. Bruising that is healing in different stages can often be indicative of various injuries sustained over time rather than a clear sign of intentional harm. Additionally, bruising around the abdomen may be related to medical conditions or minor accidents rather than abuse. Therefore, the bilateral nature of bruising around the ears and neck is particularly concerning and warrants further investigation for potential abuse scenarios.