護理師照顧一位由家人帶至診所的高齡病人。下列哪些評估發現應讓護理師懷疑存在老人虐待？（選所有適合的）
A nurse is caring for an elderly client who was brought to the clinic by a family member. Which assessment findings should lead the nurse to suspect elder abuse? (Select all that apply.)
- AThe client has multiple bruises in various stages of healing✓ 正解病人有多處處於不同癒合階段的瘀傷
- BThe caregiver answers all questions for the client✓ 正解照顧者代為回答所有問題
- CThe client has a well-managed chronic condition like hypertension病人有良好控制的慢性病，如高血壓
- DThe client appears malnourished and has poor personal hygiene✓ 正解病人營養不良且個人衛生狀況不佳
- EThe client becomes withdrawn and avoids eye contact when the caregiver enters✓ 正解當照顧者進入時，病人變得孤僻並避免眼神接觸
老人虐待的篩檢是護理實務中極為關鍵的一環。懷疑虐待的跡象包括生理與行為兩大層面：生理上，不同癒合階段的瘀青（Option A）暗示長期且反覆的身體傷害；嚴重的營養不良與衛生不佳（Option D）則是忽略（Neglect）的象徵。行為上，照顧者過度控制對話、不讓病人自行回答（Option B）是心理控制的警訊；病人看到照顧者時表現出退縮、恐懼或躲避視線（Option E），反映了病態的家庭動力。至於慢性病管理良好（Option C），通常代表照顧品質尚可，並非虐待的典型指標。護理師一旦懷疑虐待，必須依照法定職責通報（Mandatory reporting），同時需將病人與照顧者分開進行個別訪談以獲取真實資訊。
Screening for elder abuse is a critical nursing skill. Indicators include both physical and behavioral findings: physically, multiple bruises in various stages of healing (A) suggest repeated injury, and severe malnutrition with poor hygiene (D) suggests neglect. Behaviorally, a caregiver who answers all questions (B) suggests psychological control, and the elder withdrawing or avoiding eye contact when the caregiver enters (E) reflects fear and abnormal family dynamics. Well-managed chronic conditions (C) generally suggest adequate care. The nurse has a mandatory reporting duty and must interview the elder and caregiver separately to obtain accurate information.
在美國，護理師是法定通報者（Mandated Reporter），若懷疑虐待未通報需負法律責任；台灣雖然也有《老人福利法》保護，但護理人員有時會因文化因素（如「清官難斷家務事」）而在通報上較為保守或猶豫。