LYNN – Paying close attention to details can expose elder abuse.Essex County District Attorney Jonathan W. Blodgett says the abuse can come in many forms – physical, mental, emotional, sexual, financial.In some cases, elder abuse involves intimidation or threats. Other instances show evidence of chicanery, like phony health insurance or Ponzi schemes aimed at bilking the aged of their savings.Blodgett has warned senior citizens about scams related to the so-called Medicare “donut hole” coverage, but another kind of abuse – that perpetrated by relatives and caregivers – has captured his attention.”We must always be vigilant about scams, especially those that target the elderly,” he said Monday. “But I’m urging everyone to be aware of another crime against our seniors, abuse by family or caregivers.”According to the U.S. Department of Justice, the latest data indicates that between 1 and 2 million Americans over age 65 have suffered abuse and for each reported case, there are about five more cases that remain unreported.Victims are often too ashamed or afraid to report the crime or may be reluctant to report a person on whom they depend for their care, said Blodgett, adding, “There are many ways in which seniors are abused or neglected. By recognizing potential abuse, we may be able to help someone, whether they are our neighbor, acquaintance, patient or customer.”Blodgett said signs of abuse include unexplained bruises, unattended medical needs, poor hygiene, unusual weight loss, sudden change in financial situation, unexplained withdrawal from normal activities or unusual isolation from friends. He cited Massachusetts General Law, Chapter 19A, Section 18, which requires specific people such as Council on Aging directors, health care professionals, police and other public safety officials to report elder abuse.Anyone who suspects abuse is encouraged to report it to adult protective services by calling the Massachusetts Elder Affairs’ 24-hour confidential hotline at 800-922-2275.Many services are available to victims, but if the situation goes unreported, victims may suffer needlessly, he said.”Unexplained bruises or other physical injuries, reports from banks about withdrawals or that an elderly customer seems particularly confused and is being accompanied by somebody can be a sign of elder abuse,” said Melissa Porter, supervisor of the Adult Protective Services unit at Greater Lynn Senior Services (GLSS). “Banks can set parameters limiting how much can be withdrawn, depending on what kind of account it is.”Porter said many abuse reports arrive anonymously. “It’s fairly common. A lot of cases we get are self-neglect referrals – elders who seem disoriented, confused, or might have poor personal care. They may look frail, malnourished or dehydrated,” she said.Each caseworker on Porter’s team has up to 20 senior citizens under their care. Once police become involved, the person’s name is included in a report related to possible abuse, which in turn sets in motion the delivery of protective services.If the elder has been financially scammed, the incident is turned over to the state attorney general’s office. If the abuse involves a professional caregiver, the state Department of Public Health becomes the investigative agency.Porter said cases run the gamut from physical harm to theft of personal items from those living in subsidized housing or nursing institutions. Identities have been stolen along with valuable possessions, both by caregivers and relatives.”We have seen plenty of stolen ATM cards and checks forged by grandchildren,” she said.Federal guidelines define elder abuse as the non-accidental use of force against an elderly person that results in physical pain, injury or impairment. Such abuse includes not only physical assaults such as hitting or shoving but the inappropriate use of drugs, restraints or confinement.Emotional or psychological abuse occurs when people speak to or treat elderly persons in ways that cause emo