While there are no clear guidelines on how families can pick up on signs of abuse in their elderly relative, experts agree on some basic principles to be aware of. "Even if the caregiver seems to be nice and sound, it is worthwhile for family members to check with their relative for any signs of abuse," states Shmuel Armon, who runs a private manpower agency in Tel Aviv and is active in Achioz, the National Association of International Manpower Companies. "Family members must be alert to changes in behavior and mood swings as well as checking the body for any physical signs that the carer is not being gentle enough," he says, admitting that it is not always easy to know if the elderly have an accurate take on the situation, especially if they suffer from dementia or Alzheimer's. Fanny Yuv, deputy director of services for the elderly at the Welfare and Social Services Ministry, adds that a lack of appetite is one good indication that the elderly are not happy with their environment. "If they start expressing sentiments such as not being interested in their life or not wanting to eat anything that could be a sign something is wrong with their living situation," she says. "If the family has any suspicions, it should immediately try to seek help from a social worker in their area." Yuv says that many social workers are now trained in spotting the signs of abuse and can offer families advice on how to deal with it, both emotionally and legally. Regarding how to chose who should work with your relative, Sara Alon, director of programs against elder abuse and neglect at JDC-Eshel, emphasizes that it is preferable to hire someone who has already been working here. "Try to get personal recommendations from previous families that the caregiver has provided services to," she says. "Make sure to sit down with the potential employee and ask questions about his or her past and family abroad." Alon also says it is essential for families to constantly check up on the day-to-day tasks. "Open the fridge and see what is inside, make sure that the medicine is being properly administered. The family must also check that its relative is being brought for scheduled doctor's appointments." Alon also says that the family members need to pay attention to the behavior of the worker. "Does he or she not leave the room when you visit? Does she not give you a chance to be alone with the elderly person? These are all possible signs that should be checked and anything unusual should be immediately reported."