Elder abuse is harm or neglect of an older adult by a caregiver or trusted person, and it can be physical, sexual, emotional, financial or neglect. It is common and underreported, so clinicians should screen in private and report suspicion to adult protective services as state law requires.
Key symptoms
- Injuries with an explanation that does not fit
- Delays in seeking care, missed appointments
- Fear, withdrawal or anxiety around the caregiver
- Unexplained money problems or changes in legal documents
- Poor hygiene, weight loss, missing glasses or hearing aids
What you find on exam
- Interview the patient alone
- Bruises in unusual places such as the inner arms, back or face
- Pressure injuries, dehydration, malnutrition
- Cognitive screen and decision-making capacity
Tests
- Screening with direct questions or a tool such as the Elder Abuse Suspicion Index
- Blood count, metabolic panel, albumin for neglect
- X-rays for suspected fractures
- Drug levels if overmedication or missed medication is suspected
Treatment basics
- Treat injuries and make the patient safe
- Report to adult protective services as required by state law
- Document findings and the patient's own words objectively
- Social work, caregiver support and safe placement if needed
- Respect the wishes of a patient with capacity
Red flags
- Immediate danger or threats at home
- Severe neglect: deep pressure injuries, starvation, dehydration
- Signs of sexual abuse
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Related guides
Sources: NCSBN 2026 NCLEX-RN Test Plan; NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.