Identifying and preventing family-mediated abuse and neglect of elderly persons.

Unexplained trauma, neglected medical problems, failure to thrive, malnutrition, and misuse of medications may be manifestations of family-mediated abuse and neglect of the non-institutionalized elderly person. Physicians frequently overlook or misdiagnose this form of family violence. Access to these persons, assessment, and intervention are facilitated by focusing on the unmet care needs of the elderly person and by moving to meet those needs. Issues of intervention can be clarified by categorizing abuse or neglect as occurring in situations in which the dependency and care needs of the elderly person are paramount or in which the pathologic behavior of the abuser is most evident. The provision of specific support services or legally mandated separation of the elderly person and the abuser can be attempted but the elderly person's right to refuse any intervention must be recognized.