Elder abuse and neglect: how to recognize warning signs and intervene.

Elder mistreatment, whether abuse or neglect, can be classified as physical, psychological, or financial/material. Several types of mistreatment may occur simultaneously. Abuse occurs across all socioeconomic, racial, and religious lines. Risk factors include a history of mental illness or alcohol/drug abuse, a family history of violence, isolation of the victim, and recent stressful events in the life of the victim or abuser. For the physician the patient workup includes a careful history and physical exam, including cognitive evaluation. Ask about living arrangements, financial status, social supports, and emotional stressors. If possible, observe the interaction between the patient and family member or caregiver. Helpful resources include your state's Office of Protective Services and the American Medical Association's recently published guidelines for diagnosis and treatment of elder abuse and neglect.