February 1, 2025. The Daily Reflector. By Carly Uhlir

As a medical student and Schweitzer Fellow who leads a no-cost fall prevention program in my community, issues that affect older adults are a top priority for me.

Let’s try an exercise: Picture a vulnerable member of society. Someone without the means or resources to protect themselves from injury, whether physical, emotional or otherwise. Someone whose age or status renders them particularly at risk of harm at the hands of another.

Many people might picture a young child in this scenario. That indeed is warranted — unfortunately, abuse or neglect of children is all too common throughout the nation. Nonetheless, another form of abuse, one that is also grossly underreported yet highly prevalent, is that which strikes our oldest community members: elder abuse.

Elder abuse and mistreatment exist in numerous forms: physical or emotional abuse, neglect or abandonment and financial exploitation, to name a few. Financial exploitation consists of accessing an individual’s retirement or Social Security benefits without permission, forging checks, hacking bank or credit card information and stealing liquid or material assets. Financial exploitation is particularly challenging to recognize yet is estimated to cost nearly $30 billion dollars in losses each year. Sadly, most abuse occurs in the home at the hands of family members. Physical disability, cognitive impairment (dementia or otherwise) and social isolation augment an older adult’s risk of abuse.

A question worth asking is, when a potentially abusive situation involving an older adult is acknowledged, is it reported? When I asked a few of my friends and family members (none of whom are employed in health care or related fields) this question, most were unaware that certain types of elder abuse warrant reporting to Adult Protective Services, and that all health care professionals and caregivers are mandatory reporters as in cases of child abuse. If people are unaware of the laws that protect the older adult population, it seems unlikely that they would report their suspicions. In fact, according to the National Council on Aging, only 1 in 24 cases of abuse of older adults is reported — a frightening statistic.

What can you do? Learn about the common signs of elder abuse:

• Unexplained injuries, such as bruises, scars or burns
• Malnutrition and/or dehydration
• Depression, anxiety and/or changes in behavior, or becoming more withdrawn
• Lack of access to personal funds, missing valuables and/or significant changes in spending habits
• Presence of bedsores, poor hygiene and/or unclean living conditions
• Being left home alone when dependent without a plan of care

If you are an older adult being abused or if you suspect elder abuse, visit ncea.acl.gov for information related to types and signs of elder abuse and methods to report it. You can also contact the Eldercare Locator, a service of the ACL, at 1-800-677-1116 to be connected to support and resources for older adults and their families.

From a health care standpoint, I recommend that clinicians implement validated brief screening tools, such as the Hwalek-Sengstock Elder Abuse Screening Test or Vulnerability to Abuse Screening Scale, into all older adult patient encounters or at least make a concerted effort to ask about safety and security in the home. “Do you feel safe in your home?” and “How do you feel about the care you are receiving?” are questions that can both go a long way.

Let’s do better as a society for our grandparents, parents, mentors and friends who are seniors.

Carly Uhlir is a 2024-25 N.C. Schweitzer Fellow and a member of the ECU Brody School of Medicine’s Class of 2027.