If you have a reasonable suspicion that abuse or neglect has been or is being committed, contact the appropriate authority referenced below. You do not need proof of confirmed maltreatment to make a report. Professionals will investigate suspected claims of elder mistreatment.
If you or someone you know is in immediate danger, call 911.
Adult Protective Services
If the danger is not imminent, report abuse in the community to the local Adult Protective Services (APS) agency. In many states, APS is the reporting agency for suspected abuse in long-term care facilities. Find the APS reporting number for your area here.
Long-Term Care Ombudsman
In some states, suspected abuse in long-term care facilities should be reported to the local Long Term Care Ombudsman. Long-term care facilities include nursing homes, assisted living centers, and board and care facilities. Find the Long-Term Care Ombudsman reporting number for your area here.
Eldercare Locator provides access to find local reporting resources. Contact at 1-800-677-1116. Language interpretation is available.
Adult Protective Services (APS) investigates allegations of elder maltreatment. They help facilitate the safety and wellbeing of older adults and adults with disabilities who experience abuse, neglect, and/or financial exploitation. APS develops care plans and helps to coordinate medical, social, financial, legal, and other emergency or supportive services with the individual experiencing or exposed to abuse.
Each state has an APS office. Client eligibility and available resources differ by state and program.
Generally, individuals who have experienced abuse must consent to APS services. in most instances older people may decide to decline APS assistance. Under certain circumstances, APS may provide protective assistance to individuals who appear to be unable to make or communicate a decision to accept or decline services or who require immediate intervention.
To find an APS agency in your area, visit the National Adult Protective Services Association (NAPSA).
For information about what you can expect after reporting to APS, access the following NCEA fact sheets:
- Adult Protective Services, What You Must Know
- Adult Protective Services Example Flow Chart
- APS wouldn’t take my report. Why?
For additional information about APS services, visit the National Adult Protective Services Association website and the Adult Protective Services Technical Assistance Resource Center Website (APS TARC)
You can visit the NCEA’s Publications Page for more information about APS.
Long-Term Care Ombudsmen serve as advocates for residents in long-term care facilities. With resident consent, they investigate allegations of abuse, help resolve complaints, protect resident rights, and work to improve the quality of life for long-term care residents.
Ombudsmen support and maximize resident participation by providing residents the opportunity to discuss complaints with confidentiality. They elicit resident preferences and wishes, advise residents of their rights, and work with residents to develop a plan of action for complaint resolution.
Informed consent is required from the resident or resident’s representative to investigate the complaint and disclose information to the facility and/or outside agencies.
To find a Long-Term Care Ombudsman in your area, visit the National Consumer Voice for Quality Long-Term Care.
For additional information about Long-Term Care Ombudsman services, visit the National Consumer Voice for Quality Long-Term Care.
You can also visit the NCEA’s Publications Page for fact sheets regarding ombudsman services.
If you have questions about elder abuse or need support, contact the following:
- Eldercare Locator provides access to find local reporting resources, contact at 1-800-677-1116. Language interpretation is available.
- National Center on Elder Abuse 1-855-500-3537 Assistance available in English, Spanish
- National Domestic Violence Hotline 1-800-799-7233 Language interpretation available.
- SAMHSA 988 Suicide and Crisis Lifeline 988 Assistance available in English, Spanish, and for deaf and hard of hearing.
- Strong Hearts Native American Domestic Violence Services | The Hotline 1-844-762-8483
- SAGE National LGBTQ+ Elder Hotline – SAGE (sageusa.org) 1-877-360-LGBT (5428) Assistance available in English and Spanish
- NAPCA Community Resource Helpline for Older Adults and Caregivers – National Asian Pacific Center on Aging 1-800-336-2722 Assistance available in English, Korean, Mandarin, Cantonese, and Vietnamese
Lawyers can help secure and preserve a client’s rights. Legal interventions include both civil and criminal remedies. Civil legal lawyers can provide a number of services to older adults who experience maltreatment. They facilitate elder safety through protective orders, can help recover exploited assets, and assist with access to benefits and services. Civil attorneys may also provide advice regarding an elder’s legal rights, assist with drafting powers of attorney, and assist with guardianships. Criminal legal remedies include the prosecution of cases of elder mistreatment.
To locate an attorney in your area, you can contact:
- Eldercare Locator provides access to free local Legal Aid services to eligible clients
- Legal Aid agencies in your area are accessible through this link
- National Academy of Elder Law Attorneys (NAELA) can provide private attorney referrals in your state
- You can also access attorney referrals through your State Bar Association. Using your preferred search engine, type the following terms: [your state] + bar + attorney + referral
Courts play a critical role in protecting the rights and safety of older adults and people with disabilities. Elder abuse may arise within several judicial contexts, including criminal, probate, civil, general jurisdiction, and tribal courts. Some courts have led the charge in community responses to elder abuse and have piloted models to better serve older people.
More information on elder abuse and the courts is available below:
- Center for Elders and the Courts, within theNational Center for State Courts, provides resources to judges and court personnel on issues related to aging, elder abuse, and guardianships
- Department of Justice (DOJ) Elder Justice Initiative supports and coordinates training, resources, and research to combat elder abuse, neglect, and financial fraud
- Department of Justice Elder Justice Initiative: Judicial Guardianship Evaluation Worksheet is a tool to guide judges in evaluating the risk of abuse in guardianship cases, assessing capacity, and identifying less restrictive alternatives to guardianship
Other Legal Resources
- National Center on Law & Elder Rights provides the legal services and aging and disability communities with tools and resources to serve older adults, including legal assistance, training, and case consultation
- The American Bar Association Commission on Law and Aging provides links to laws relating to elder abuse, neglect, and exploitation; best practice tips and manuals; information about state guardianship statutes; Adult Protective Services reporting laws, among other resources and information
Elder shelters provide safe, short-term housing, resources, and social support for older adults who have been mistreated. Services may include shelter, therapy, counseling, medical aid, spiritual support, legal and community referrals.
- The Spring Alliance coordinates a network of regional elder abuse shelters and similar service models working closely to share resources, provide technical assistance, and support the development of new facilities to aid older adults who have experienced maltreatment. The Spring Alliance provides an array of materials, forms, and protocols to assist groups in creating elder shelters in their own communities
- Elder Justice Neighborhood Map provides links to local resources and supports
For additional shelter resources, visit the US Department of Housing and Urban Development Find a Shelter
Multidisciplinary Teams (MDTs) bring together elder justice professionals from different disciplines to collaborate on a range of issues including policy, case review, and improving systems. Teams vary based upon type, community needs, and available resources. MDT guidance may be delivered through various means including coalitions, fraud prevention networks, and case review teams. Many teams offer advice, connections to resources, and direct assistance.
Some MDTs review complex cases of elder abuse and members collectively offer recommendations for resolution. Professionals most commonly participating in case review are Adult Protective Services, law enforcement, case managers, medical providers, mental health services, prosecutors, and victim advocates. Teams may also include the public guardian, social service providers, Legal Aid, psychologists, physicians, and financial experts. Types of MDTs include:
- Elder Abuse Forensic Centers (EAFC)
- Enhanced Elder Abuse Multidisciplinary Teams (E-MDTs)
- Financial Abuse Specialist Teams (FAST)
- Elder Death Review Teams
Some MDTs have Service Advocates or Elder Advocates who help older adults with safety planning and case management.
For more information on MDTs, access the NCEA’s Issue Brief: Multidisciplinary Teams
To locate an MDT in your area and for resources, visit the Multidisciplinary Team Technical Assistance Center
Many states require certain professionals to report suspected abuse. These professionals are called mandatory reporters. Mandatory reporters are designated by state statute to report incidents of suspected mistreatment to agencies, including Adult Protective Services. All states have mandatory reporting laws, but there is variability in the types of abuse that are reported and the professionals who are required to report. Mandatory reporters may include healthcare professionals, social service providers, caregivers, clergy, and employees of financial institutions such as bank tellers, among others.
For your state’s statute on mandated reporting, visit here.
Screening instruments are standardized protocols that assist providers in identifying signs of abuse or the risk factors that may predict an increased likelihood of mistreatment.
Several assessment tools have been developed for use in health care and social service settings to identify at-risk elders or cases of elder mistreatment. Promising practices suggest that tools be tailored to the type of abuse, the setting, and the population. It is recommended that assessments be used in combination with expert observation and evaluation.
Several tools have been tested and some validated, but there is no gold standard that definitively detects the presence or absence of abuse. Developing one standard assessment to detect maltreatment may be difficult to achieve given the multiple forms of abuse, differing legal definitions of abuse, the range of clinical settings and patient conditions, and the overlap of signs of abuse with markers of disease.
Assessments are most helpful to detect the presence or risk of abuse at the time the test is administered. They may be less effective in assessing changes in abuse severity or mitigation over time. Validity testing of instruments is needed. Screening should be tested within different cultural contexts and across diverse patient and professional settings.
Examples of screening tools for use by healthcare professionals are provided below:
- Screening Tools for Healthcare Professionals (NCEA)
- Cognitive Screening Tools (Alzheimer’s Association)
Screening tools are also available for use by attorneys:
- Legal Screening and Intake (NCLER)
- Legal – How to Screen for Elder Fraud and Abuse (ABA Commission on Law and Aging)
It is promising and preferred practice for professionals to document suspicions and signs of abuse. Potential signs of abuse and/or neglect, such as behavioral changes, physical markers, and financial inconsistencies, may be unrelated to maltreatment. But, if observed and suspicious, they should be documented.
- The Department of Justice’s Elder Abuse Guide for Law Enforcement (EAGLE) is a web-based module that provides law enforcement, adult protective services, and other investigative agencies with tools and resources to investigate suspected abuse. EAGLE documentation tools include the First Responder Checklist and the Evidence Collection Checklist
- The Geriatric-Injury Documentation Tool (Geri-IDT) and the Bruising Identification Chart can be used by healthcare practitioners to document bruising and other forensic indicators of abuse forensic indicators of abuse.