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Elder abuse has been largely under detected and under prosecuted.   Neighbors, friends, aides or anyone who suspects abuse should report it to the appropriate authorities, clearly describing the symptoms of abuse.  The state of New Jersey seems to have taken elder abuse as a challenge.  The issuance of report cards helps consumers choose from many nursing homes. This can be done by ascertaining whether the home is a licensed one, exploring the track record of the institution and the staff, inquiring whether the nursing home has special service units to guard against elder abuse .  All these can be done with the help of the report cards.  The National Center for Elder Abuse in the United States also collects and publishes data on nursing home residents and their abuse.  Looking out for such information can help the consumer choose a better nursing home.  Thus, Superior Court of New Jersey, in 1990 held that aging of the population and the special housing needs of the elderly, irrespective of their individual financial resources, create significant social problems which government, as a matter of the general welfare, is obliged to address.  Jayber, Inc. v. Municipal Council of Tp. of West Orange, 238 N.J. Super. 165, 175 (App.Div. 1990).

There are no well- validated protocols for detection in primary care. Despite the shortcomings, a physician is uniquely equipped to recognize and address elder abuse. The primary care physician should maintain a high index of suspicion, seeking inconsistencies and irregularities in the patient history, and using direct questions to explore possible abuse or mistreatment. The physician should be alert to physical and psychosocial findings suggesting physical, sexual or neglectful abuse. Upon discovery of abuse, intervention may be hampered by unwillingness on the part of the individual or the caregiver to comply with recommendations. A practical recommendation is to advise physicians to be alert for indicators of elder abuse, and to institute measures to prevent further abuse.

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