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Elder abuse — ABIM Board MCQ

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HardGeneral Internal MedicineElder abuseABIM Board

An 86-year-old has bruises in different stages of healing, poor hygiene and missed appointments. His caregiver answers every question and he appears fearful when the caregiver approaches. What is the most appropriate immediate clinical response?

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Correct answer: A — Interview him privately and complete an immediate safety and reporting assessment

The best answer is “Interview him privately and complete an immediate safety and reporting assessment”. The pattern raises concern for mistreatment or neglect. A private, trauma-informed interview and immediate safety assessment reduce coercion, while cognition, injuries, needs and the patient’s account are documented objectively. Reporting duties vary by jurisdiction and setting, but uncertainty is not a reason to ignore credible warning signs.

Reference: CDC About Abuse of Older Persons: https://www.cdc.gov/elder-abuse/about/index.html