Elder abuse treatment is twofold. First, emergency department treatment of the injuries and illnesses resulting from abuse or neglect must be specific for the injuries and illnesses detected. Second, detection of elder abuse or neglect must be aimed at intervention. Therefore, all treatment, whether delivered in the emergency department or the hospital, for both victim and the victim's caregiver, should be on the basis of multidisciplinary assessment and may result in admission of the elderly patient to an extended-care facility.

Intervention includes the resolution of disposition problems brought about through caregiver exhaustion, the inability of patients to care for themselves in the community, and abandonment by individuals and institutions. Intervention requires a complex array of skills. For example, the serious problem of drug and alcohol abuse among the elderly must be recognized and addressed by emergency department staff. Physical problems often disguise the existence of a problem of substance abuse.

In cases of proven or strongly suspected elder abuse or neglect, intervention must include the involvement or adult protective services. 7 All 50 states have passed legislation aimed at protecting elderly victims of domestic abuse and neglect and establishing adult protective services programs. In 1997, it was reported that 42 states had mandatory reporting laws directed toward health care and social-service professionals. These laws require disclosure of suspected elder mistreatment despite the adult victims' wishes.

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