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Elder abuse and neglect
Abuse of an older person — physical, psychological, financial, sexual or neglect — is common and hidden; the doctor must suspect it, speak with the patient alone, document, ensure safety, and in Israel a professional must report when there is reasonable ground to believe an offence was committed against a helpless person.
Why it matters in the exam
The exam presents an older adult with bruises that do not fit the explanation, neglected pressure injuries, weight loss, missed medications or a sudden change in finances, and asks for the next step: interview alone, document in detail, report. Candidates are also asked about risk factors: dependence, cognitive decline, isolation, and a caregiver who is overburdened, has a substance problem or depends financially on the patient.
In Israel, section 368D of the Penal Law obliges doctors, nurses and other professionals to notify the police or a social worker (under the Protection of Helpless Persons law) when there is reasonable ground to believe an offence was committed against a helpless person; hospitals follow a dedicated Ministry of Health procedure. By World Health Organization estimates, about one in six older adults in the community experiences some form of abuse each year.
Abuse is linked to increased mortality, admissions and moving into an institution, and most cases are not reported. The abuser is usually a family member or a close caregiver, who is sometimes financially or emotionally dependent on the patient. The exam also asks about the doctor's role in an institution: an unexplained injury in a care-home resident requires the same examination, documentation and reporting. In self-neglect — an older adult living in dangerous conditions who does not look after themselves — capacity is assessed, a social worker is involved, and sometimes the court is approached.
Key points
- Abuse is common and hidden: physical, psychological, financial, sexual, neglect.
- Risk factors: dependence, cognitive decline, isolation, an overburdened or addicted caregiver.
- Interview alone, document precisely, ensure safety.
- In Israel: section 368D — a professional's duty to report.
- Bruises on the face, neck and back are more suspicious than bruises on the limbs.
Summary table
| Type | Suspicious signs | Action |
|---|---|---|
| Physical | Bruises on the face, neck, outer arm or back; bruises at different stages of healing; unexplained fractures | Examination, imaging, documentation |
| Neglect | Pressure injuries, dehydration, undernutrition, poor hygiene, medications not given | Assess the caregiver and the environment |
| Psychological | Fear, withdrawal, humiliation, threats | Interview alone |
| Financial | Sudden change in a will or accounts, unpaid bills | Social worker, guardianship if needed |
| Sexual | Genital bruising, a new sexually transmitted infection | Dedicated examination and reporting |
Free exam questions
בת 70 ,, מסיימת שיקום 6 שבועות לאחר CVA שהשפיע על ה- Left Parietal Lobe . אין לה שום פגיעה מוטורית שארית, וחולשת יד ימין איתה התייצגה חלפה לחלוטין. עם זאת, היא מביעה תסכול מכך שלא מצליחה לבצע פעולות בסיסיות כגון לבוש, שימוש בסכין ומזלג, או סירוק השיער. היא מבינה את ההנחיות, יכולה לתאר במילים את רצף הפעולות הנדרש, אך לא מצליחה לייצר את התנועות הנדרשות באופן מותאם על מנת לסיים את המשימה. כיצד נקראת התופעה שאותה ?מציגה המטופלת (the question as examined, in Hebrew)
- א. Ataxia
- ב. Neglect
- ג. Apraxia
- ד. Agnosia
איזה מבין השברים הבאים מוגדר כבעל ספציפיות בינונית ל אבחנה של child abuse ? (the question as examined, in Hebrew)
- א. שבר בסקפולה
- ב. שבר בסטרנום
- ג. שבר בגוף חוליה
- ד. שבר בזיז של חוליה
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Sources
- World Health Organization — Elder abuse fact sheet and global prevalence review, 2017–2024 — Types, prevalence and risk factors
- Israeli Penal Law, 1977 — section 368D (duty to report an offence against a minor or a helpless person), current version — Reporting duty of professionals
- Israeli Ministry of Health — procedure for the care of older adults who are victims of abuse, current version — Identification, documentation and reporting
- Geriatrics Review Syllabus (American Geriatrics Society), 11th edition (2022) — Mistreatment of older adults
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.