In an older adult hospitalized with recurrent falls, weight loss, without clear injuries, but with an inconsistent or difficult-to-reach caregiver, what findings would make you formally report suspected elder neglect and/or abuse?

I'm so glad that you're thinking about the possibility of abuse/neglect in this scenario! It's important to have it on our differential, or we'll always miss this diagnosis. First, it would be good to see if the patient can explain what is happening and provide contextual information that veers us away from abuse/neglect... doesn't seem likely, but it's possible. And it's important to hear what the patient thinks, wants, and believes.

From a legal perspective, it depends on your state's laws. I'...

I agree with Dr. @Dr. First Last - and would add that I also try to enlist our social worker. Sometimes patients are already enrolled with an outpatient case manager - and the PCP for collateral and input early on.