Some barriers to detection of elder abuse by primary health care clinicians include a tendency to focus only on medical concerns, the reluctance of victims to acknowledge abuse or neglect, clinicians' ageist attitudes, and lack of knowledge of victims and their families. Physicians should approach elder abuse the way they approach diseases that compromise the quality of life and independence. Screening in a primary care clinician's office should be targeted at obtaining an accurate depiction of the elderly person in the context of his/her home environment. Vital information should include data on personal health, functional abilities, mental capacity, social and economic resources, and information about the living situation. Much of this information can be obtained in cumulative fashion in primary care settings to create a profile or database on each elderly patient. This chapter includes specific questions designed to elicit this information. These questions may help to identify an individual at high risk of being abused or may detect a previously unrecognized victim. Suggestions are also offered for interviewing perpetrators. 23 references