A recent national incidence study of elder abuse in community settings found an estimated 451,000 elderly persons who had suffered abuse in 1996. The figure increased to 551,000 when self-neglecting elderly persons were included. The study also estimated that only 21 percent of cases of elder abuse were reported. Such abuse was found to occur in all socioeconomic, racial, and religious groups, with victims varying in functional abilities and levels of dependency. Although elder abuse is not a recent phenomenon, it was not until 1975 that "granny battering" was discussed in the medical literature. Today, nearly every State has mandatory reporting laws regarding suspected elder abuse. The California Welfare and Institutions Code provides definitions for the types of elder and dependent-adult abuse. They involve physical abuse, neglect of another, self-neglect, abandonment, isolation, financial abuse, and psychological abuse. Abuse is more likely to occur in situations in which the caregiver and the elderly person have a pre-existing, problematic relationship; and often the abuser is financially and/or emotionally dependent on the elderly person. Mental illness, addiction to alcohol or drugs, or character traits of the caregiver can also be factors that contribute to abuse. Health professionals are in a unique position to recognize elder abuse. Indicators of abuse may be found in a physical examination and can include the following: bruises in various stages of healing; lacerations or abrasions to the mouth, lips, or gums; burns in unusual locations or shapes; or marks on wrists and ankles. Findings from the physical exam that are inconsistent with the caregiver's explanation of how they occurred may also suggest abuse. Upon identification of suspected elder abuse, health-care practitioners must report their concern to adult protection services or law enforcement agencies. The chapter describes procedures typically followed by adult protective services upon receiving a report of suspected elder abuse. A case history with follow-up questions is provided. 5 selected readings