Abuse of the elderly is a relatively new phenomenon, at least in terms of the dialogue becoming public. It is not as easy as child abuse to recognize and it takes a variety of forms including overt physical abuse, self-abuse, neglect, verbal abuse, and emotional behavior. There are several evaluation assessments. Not all of them are effective, and even the more accurate tools cannot definitively determine for certain whether there is abuse. They can only suggest the possibility that there may be abuse and therefore circumstances should be further investigated to determine whether there is reason to report suspected abuse. The inherent ethical conflicts associated with reporting are also investigated. In addition, the issue of confidentiality is explored particularly with reference to privacy laws. There are 2 cases presented, and the ethical considerations are embedded throughout the cases and the summary passages.