As an emergency physician, I have treated older adults who arrive in the ER with horrific signs of physical abuse, including injuries that led to disability or death. I have also seen our elders who are mentally, emotionally, and sexually abused, and who are targets of financial crimes and exploitation.

The statistics of elder abuse are shocking: one in 10 Americans aged 60 or older have experienced some form of abuse, and as many as five million older adults are abused every year. Unfortunately, only one in 14 cases are reported to the appropriate authorities. Another disturbing fact: 60% of perpetrators of abuse are family members of the victims. Elder abuse is happening right in our homes and communities every day.

June 15, 2018 was World Elder Abuse Day. The Baltimore City Health Department and the Baltimore City Department of Social Services (DSS) developed a Senior Resource Fair at the Jenkins Senior Living Pavilion. The Health Department’s Division of Aging and CARE Services team, led by Deputy Commissioner Heang Tan, discussed the Senior Companion Program and provided information about how all of us must work together to prevent the abuse of older adults. I want to thank Heang and her team, as well as DSS Director Stacy Rodgers, for their collaborative efforts—under Mayor Pugh’s leadership—to advance health and safety for our older adults.

Our World Elder Abuse Day event also highlighted the Health Department’s continued collaboration with the Baltimore Police Department, the State’s Attorney’s Office, non-profit partners, and physicians across the City. We must recognize that we all have a role to play in responding to elder abuse – it’s a community problem, a public health concern, and a criminal matter. Everyone can help. We can look for warning signs, including signs of physical injury, as well as signs of withdrawal, isolation, or nervousness among our elders. We should report instances or suspected instances of abuse: All of us should speak up, and not assume that someone else will do so.

Given recent developments on our southern border, I also wish to comment on the violent separation of immigrant children from their parents, and subsequent detention in makeshift facilities on the U.S.-Mexico border. The American Academy of Pediatrics, the American College of Physicians, and the American Psychiatric Association – organizations representing more than 250,000 doctors across the country – have all issued statements against the family separation and detention practices imposed by the Trump Administration. The trauma these children are enduring at the hands of our government will fundamentally change the physical structure of their brains, and lead them to develop PTSD, anxiety, depression, and other mental health challenges. It is clear to me as a doctor and as a mother that our treatment of immigrant children – many of whom are fleeing gang violence, sexual abuse, and extreme material deprivation – is immoral and inhumane.

As the late Elie Wiesel, Holocaust survivor and Nobel Laureate, said: “Indifference is the sign of sickness, a sickness of the soul more contagious than any other.” We cannot afford to be indifferent to the abuse that is happening all around us. We must work to protect the most vulnerable in our communities, and to treat our older adults and children – no matter where they come from – with the dignity, humanity, respect, and compassion they deserve.

Leana Wen, M.D., M.Sc.