Elder abuse is defined as a single or repeated act that causes harm or distress to an older person within a relationship where trust is expected. Common types of elder abuse include psychological, financial, physical, and neglect. Analyses found that adult children and spouses or partners are most often the abusers. Professionals and victims may discount abuse by believing it is not a problem or that nothing can be done. Institutional abuse involves the failure of an organization to provide an appropriate service for older adults. Signs of abuse include injuries, malnutrition, poor hygiene, and behavioral changes. Responding appropriately involves listening without judgment, documenting concerns, ensuring safety, and monitoring the situation.