Same 85-year-old patient as above. Given the son's hostility, the patient's withdrawn demeanor, and unexplained bruises on the arms, which of the following should the doctor do?

Correct answer: A. Report to Adult Protective Services (APS)

• A. CORRECT — Dentists in all U.S. states are mandated reporters when there is reasonable suspicion of elder abuse. The cluster of hostile caregiver, withdrawn patient, and unexplained bruises meets the threshold for reporting to Adult Protective Services (APS). Reporting is required based on suspicion; you do not need proof.
• B. Documenting alone without reporting fails the mandated-reporter duty when reasonable suspicion exists.
• C. Discussing concerns with the potential abuser present would endanger the patient and violate confidentiality.
• D. Delaying and simply following up is inadequate when reasonable suspicion of elder abuse exists — the patient may not return, and harm may continue.