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Every year, approximately 4 million older Americans fall victim to abuse and neglect. And for every reported case of elder abuse and neglect, approximately 23 cases go undetected. About 90% of elder abuse is committed by a family member in the home, with the other 10% committed by hired caretakers, intimate partners, or healthcare workers in long-term care facilities. In some cases, the elderly person is neglecting or abusing him- or herself. Nurses are obliged to provide comprehensive and compassionate end-of-life care. This includes recognizing when death is near and conveying that information to families. Nurses should collaborate with other members of the health care team to ensure optimal symptom management and to provide support for the patient and family. Nurses and other health care providers have a responsibility to establish decision-making processes that reflect physiologic realities, patient preferences, and the recognition of what, clinically, may or may not be accomplished. Establishing goals of care for this patient at this time may provide a framework for discussion about what care should be provided. This process often involves collaboration with experts in decision-making, such as ethics committees or palliative care teams. References Swanson, E. (2015). Legal implications of nursing action. Journal of Nursing; 37(9): 78-92.