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Elder and Dependent Adult Abuse Prevention (revise forms 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out the 'Elder or Dependent Adult in Need of Protection' section. Enter the full name, gender, and age of the individual requiring protection.
  3. In the 'Person From Whom Protection Is Sought' section, provide the full name and address of the individual from whom protection is being requested.
  4. Complete the 'Person Requesting Order' section by checking the appropriate box indicating your relationship to the elder or dependent adult. If applicable, include details about your legal authority.
  5. Fill in your contact information accurately. If you have a lawyer, provide their details; otherwise, you may use an alternative mailing address for privacy.
  6. Continue through each section detailing descriptions of abuse, relationships between parties, and any additional protected persons as necessary. Use attachments if more space is needed.

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Educate yourself and others. Simple support for children and parents can be the best way to prevent child abuse. After-school activities, parent education classes, mentoring programs, and respite care are some of the many ways to keep children safe from harm.
Relay your concerns to the local adult protective services, long-term care ombudsman, or the police. If you have been the victim of abuse, exploitation, or neglect, you are not alone. Many people care and can help.
Elder abuse can take several forms, including neglect and physical, emotional, financial, or sexual maltreatment. Adult self-neglect is the most common form of elder abuse2 (Table 124).
Listen to the person, acknowledge what they are saying and validate their feelings. Determine the level of urgency is it an emergency, urgent call 000 or non-urgent? Follow agency procedures, including informing line managers. Take steps to safeguard the older person and others in any response to the abuse.
The first step in preventing elder abuse is educating yourself. You need to know what the common signs of it are and get rid of any stereotypes you may have. Educate others. Once you know more about the issue, you can do your part to educate others.

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