Nearly 1 in 10 seniors in the United States experience elder abuse at the hands of a loved one or health care provider. But a recent study published in the Journal of the American Geriatrics Society shows that the problem is going largely undiagnosed in hospital emergency departments across the country, putting millions at risk of illness, physical harm and neglect, HealthDay reports.

Elder abuse is defined as a single or repeated act that harms an older person or as the neglect of a senior by a trusted caretaker. Warning signs among elderly people include unexplained bruises, welts or scarring; poor hygiene; unexplained withdrawal or depression; and failure to take needed medication regularly. Spouses, partners, family members, friends or paid health care providers are all possible perpetrators of elder abuse.

For the study, researchers at the University of California, San Diego; the University of North Carolina, Chapel Hill; and other institutions examined more than 29 million emergency room visits of individuals age 60 and older recorded in the 2012 Nationwide Emergency Department Sample (NEDS) or the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). The primary goal of scientists was to find the proportion of emergency room visits that identified elder abuse.

Although researchers noted that up to 10 percent of the older adult population is affected by elder abuse, findings showed that elder abuse was diagnosed in only 3,846 visits overall, a ratio of 1 in 7,700. This indicates that this type of domestic violence is vastly underdiagnosed in U.S. emergency rooms. Neglect and physical abuse accounted for nearly 65 percent of cases reported in emergency departments of older patients suffering ill treatment at the hands of caretakers.

“Emergency physicians strive to make sure that for each patient who comes through the door, all serious and life-threatening conditions are identified and addressed. For elder abuse, EDs [emergency departments] across the country are falling short,” said Timothy Platts-Mills, MD, PhD, an assistant professor of medicine at UNC’s School of Medicine and senior author of the study.

Researchers also noted that victims of elder abuse often do not receive routine checkups from a primary care doctor and often depend on the emergency department, which makes a diagnosis of abuse more difficult. What’s more, it’s hard to identify elder abuse because many seniors who are physically frail or have mental health issues are prone to injury and may have difficulty caring for themselves.

Still, with elderly Americans across the country making more than 23 million visits to emergency rooms each year, it’s clear that these facilities can and should play an important role in ensuring the safety of these patients.

Click here to learn more about elder care and the proper way to support a loved one in need.