Elder mistreatment is a surprisingly common and often misunderstood phenomenon. It causes significant pain and suffering and is especially prevalent among those who have a dementing illness. Financial abuse is one of the most common types of mistreatment and often co-exists with other types (such as emotional and/or physical abuse). Sometimes the clinician is called upon to assess capacity for financial transactions. The implications and consequences of such an assessment are significant, and it is often helpful to engage a geropsychologist or neuropsychologist to assist with an accurate determination. It is critically important for the clinician to ask about abuse and to identify high-risk situations. Once abuse is suspected, the clinician must know what the reporting requirements and options are, as these vary among states. In general, suspected abuse in licensed facilities is reported to the Long-Term Care Ombudsman, and suspected abuse in community settings is reported to Adult Protective Services. Health practitioners have an opportunity to prevent and detect abuse at early stages, thus improving the quality of life for their patients and those who love them.