If you have a client in treatment for a gambling disorder who is leaving a disabled older adult unattended while he/she gambles, what should you do?

• A. You should call the police
• B. You are bound by confidentiality
• C. You may have a duty to report elder abuse
• D. You should contact more responsible family members

Answer: (C)

The key idea is that protecting a vulnerable, dependent adult overrides routine confidentiality when there is reasonable concern of elder abuse or neglect. In this scenario, leaving a disabled older adult unattended while the client in treatment gambles creates clear risk to the elder’s safety and well-being. That situation triggers ethical and often legal obligations to act.

You may have a duty to report elder abuse under mandatory reporting laws or professional guidelines. This usually means following your jurisdiction’s rules by notifying the appropriate adult protective services or equivalent agency, and consulting your supervisor or agency policies. It’s also important to assess immediate risk, ensure the elder’s safety, and document what you’ve observed. If the elder is in imminent danger, calling emergency services is appropriate.

Confidentiality isn’t absolute; it has exceptions when a vulnerable person is at risk. Simply telling you to involve more responsible family members doesn’t address the safety concern or meet the reporting requirements. Calling the police directly may be part of the response in urgent, criminal-context cases, but the standard professional step is to report suspected elder abuse to the designated protective services first, following local laws.