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Năm ngoái, Hoa Kỳ có kinh nghiệm một loại bạo lực đã thực sự gây sốc cho quốc gia và có thể thay đổi đất nước của chúng tôi mãi mãi. Tuy nhiên, trước khi các sự kiện của ngày 11 Tháng 9, bạo lực đã ngày càng trở thành một phần không mong muốn của xã hội chúng ta. Vụ giết người, cướp, và các cuộc tấn công là những triệu chứng rõ ràng, | Matters of Importance Last year the United States experienced a type of violence that has truly shocked the nation and probably changed our country forever. However before the events of September 11 violence had increasingly become an unwanted part of our society. Murders robberies and assaults are the obvious symptoms but family violence is insidious and even more destructive to the fabric of our society. It often affects those who cannot defend themselves and who because of perceived dependence cannot extricate themselves from the abusive situation. In the past we have dealt with child abuse1 and spousal abuse.2 The article by Drs. Chen and Koval in this issue focuses on the third type of abuse that done to the elders of our society. This element is the most difficult because it can have so many different facets. As pointed out by the authors all states now have laws that specifically target abuse in the elderly and mandate reporting by health care professionals. Although the incidence of elder abuse may be as much as 1 to 2 of the noninstitutionalized older population 3 it is less commonly reported than spousal abuse or child abuse. Elder abuse by nature can be emotional sexual financial or physical either assault or deprivation . This range makes the signs and symptoms of elder abuse even more diverse and harder to comprehend. The difficulty in recognition may be compounded by the elderly person s reticence to report abuse because of the fear of being isolated feelings of dependence or the fear of family embarrassment. Even when it is reported elder abuse may be discounted as signs of aging disease or dementia. Our responsibility as physicians is clear we must educate ourselves to know what the problem is and how to effectively recognize it. We each need to understand the laws of our own state the reporting mechanisms and the agencies that can help our patients. As we were willing to step forward to help with the victims of the terrorist attacks so we need to .