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You have brought up many great points within your post for gaining a full understanding of the patient’s background for developing a decision of whether or not abuse is the cause of the patient’s condition. Although the appearance of abuse is there the first priority for the physician is to stabilize the patient by determining the cause of the breathing issues, looking into the kidney failure, and once stabilized investigating the potential abuse. You have additionally pointed out that patients suffering from Alzheimer’s can be confrontational and could lash out because they do not understand what the medical staff is doing to them. Regardless of the medical prognosis documentation is key if abuse is determined to ensure that the abuser is brought to justice