1. The alarm signs for potential elder abuse in this situation include the submissive behavior and the patient's reliance on her son to answer direct questions. In addition, the fact that the son has the patient's checkbook and forges the signature is troubling and suggests financial abuse. 2. The next steps in reporting suspected elder abuse should include speaking with the patient alone...let the patient know that you simply want to help. If the patient is reluctant, it may signal abuse. If the situation is not urgent, notify adult protective services in the home state.