On Monday, June 15, organizations and activists around the world will come together to mark World Elder Abuse Awareness Day, an annual event to educate the public about this growing problem.

More than two million aging Americans fall victim to elder abuse each year, and what’s more, one in three nursing homes have been cited for abuse. Sadly, the problem is much more extensive than even those grim numbers suggest; for every case reported to authorities, at least five go unreported, according to consumer rights activists with the National Center on Elder Abuse.

“A majority of cases go unreported because they deal with family members who are also caregivers,” says elder rights advocate Nancy Ketcham. “Ninety percent of abusers are caregivers who are family members. Victims are also afraid of retaliation from their caregivers if they report it.”

Since 2006, the United Nation’s World Health Organization and the International Network for the Prevention of Elder Abuse have teamed up to hold events all over the world designed to better protect senior citizens. According to the official World Elder Abuse Awareness Day website: “WEAAD serves as a call-to-action for individuals, organizations, and communities to raise awareness about elder abuse, neglect, and exploitation.”

What are some of the signs of elder abuse?

Elder abuse can take many forms, such as financial abuse, physical abuse, healthcare fraud, and neglect. Some signs to watch out for:

• Unexplained injuries or signs of struggle, such as bruises, welts, or broken eyeglasses

• Missing or stolen medication. Alternatively, extra medication as a result of failing to administer the pills regularly

• Untreated health problems like bed sores, or being left unwashed or in unsanitary conditions

• Isolation, such as when a caregiver refuses to let you see the elder alone

• Sudden changes in financial reports, unnecessary services or billings, duplicate billings, and unusual financial activity

Additionally, one study suggests that as many as 50% of dementia patients suffer elder abuse. And because older citizens will make up 20% of the total U.S. population in the coming decades, experts say the problem will only become more widespread.

Many U.S. states now have agencies where citizens can report elder abuse, and most countries have national hotlines for reporting as well.