Lack of proper training of service providers, such as social workers, law enforcement, nurses, etc., about elder abuse, therefore the number of cases reported tend to be low. The subjective nature of elder abuse, which largely depends on ones interpretation. Another reason why there is a lack of accurate statistics is the debate of whether to include self-neglect or not. Many are unsure if it should be included since it does not involve another person as an abuser. Those opposed to the inclusion of self-neglect make the claim that it is a different form of abuse and thus, should not be included in the statistics. Due to this discrepancy and the others mentioned above, it is difficult to get accurate data concerning the abuse of the elderly. Prevention
Doctors, nurses, and other medical personnel can play a vital role in assisting elder abuse victims. Studies have shown that elderly individuals, on average, make 13.9 visits per year to a physician. Although there has been an increase in awareness of elder abuse over the years, physicians tend to only report 2% of elder abuse cases. Reasons for lack of reporting by physicians include a lack of current knowledge concerning state laws on elder abuse, concern about angering the abuser and ruining the relationship with the elderly patient, possible court appearances, lack of cooperation from elderly patients or families, and lack of time and reimbursement. Through education and training on elder abuse, health care professionals can better assist elder abuse victims.
Atrophic rhinitis is also associated with similar atrophic changes in the pharynx or larynx, producing symptoms pertaining to these structures. Hearing impairment can occur due to Eustachian tube blockage causing middle ear effusion. Etiology
Causes can be remembered by the mnemonic HERNIA:

Hereditary factors: the disease runs in  families
Endocrine imbalance: the disease tends to start at puberty and mostly involves females
Racial factors: white people are more susceptible than natives of equatorial Africa
Nutritional deficiency: vitamins A or D, or iron
Infection: Klebsiella ozaenae, diphtheroids, Proteus vulgaris, E. coli, etc. Autoimmune factors: viral infection or some other unidentified insult may trigger antigenicity of the nasal mucosa. Secondary atrophic rhinitis
Specific infections, such as syphilis, leprosy and rhinoscleroma, may cause destruction of the nasal structures leading to atrophic changes. Atrophic rhinitis can also result from long-standing purulent sinusitis or radiotherapy of the nose, or as a complication of surgery of the turbinates. The United Kingdom National Health Service has stated that "Most cases of atrophic rhinitis in the UK occur when the turbinates are damaged or removed during surgery". Some authors refer to as Atrophic rhinitis secondary to sinus surgery as the empty nose syndrome. Unilateral atrophic rhinitis
Extreme deviation of nasal septum may be accompanied by atrophic rhinitis on the wider side. Pathology
The ciliated columnar epithelium of the nasal mucosa is replaced by stratified squamous epithelium. Atrophy of mucosa, turbinal bones and seromucinous glands tends to occur, due to obliterative endarteritis and periarteritis causing decreased blood supply, hence the supplying area atrophies. Arrested development of paranasal sinuses.