A safeguarding concern in long-term care rarely arrives already labelled as abuse. It may begin with an older person becoming unusually quiet when a relative enters the room, unexplained withdrawals from a bank account, repeated missed medication, a disabled person being prevented from leaving home, or a family caregiver whose exhaustion has reached the point where essential support is no longer reliably provided. The operational challenge is recognizing what those signs mean without assuming that vulnerability removes a person's right to make decisions.
That tension between protection and autonomy is central to safeguarding in Costa Rica. The country's legal and institutional framework combines protections for older people, disability rights, domestic-violence measures, criminal justice, health services and an evolving long-term care system. The wider Costa Rica Aging, Long-Term Care & Community Support Knowledge Hub examines how these systems interact as population aging and demand for care increase.
Safeguarding cannot therefore be reduced to one institution or reporting route. The Consejo Nacional de la Persona Adulta Mayor (CONAPAM), Consejo Nacional de Personas con Discapacidad (CONAPDIS), Poder Judicial, Organismo de Investigación Judicial, Fiscalía, police, health services, care organizations, families and communities can all encounter situations requiring action. Their responsibilities differ, and not every concern requires the same response.
The stronger safeguarding model is one that can recognize serious harm quickly while remaining rights-based: protecting people from abuse, neglect, exploitation and abandonment without turning age or disability into a justification for unnecessary control.
Costa Rica's safeguarding architecture begins with rights
For older people, Law No. 7935, the Ley Integral para la Persona Adulta Mayor, provides an important national legal foundation. Costa Rica has also incorporated the Inter-American Convention on Protecting the Human Rights of Older Persons through Law No. 9394. Together with the country's wider constitutional and legal framework, these establish older people as rights-holders rather than passive recipients of protection.
For disabled people, Law No. 7600 on equal opportunities, the Convention on the Rights of Persons with Disabilities incorporated through Law No. 8661, and Costa Rica's subsequent autonomy framework reinforce equality, participation and legal agency.
This rights foundation changes the meaning of safeguarding.
The purpose is not merely to keep a person physically safe. Protection must also consider dignity, liberty, privacy, property, relationships, community participation and the person's ability to express preferences and make decisions.
That distinction becomes particularly important when somebody requires substantial support. Dependency may increase exposure to abuse because another person controls essential parts of daily life. It does not transfer ownership of the person's life to the caregiver, organization or state.
Effective adult safeguarding frameworks therefore need to combine protection with procedural safeguards and meaningful participation.
Abuse is broader than physical violence
CONAPAM's public guidance identifies a broad spectrum of harm affecting older people, including abuse, mistreatment, negligence, abandonment, exploitation and physical, psychological, patrimonial and sexual violence.
That breadth is operationally important because some of the most damaging forms of abuse can remain largely invisible.
Patrimonial abuse may involve somebody taking control of an older person's pension, coercing them into transferring assets, using their money without consent or preventing access to their own resources. Psychological abuse can involve intimidation, humiliation, threats or deliberately creating dependency. Neglect can arise through deliberate withholding of support, but it can also emerge where an overwhelmed caregiver can no longer safely meet increasingly complex needs.
Disabled people can experience additional forms of coercion associated with dependency on assistance, communication support, transport, housing or financial management. A person may fear reporting abuse because the alleged perpetrator is also the person who helps them get out of bed, access the community or communicate with others.
Safeguarding practice therefore needs to understand abuse, neglect and exploitation as patterns of power and dependency as well as individual incidents.
A bruise can be investigated. Financial control, coercion or sustained psychological intimidation may require a much more careful understanding of relationships and circumstances.
Protection routes depend on the nature and urgency of the concern
Costa Rica does not route every safeguarding concern through a single adult-protection agency. The appropriate response depends on what has happened, who is involved and whether immediate danger or possible criminal conduct is present.
CONAPAM advises that violence against an older person can be reported through relevant judicial and criminal routes, including the Organismo de Investigación Judicial and courts dealing with violence, while emergencies can be directed through 911. CONAPAM's Línea Dorada 1165 also provides continuous access to professional support.
Abandonment has particular legal significance. Since 2019, abandonment of an older person can constitute a criminal offense, and CONAPAM directs such cases toward the Organismo de Investigación Judicial or the Fiscalía.
The distinction matters because safeguarding encompasses several different responses:
- immediate emergency intervention where somebody faces imminent danger;
- criminal investigation where conduct may constitute an offense;
- judicial protection measures where legal protection is required;
- health or social intervention where unmet needs or caregiver breakdown create risk;
- organizational investigation where a service or worker may have caused harm; and
- preventative support where risks can be reduced before serious harm occurs.
A mature system needs these routes to connect. Sending a concern to the technically correct institution is not sufficient if nobody remains responsible for whether the person becomes safer.
Operational scenario: financial control hidden inside family support
An 81-year-old woman lives in her own home and receives substantial help from an adult son. He buys groceries, arranges transport and helps manage household payments. During a routine interaction with a community service, she quietly says she no longer knows how much money remains in her account. Her pension card is held by her son, and she says she is frightened that asking for it back will make him stop helping her.
The situation should not be reduced immediately to a family disagreement. There are indicators of possible patrimonial abuse and coercive dependency.
At the same time, safeguarding practice should avoid assuming incapacity simply because the woman is older or receives assistance. The first requirement is to understand her account, wishes and immediate safety in circumstances where she can speak freely.
If information indicates possible criminal exploitation or violence, the appropriate authorities may need to become involved. Practical planning also matters. If the son withdraws support, can she safely obtain food, medication and transport? Does she require additional home or community assistance? Is there another trusted person she wishes to involve?
The case demonstrates why safeguarding is simultaneously about rights and infrastructure. Removing an abusive relationship without replacing essential support can leave somebody technically protected but practically unsafe.
Organizations working through comparable decisions can use the Positive Risk Enablement Planner to structure thinking about autonomy, proportionality and risk. It does not determine Costa Rican legal action, but it can help teams distinguish protection from unnecessary restriction.
Family care creates both protection and vulnerability
Families remain fundamental to Costa Rica's long-term care landscape. They provide companionship, practical assistance, supervision and large volumes of unpaid care that formal services do not replace.
Safeguarding analysis should neither romanticize nor stigmatize this role.
Most family care is not abusive. Yet intensive dependency can create conditions in which risks increase: exhaustion, financial pressure, conflict, inadequate knowledge, isolation and lack of respite can gradually destabilize a care arrangement.
This is particularly important where safeguarding systems distinguish deliberate abuse from unmet need or caregiver breakdown without minimizing the consequences for the person receiving care.
An exhausted spouse who is no longer safely transferring a partner from bed requires a different response from somebody deliberately assaulting them. Both situations may create serious harm. Their causes and appropriate interventions are different.
Earlier caregiver support and navigation can therefore contribute to safeguarding. Respite, training, community services, health support and contingency planning can reduce risks before a family arrangement reaches breaking point.
This is an important connection between Costa Rica's safeguarding agenda and the developing Sistema Nacional de Cuidados y Apoyos (SINCA). Expanding formal care capacity can have a protective effect when it reduces excessive dependence on one unsupported relationship.
Protection must not become substituted decision-making
Safeguarding becomes ethically difficult when professionals, relatives or organizations believe that a person's preferred decision involves risk.
An older person may choose to continue living with a relative despite a complicated relationship. A disabled person may want to manage their own money after previously experiencing exploitation. Somebody may refuse a proposed service or choose to remain at home despite professionals believing that residential care would be safer.
Risk alone does not erase legal agency.
Costa Rica's disability-rights reforms are particularly relevant here. Law No. 9379 on the promotion of personal autonomy for persons with disabilities strengthened the move toward supported decision-making and equal recognition before the law.
Recent Costa Rican jurisprudence reinforces the importance of the person's voice. In a 2025 case involving an older person with a disability and protective measures, the Tribunal de Familia emphasized that proceedings concerning violence and safeguards for legal equality are not mutually exclusive and highlighted the need for judicial authorities to hear the older or disabled person's own opinion.
This reflects a wider principle within rights, consent and decision-making: safeguarding decisions should be made with the person wherever possible, not merely about them.
There are circumstances where urgent protective action is necessary. But urgency should not become a general rationale for excluding the person from subsequent decisions.
Costa Rica's newer judicial protection route broadens the safeguarding landscape
The Código Procesal de Familia, which entered into force in October 2024, added an important dimension to protection in Costa Rica.
Its special precautionary protection procedure allows people in vulnerable situations, including older people and persons with disabilities, to seek protection of fundamental rights through courts dealing with domestic violence and precautionary protection. The Poder Judicial has explained that this route is not limited to circumstances that fit a conventional domestic-violence case.
That matters because vulnerability can arise in circumstances where a person's fundamental rights require protection even though the facts do not map neatly onto an intimate or family violence framework.
The legal route does not remove the need for operational coordination. A court can order protective measures, but the person's everyday circumstances may still depend on healthcare, housing, income, personal assistance or long-term care.
The safeguarding pathway therefore needs to connect judicial protection with whatever practical support is necessary to make protection sustainable.
Disabled people can face distinctive safeguarding barriers
Disability does not itself create abuse. Environmental and relational conditions can, however, increase exposure to harm or make disclosure more difficult.
A person who relies on somebody else for communication may struggle to report that same person's behavior. Someone who cannot independently use transport may have limited opportunity to seek help privately. An inaccessible complaints process can make a nominal right to report practically unusable.
Women with disabilities can experience intersecting risks. In 2026, CONAPDIS and the Instituto Nacional de las Mujeres published guidance specifically addressing identification, understanding, response, referral and prevention of violence against women with disabilities, including physical, institutional, patrimonial, psychological, sexual and neglect-related violence.
The development illustrates why safeguarding systems need accessibility built into their design rather than added after a disclosure occurs.
That can include accessible information, communication support, private opportunities to speak, physical access, recognition of alternative communication and ensuring that the person providing assistance is not automatically used as the intermediary where that person may themselves be implicated.
Accessibility is therefore a protective mechanism as well as an equality requirement.
Operational scenario: communication changes the investigation
A 36-year-old woman with an intellectual disability receives daily support and lives with relatives. Workers notice that she has become distressed when one particular family member is present. She has limited spoken communication, and a relative initially explains that her behavior is simply part of her disability.
A poor safeguarding response accepts that explanation or attempts to question her rapidly using language she does not understand.
A stronger response creates conditions in which she can communicate in the way that works for her. Staff familiar with her usual communication identify changes in behavior but do not speak on her behalf. Appropriate communication support is arranged, and she is given time and privacy away from the relative.
Information emerges suggesting that money intended for her needs is being taken and that she has been threatened when she objects.
The response can now address possible patrimonial and psychological abuse through the appropriate protection and investigative routes. Her immediate support arrangements are also reviewed so that protection does not inadvertently leave her isolated or without essential assistance.
The operational lesson is important: communication difference must not be mistaken for absence of evidence. A safeguarding system that is inaccessible can systematically underestimate abuse among the people who depend most heavily upon it.
Safeguarding in care services requires organizational accountability
Not all safeguarding concerns originate within families. Residential homes, day services, home-support arrangements and other organizations can themselves create or conceal harm.
The risk may involve an individual worker, but organizational conditions matter. Weak recruitment, poor supervision, excessive workload, inadequate training or a culture in which concerns are discouraged can increase the likelihood that harmful practice continues.
Institutional harm can also become normalized without an obvious perpetrator.
Rigid routines that unnecessarily restrict residents, routinely ignoring people's preferences, leaving people without assistance for prolonged periods or using control primarily for organizational convenience may not initially be described as safeguarding issues. Yet repeated or severe practices can affect dignity, autonomy and wellbeing.
This is why quality, safety and safeguarding in aging services cannot be separated completely.
Ministry of Health requirements and CONAPAM oversight provide important elements of Costa Rica's assurance architecture, but organizations also need internal systems capable of recognizing harm between formal external reviews.
That includes clear reporting arrangements, management review, safe routes for workers to raise concerns and the ability to distinguish a minor practice issue from something requiring urgent external escalation.
Frontline workers need judgment, not only a reporting procedure
Safeguarding depends heavily on people who notice changes.
A home-support worker may be the only professional regularly entering somebody's home. A nurse may observe injuries during a health appointment. A therapist may notice that equipment has been withheld. A community worker may hear an older person repeatedly describe being left without food.
Training therefore needs to extend beyond knowing the telephone number for reporting concerns.
Workers need to understand different forms of abuse, recognize changes in behavior, document observations accurately and know when immediate escalation is required. They also need enough confidence to question explanations that do not fit what they are seeing.
At the same time, safeguarding training should discourage overinterpretation. Poverty, unconventional family arrangements or a person's decision to accept risk are not automatically evidence of abuse.
The competence lies in recognizing indicators, listening, documenting and escalating proportionately rather than attempting to become an investigator.
Organizations examining their safeguarding governance can use the Governance Maturity Assessment to test whether responsibilities, escalation and oversight are sufficiently clear. It does not replace Costa Rican safeguarding law or institutional procedures, but it can expose gaps between written policy and operational accountability.
Health services occupy an important detection point
The Caja Costarricense de Seguro Social (CCSS), including primary healthcare and hospital services, occupies an important position because health professionals encounter people who may not otherwise be connected to formal social support.
Safeguarding indicators can appear clinically: repeated injuries, malnutrition, medication problems, anxiety, poor hygiene, delayed treatment or deterioration inconsistent with the explanation provided.
None proves abuse independently.
They do, however, create a requirement to consider the wider circumstances rather than treating each presentation only as a medical event.
The interface becomes particularly important during hospital discharge. A person may be medically ready to leave hospital while the home environment has become unsafe. Returning somebody automatically to the same arrangement without considering credible evidence of neglect, violence or caregiver collapse can reproduce the risk.
Conversely, safeguarding should not be used to delay discharge simply because professionals dislike a person's chosen living arrangement.
Strong coordination across health and social support helps distinguish these circumstances and ensures that concerns identified clinically reach the institutions capable of responding to the wider risk.
Operational scenario: discharge exposes an unsafe care arrangement
A 79-year-old man is admitted to hospital following dehydration and a fall. He lives with a daughter who provides most of his daily assistance. During admission, staff learn that he has sometimes remained in bed for extended periods because his daughter works long shifts. She tells the team that she is exhausted and can no longer provide the same level of care.
The situation requires careful interpretation. There is potential neglect, but there is also evidence that the care arrangement may have exceeded the family's capacity rather than evidence of deliberate cruelty.
A discharge process focused only on the man's medical stability could return both people to the conditions that contributed to admission.
Instead, the wider support requirement is reassessed. The man's own preferences remain central: he wants to return home and wants his daughter involved, but agrees that additional support is necessary. Formal services, community options and contingency arrangements are explored alongside clinical follow-up.
If evidence emerged of deliberate harm or immediate danger, protective and investigative routes would still be required. In this case, however, strengthening the care arrangement may itself be the most important preventative safeguarding intervention.
The scenario demonstrates why safeguarding and hospital discharge and transitional care need to intersect. Risk cannot always be understood from the hospital bed; it often sits within the care network to which the person will return.
Abandonment reveals the boundary between family responsibility and public protection
Abandonment of older people presents Costa Rica with a particularly difficult intersection between family responsibility, criminal law, social protection and long-term care capacity.
CONAPAM has emphasized the country's continuing challenge around abandonment, while its current services include support for older people experiencing abandonment and homelessness. In September 2026, CONAPAM reported that more than 1,170 older people, predominantly men, were receiving continuing support through its program for people in conditions of abandonment.
The existence of criminal sanctions is important, but punishment cannot by itself create somewhere safe for a dependent older person to live.
Safeguarding therefore intersects with service capacity.
If an older person loses their only support network, institutions may need to address accommodation, healthcare, income, functional dependency and longer-term support simultaneously. The person may also have preferences that differ from what professionals consider administratively convenient.
This creates a broader policy requirement. Prevention of abandonment includes responding to harmful conduct, but it also involves building a care system capable of supporting people before fragile family arrangements collapse completely.
The developing SINCA architecture is relevant because greater access to formal support can reduce the binary choice between unlimited family responsibility and institutional rescue after breakdown.
Financial safeguarding will become increasingly important
As Costa Rica's population ages, patrimonial abuse deserves sustained attention.
Financial exploitation can occur through theft, coercive transfers, misuse of pensions, fraudulent transactions or pressure around property and inheritance. It may be particularly difficult to identify where another person legitimately helps manage finances.
The operational question is not simply who carries out transactions. It is whether those transactions reflect the older or disabled person's authorization and interests.
Digital banking introduces both protection and new exposure. Electronic records can make unusual activity more visible, but people with limited digital confidence may become increasingly dependent on relatives or other intermediaries. Password sharing and delegated access can blur boundaries.
Technology should therefore not be assumed to remove financial safeguarding risk. It changes its form.
The same principle applies to technology-enabled care. Monitoring systems, location devices and sensors may increase safety, but intrusive surveillance can undermine privacy and autonomy if introduced without appropriate consent or safeguards.
Organizations considering digital systems can use the Digital Transformation, AI and Cybersecurity Readiness Assessment to structure questions about governance, access, privacy and digital risk. The tool is not a Costa Rican data-protection or safeguarding standard; it provides a framework for examining whether technology governance is keeping pace with operational adoption.
Rural safeguarding depends on reach and visibility
Geography can change how safeguarding operates.
In a densely connected area, somebody may encounter healthcare staff, neighbors, community services and multiple relatives. In a remote community, a dependent person may have far fewer points of contact outside the household.
Distance can also complicate professional response. Travel times affect home visits. Specialist services may be concentrated elsewhere. Digital communication can extend reach, but connectivity and digital confidence are uneven.
These conditions do not mean rural communities are inherently unsafe. Close community relationships can provide powerful protective networks. The issue is whether a person has confidential and accessible routes to seek help when the principal support relationship itself becomes unsafe.
Effective safeguarding in rural and underserved communities therefore needs to consider visibility, transport, communication and professional reach alongside formal reporting procedures.
A national safeguarding framework can define rights consistently while still requiring locally workable routes for exercising them.
Operational scenario: a rural concern requires coordinated escalation
An EBAIS professional in a rural area becomes concerned about a 72-year-old disabled man whose nephew provides most of his assistance. During several contacts, the man appears increasingly withdrawn. His mobility equipment is poorly maintained, and he says he rarely leaves the property because his nephew controls transport.
There is no single disclosure of assault. The concern develops from a pattern: isolation, dependency, deteriorating equipment and restricted access to the community.
The professional documents observations and arranges an opportunity to speak with the man privately. He explains that he wants to remain at home but does not want his nephew controlling every aspect of his life.
The safeguarding response therefore needs more nuance than either leaving the situation untouched or automatically removing him from home. His wishes guide planning while possible coercion is considered through the relevant protection routes. Practical alternatives are equally important: equipment support, transport, formal assistance and community connections may reduce his dependence on the relationship.
If subsequent evidence indicates criminal conduct or immediate danger, escalation changes accordingly.
What makes the case governable is continuity. The concern does not disappear after referral. The professionals involved need to know whether the protective and support responses actually reduce isolation and increase the man's control over daily life.
Information sharing must be purposeful and proportionate
Safeguarding often creates pressure to share information rapidly. That can be necessary, particularly where somebody faces serious harm.
But the existence of a safeguarding concern does not make privacy irrelevant.
Costa Rica's broader legal framework on personal data remains relevant to institutions handling sensitive information. SINCA itself depends increasingly on coordination and information exchange, creating both opportunities and responsibilities.
Organizations need to understand what information is required, why it is being shared, who needs it and what legal basis or protective necessity supports the exchange.
Over-sharing can expose highly personal information unnecessarily. Under-sharing can prevent another institution from understanding serious risk.
This makes privacy, confidentiality and data protection part of safeguarding governance rather than an obstacle to it.
Good information exchange is purposeful. It provides enough context for action while respecting the person's rights and avoiding indiscriminate circulation of sensitive records.
Governance should look for recurrence, not only individual closure
A safeguarding system becomes more effective when it learns across cases.
Individual investigations need confidentiality, but aggregated patterns can reveal weaknesses that no single case exposes. Repeated financial concerns involving the same service, several neglect incidents associated with workforce shortages or recurring complaints about inaccessible reporting routes may indicate systemic risk.
Useful governance questions include whether concerns are increasing, where they occur, which populations appear underrepresented in reporting, how quickly serious risks are escalated and whether the same underlying causes recur after corrective action.
Low reporting should not automatically be interpreted as low abuse. It may indicate effective prevention, but it can also indicate that people do not know how to report, fear consequences or lack accessible routes.
Organizations can use the Quality Dashboard Builder to structure broader combinations of safety, quality and outcome indicators. Used carefully, dashboard approaches can help leaders identify patterns without reducing complex safeguarding decisions to a target number.
System learning becomes particularly valuable where responsibilities cross institutions. If the same gap repeatedly appears between health services, long-term care and judicial protection, that is no longer simply an individual-case problem. It becomes a governance issue.
The future safeguarding model is preventative as well as protective
The most visible safeguarding activity happens after concern is identified. The greater long-term opportunity lies upstream.
Reliable home support can reduce dependence on a single caregiver. Respite can prevent exhaustion becoming neglect. Accessible transport can reduce isolation. Supported decision-making can reduce opportunities for coercive control. Workforce training can improve early recognition. Strong complaints systems can surface poor practice before it becomes severe.
These interventions do not eliminate abuse. They reduce some of the conditions in which harm can remain hidden or become normalized.
As SINCA develops, safeguarding should therefore be considered part of system design rather than a specialist process activated only after an incident.
This is especially important as Costa Rica expands community-based support. Moving care away from institutions can strengthen autonomy and inclusion, but dispersed support also requires effective mechanisms for identifying harm occurring behind private doors.
The strategic objective is not maximum surveillance. It is sufficient connection that people can seek help, professionals can recognize credible risk and institutions can act without unnecessarily removing control from the person they are trying to protect.
International learning: protection and autonomy are not opposing objectives
Costa Rica's safeguarding architecture is shaped by its own legal system, institutional responsibilities and rights framework. Its mechanisms cannot simply be transplanted into another country.
There is nevertheless a wider lesson in the relationship between protection and legal agency.
Safeguarding systems can become overly paternalistic when age, disability or dependency is treated as evidence that somebody else should decide what is best. At the opposite extreme, an excessively narrow interpretation of autonomy can leave people exposed to coercion because intervention is avoided even when their ability to exercise genuine choice is being undermined.
The stronger approach recognizes that autonomy sometimes requires support and protection. Accessible communication, independent advice, personal assistance, financial safeguards and reliable care can increase rather than diminish a person's ability to make decisions.
The transferable principle lies less in Costa Rica's specific institutions than in connecting rights, protection and practical support. A court order, criminal investigation or safeguarding referral may be essential, but sustainable safety frequently depends on what happens afterward in the person's home, relationships and support network.
Conclusion
Costa Rica has substantial legal and institutional foundations for protecting older and disabled people from abuse, neglect, exploitation, violence and abandonment. Law No. 7935, disability-rights legislation, domestic-violence protections, the newer family-procedure framework and the roles of CONAPAM, CONAPDIS, the justice system, police, health services and care organizations create multiple routes through which harm can be recognized and addressed.
The central strategic challenge is making those routes work as a connected safeguarding system. A person should not become lost between criminal investigation, judicial protection, healthcare and long-term support. Nor should protection remove the person's voice simply because age, disability or dependency makes decision-making more complex.
As Costa Rica develops SINCA and expands community-based care, prevention will become increasingly important. Reliable formal support, accessible reporting, caregiver assistance, competent workers, appropriate information sharing and stronger cross-institutional learning can reduce the circumstances in which abuse remains hidden or fragile care arrangements collapse.
The strongest safeguarding system is therefore neither one that intervenes in every risk nor one that waits for incontrovertible evidence of serious harm. It is one capable of recognizing patterns early, escalating proportionately and sustaining practical protection while preserving dignity, autonomy and participation. For Costa Rica, connecting those principles to everyday delivery will determine whether a strong rights framework becomes equally strong protection in people's actual lives.