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A 75-year-old male is brought to the ED by his son- in-law for evaluation of altered level of consciousness. The patient has reportedly been bedridden for 2 days. Examination shows advanced sacral decubitus ulcers and bilateral ecchymoses of the upper arms. The son-in- law and the daughter both live with the patient. The son-in-law reports that the patient has been increasingly paranoid in recent weeks, with delusions of poisoning. What is the MOST likely diagnosis?

(A) Urosepsis

(B) Elder abuse

(C) Dementia

(D) Alcohol withdrawal

(E) Medication side effect

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(B) Elder abuse