Fear of misinterpreting a case of elder abuse may be stopping some nurses from reporting it, according to a survey.
The poll found no evidence that abuse was going unreported
Some 60% of 850 private and NHS nurses polled said such concerns might stop them making a report, while 26% cited fear of retribution from the abuser.
But the poll by Help the Aged provided no evidence that abuse in hospitals or care homes, which it primarily examined, was going unreported.
Nursing home representatives said staff training was better than ever.
According to studies, as many as 350,000 older people are at risk of abuse in the home.
But few statistics are available on abuse in the hospital or care home - which this poll primarily looked at.
The thrust of the findings was positive - around 80% of the nurses were happy with both the training they had received and knew what to do if they suspected someone was being abused.
The same number of respondents were also confident that correct procedures would be followed if suspected incidents were reported.
But while some said "nothing" would stop them reporting their suspicions, nearly 60% said concern that they may have misinterpreted the situation could put them off.
And 26% said fear of the abuser confronting them was a barrier.
The presence of bed sores - often seen as a sign of neglect but not necessarily a marker - are one example of where misinterpretation can occur.
When asked what stopped staff providing the best possible care for vulnerable adults, nearly 70% said lack of training and nearly 62% said responsibility for too many clients.
However, more than 80% said they would feel happy for their parents or an elderly relative to be treated at their place of work, taking into account the policies on elder abuse in place.
The nurses polled worked both privately and for the NHS. They worked within hospitals, care homes and the community.
Jean Gould, legal policy officer for Help the Aged, said: "It is a national disgrace that we sit back while thousands of older people are abused every day."
Rebecca Neno, the Royal College of Nursing's spokeswoman for elder abuse, urged nurses not to be afraid "of upsetting or embarrassing the older person" when they suspected a case of abuse.
"They have a duty to safeguard and protect these patients," she said.
But Frank Ursell, chief executive officer of the Registered Nursing Homes Association, said staff were better trained than ever before.
"Obviously there is work left to do, but these reports often end up undermining nurses and making older people worry unnecessarily."
The Department of Health said it was working hard to root out the abuse of vulnerable and older people, noting that the NHS provided a range of materials to raise the profile of abuse prevention and assist with recognition.