A PMHNP conducts a home visit for a 78-year-old woman with major depressive disorder and early vascular dementia. The patient's adult son, who is her primary caregiver, is present. The PMHNP notices the patient has lost 20 pounds since the last visit, has an unkempt appearance, a stage II pressure ulcer on her sacrum, and an unexplained bruise on her left forearm. When asked about meals, the patient whispers, 'He forgets to feed me sometimes, but don't say anything — he's all I have.' The son becomes defensive and states, 'She's exaggerating — I do my best.' The PMHNP must determine her legal obligation while navigating the patient's explicit request not to report.