For many senior citizens and the chronically sick, moving from nursing-home to in-home care is a preferable option when available. After all, we'd much rather be in a familiar, comfortable environment than in what can seem an impersonal medical facility. For this reason the shift to in-home care is quite understandable. Sadly, however, the opportunities for elder abuse and neglect also multiply in a home setting, as a recent article in The Atlantic makes evident. This comes down to one pivotal reason: a systemic lack of oversight to ensure patient safety and caregiver responsibility.