Yes, physical abuse is a major concern, but I'm somewhat less exposed to it in my practice. I've nevertheless seen it.
As an example, I can cite a situation associated with one of my cases. It involved a person who was being neglected and abused by her granddaughter. The family history was very complicated and involved crime and other issues. The woman couldn't report her granddaughter, first of all, as a result of her emotional tie to her, but also because her granddaughter was virtually the only family member she was in touch with.