The number of older people vulnerable to abuse, neglect, and exploitation has increased along with the general increase in the population of senior citizens; there are few reliable safeguards to protect them against abuse. As protection services have been established, the elderly population has become more dependent on competent caregivers. There are similarities and differences between the elderly population and the population of children who are the subject of comparable protection services. But while the abusers often suffer from alcohol or drug dependency, children are more likely to be rehabilitated from their abuse, which is often motivated by frustration and rage, while elder abuse usually stems from financial greed. In 1983, a group of hospital social workers, doctors, nurses, and social service advocates began to lobby the provincial government in Nova Scotia, Canada, to legislate a new adult protection act, which was passed in 1985. The Act to Provide Protection of Adults from Abuse and Neglect gives authority to the Public Trustee in cases of neglect and incompetency (this mandate was also strengthened by the Public Trustee Act), requires mandatory reporting of abuse, and recommends steps to protect elders from abuse. This Act also made the role of hospital social workers a critical one in cases of elder abuse: they must learn how to detect the problem, gain the cooperation of the health care team, and use available resources to plan and carry out an effective discharge program. In addition, the Incompetent Persons Act gives psychiatrists a vehicle for providing guardianship to vulnerable, non-functioning elders. Five cases are presented to demonstrate how elder abuse is handled in a hospital setting. 8 references.