Estimates of elder abuse cases in the United States range up to 2.5 million per year; most victims are women, aged over 75, physically dependent, and with some mental impairment. The incidents cover the spectrum of physical abuse, psychological abuse, financial abuse, sexual abuse, and neglect. In most cases, elder abuse is not a crime, but an indication of a family in need of help. Family caregivers may feel trapped in a situation where they have no experience, coping skills, or choices. The situation can reactivate old family conflicts, triggering frustration and resentment. Communications are thwarted by misunderstandings and even loss of speech or hearing. Personal stress factors are exacerbated by chronic illness, inadequate finances, and lack of a support system. Substance abuse and personality traits are often involved in elder abuse. The cycle of abuse is usually triggered by a crisis; the caregiver's guilt increases the stress level and leads to further abuse. As families continue to care for their elderly at home, social services need to be expanded, professional intervention options legislated, and preventive measures implemented. 3 references.