The first section provides background information on older persons and the institutional environment in this period of crisis for the welfare state. The second section outlines the problem of abuse and neglect of the elderly in institutional settings, followed by a section that discusses the role, responsibility, and perspectives of older persons regarding the problem. Turning to the roles of institutions and caregivers, the discussion addresses prevention, detection, and intervention techniques, respectively, in the next three sections. Sections seven and eight consider two issues of critical importance for fashioning a better future: training in care-providing settings, both as a preventive tool and as a way to change attitudes and practices; and the ethical considerations that guide not only the practices but also the philosophical direction of a society with an increasing proportion of elderly persons. The paper concludes that although the prevalence of mistreatment in institutional settings is not known, current estimates are from 4 to 11 percent. The literature clearly shows the importance of sensitizing the community both to the aging process and to the problem of abuse of older adults in institutional settings through education and information dissemination. 42 references