No one theory explains the etiology of all elder abuse, neglect, or inadequate care, nor can one theory prescribe the best course of action in response to suspicion or identification of abuse and neglect. The prevailing theories of the causes of elder abuse are based on the assumptions that elder abuse and neglect are neither normal nor to be condoned, that neglect is the most common form of elder mistreatment, and that multiple causes or conditions may be present that must be addressed. "Risk factors" rather than "causes" is the preferred terminology in elder abuse research for many reasons, including the inability of inductive theory building to demonstrate cause and effect empirically. The most commonly accepted risk factors are a history of substance abuse or mental pathology in either the older person or the caregiver; a previous history of abuse in the caregiving context; financial dependence of the caregiver on the older person; chronic illness or impairment that affects the older person who lacks informal support; and chronic illness or impairment that affects the older person and exceeds the capacity of the caregiver to help. The prevailing theories of elder abuse and neglect, including self-abuse and self-neglect, relate to the most commonly cited risk factors. These theories ascribe elder abuse and neglect to the psychopathology of the abuser; transgenerational violence; exchange theory, which includes social exchange and symbolic interaction; vulnerability/impairment of the elderly person; and excessive situational demands. Each of these theories is reviewed in this chapter. Although not a theory of elder abuse and neglect, the environmental press model has robust practical implications for diagnosing likely reasons for inadequate care of an elderly person and for recommending courses of remediation. The use of this model in the provision of diagnosis and remediation is explained in the chapter. 1 figure and 39 references