Because of major advances in medicine, public health, and nutrition, the current elder population is larger and more physically incapacitated than the previous 'older' qeneration. In addition, the younger generation is decreasing in size, elders live long beyond their economically productive years, and generationally inverted families in which the elder is dependent on the child are no longer unique. Many stresses are related to conflict and violence in generationally reversed families, including the elder's economic, emotional, and physical dependency; loss of control over his or her environment; and lack of privacy. Research has shown that the most frequent abusers of the elderly are family members and that abuse tends to be concentrated among the elderly 75 or older. Women are not only most likely to be caregivers for elderly parents, but also comprise the overwhelming majority of the vulnerable elderly. Violence is the method of last resort used by both caregivers and elders when they perceive no other method will work. Moreover, some parents never understand that their children are adults. Counseling should address three areas: decisionmaking regarding the assumption of the caregiver role, with attention to the resources available; counseling the family while caregiving; and helping the family address the need for alternatives when the cost of caring for the elderly outweighs the benefits cost of caring for the elderly outweighs the benefits derived from this role. The family must be educated about the care of the elderly, possibly through role playing exercises. Tables, a checklist for families who may assume the care of an elder, a role playing game, and 40 references are supplied.