Although Canadian policies support "aging in place," there still will be a number of older adults who will require institutional care in the future. Most research on elder abuse, however, has focused on domestic abuse and has paid less attention to institutional abuse. The purpose of this article is to comprehensively review current research to identify gaps in knowledge and methodological issues in the study of institutional abuse. Overall, 49 studies in English and 20 studies in French were reviewed, and 11 key-informant interviews were conducted with methodological experts. Methodological challenges are addressed in light of the review and interviews.

Many questions and contradictions pervade both the understanding of what has come to be known as ‘elder abuse and neglect’ and attempts to address it. Four major competing constructions reflecting four differing needs discourses can be discerned in legislation, programmes and services, and in the actions of individuals. In this paper these constructions are introduced, examined and situated, with reference to the social and historical antecedents that have contributed to the emergence of elder abuse and neglect as a social problem. The article considers how these constructions are manifest in public and private responses to elder abuse and neglect, through discussion of the Canadian experience of service delivery to older people in situations of mistreatment and neglect, in non-institutional settings. It is concluded that deeply embedded value conflicts in Canadian society and in its political economy, compound the problem of resolving issues of mistreatment through public policy.

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This article provides an overview of the ways in which the mistreatment and neglect of older people have come to be understood as a social problem, one which is underpinned by a variety of substantive and theoretical assumptions. It connects the process of conceptualizing elder abuse and neglect to political-economic and social evolution. The authors draw on a review of the literature, government sources, interest group websites, and their own research to provide a critical commentary illustrating how these understandings have become manifest in legislation, policies, and programs pertaining to "elder abuse and neglect" in Canada. Suggestions are provided for changes in direction for policies, programs, and research.

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