[Violence against the elderly--by the elderly: does it exist?--Medical aspects] .

Thus far there has been very little research on violence in relation to age. This is due to various problems: the definition and delimitation of the term "violence" is unclear, and violence is considered an interactive event in which everyone involved is both victim and perpetrator. Violence is a taboo topic which people prefer to conceal, and those involved do not talk about the violence they experience. The different forms of violence are physical violence, psychic violence, neglect, restraint, financial exploitation and structural violence. Views on the incidence of violence vary: one certainty is that it occurs in care relationships and that psychic violence and neglect are commoner than physical violence. There is no doubt about the correlatives of violence: limited cognitive abilities, disruptive behaviour, troubled relationships, overtaxing, exhaustion and inappropriate structures. Medical care requires awareness of the problem, facing up to one's own violent behaviour, and knowledge of the risks, causes and consequences of violence. Only in this way is effective prevention and intervention possible. Empirical research offers an approach to future prevention and rehabilitation. People required to deal with violence are under a heavy burden, and decisions must often be made in conflict situations. The law provides a framework, which nevertheless allows scope for action. Ethical guidelines may be of great assistance in this context.