In this season’s first episode of NYPD Blue, a television series of which I have been an off-and-on fan, a woman in her 80s is carried out of her apartment building on a stretcher. She has been assaulted by a young man whose brutal crime disgusts even hardened police detectives. The brief sight one gets of her is upsetting: she is covered with bloody bruises and looks comatose.
This scene, with its evidence of a terrible attack on a defenseless old woman, has reminded me how widespread elder abuse has become. I find the subject painful even to contemplate, the reason why I have not written about it before now. But a talk given last month at a week-long seminar for journalists has raised my consciousness of how a great many older Americans suffer abuse at the hands of other people and the need for the public to become aware of it.
The seminar speaker was Robert Blancato, who now serves as president of the National Committee to Prevent Elder Abuse. He knows the way Congress works because, for more than ten years, he staffed the House Select Committee on Aging.
In testimony to the U. S. Senate, Bob Blancato put the number of elder abuse cases nationwide at almost 500 thousand. Of these, 15 thousand were alleged to have taken place in nursing homes and other long-term care facilities. But these are only the reported cases; he estimates that the total number could be five million, because eight out of every ten instances go unreported.
Blancato supports the “Elder Justice” legislative proposal introduced by Senator Breaux that would strengthen and reorganize federal efforts to fight abuse. This proposal aims at establishing dual offices of Elder Justice, one at Health and Human Services, the other at the Department of Justice. These offices would coordinate efforts on various governmental levels and also strengthen protective services around the country.
Most elder abuse – physical, sexual, emotional/psychological – comes from family members, many of them caregivers of the person abused. Financial exploitation, neglect, and abandonment are other common forms of offenses against older people.
Women are more likely to be mistreated than men. Those with ailments like Alzheimer’s disease that make them more vulnerable, suffer more abuse than others. Spouses who have had a history of struggling with their partners for domination by violence, threats, or other tactics may turn to other forms of abuse. Experts describe many such cases in the phrase “domestic violence grown old.”
In Massachusetts we are fortunate to have an effective protective services network with more than two decades’ experience. Among its features is a legal requirement for doctors, nurses, social workers and other professionals in the medical and helping fields to report evidence of elder abuse.
The easiest way for anyone to get help is to contact the state office responsible for elder services at a hotline open 24 hours, seven days a week: 1 800 922-2275. But you can also call your regional home care agency (known as an ASAP – “Aging Service Access Point”) or local council on aging. The social workers who respond to requests for help I have found to be caring and sensitive in emotionally complicated situations.
One such protective services social worker to whom I talked for this column is Gavin Malcolm of Somerville-Cambridge Elder Services. In responding to instances of abuse by family members, he and his colleagues exercise prudence. “We try to utilize the least restrictive intervention possible,” he says. Each scenario is different and requires sensitivity.
Often, the pressures leading to abuse can be much relieved by providing additional support to the family caregiver, Malcolm explains. Often the latter does not know about adult day care centers, for example, or assisted living alternatives. Helping a spouse or other family member connect with outside assistance can improve the situation greatly.
It is rare, Malcolm reports, to find the abuser sadistic. Much more likely are cases like those in which the adult son or daughter of an elderly father with Alzheimer’s punches the elder, pushes him down, or threatens him with nursing home placement. Obviously, in a situation like that, the caregiver may be suffering an overload of stress and need help rather than condemnation.
Adam Kramer, a spokesman for the Executive Office of Elder Affairs, agrees with national experts in saying “clearly elder abuse is an underreported crime.” He shared with me two of his agency’s new programs designed to detect financial exploitation, a form of abuse that the protective service network has become more aware of lately.
The first program is a bank reporting project whereby tellers are trained to recognize efforts to take advantage of an elder’s money. Suspicious signs include unusually large withdrawals or special nervousness on the part of a companion.
The other is a money management program that can help forestall chaos in elders’ finances making them an easy target for chicanery.
If how we treat our elders is one gauge of a healthy society, then protecting them against abuse surely deserves high priority.
Richard Griffin