He spent his final decades alone, a tenant—“resident” is the preferred term—in a low-income seniors’ and disabled persons’ rent-subsidized housing project. He was, in fact, all three: low-income, elderly, disabled. A paid “caregiver” jabbed, pushed and yelled at him. The apartment, a small studio, reeked. While inventorying his possessions during one of his hospital stays, she was heard to comment to a compeer, “We can sell this.” She had his pin number and had gotten her name onto his bank account. Asked why he didn’t request a different caregiver, he responded “I’m afraid.” No eccentric recluse, he wanted to be out and about. On weekends, when no building staff were on the premises, he would emerge from his cell and, leaning on his walker, navigate the corridor back and forth as many times as he possibly could.
Many senior citizens are like him, alone and without family, dependent on a so-called caregiver. In 2006, twenty percent of reported elder abuse involved caregiver neglect. English may not be their “first language.” They may fear losing their rent subsidy. Building management may be hostile, indifferent at best. Attempts to learn the time and place of neighbors’ funeral services can be “turned off.”
The decennial White House Conference on Aging is in the planning stages. Its purpose is to make recommendations to the President, who did not attend the 2005 Conference, and Congress to help guide national aging policies for the next ten years and beyond. The White House Conference on Aging in 2015 theme is “The Shape of Things to Come.”
The U.S. Census Bureau projects that more than 62 million Americans will be age 65 or older in 2025. Newspapers worldwide report elder abuse, a crime in many locations. And because most “senior citizens” are women, the majority of low-income elders, both ageism and sexism are frequently involved. Older women are far more likely than men to suffer from abuse. Interestingly, slightly more than half of the alleged perpetrators of elder abuse were female (fifty-three percent) in the National Center on Elder Abuse 2004 study.
Across the nation, newspapers headline abuse. England’s Guardian reports a government-backed study to examine risk of abuse and neglect of older people in care homes and on National Health Service wards. Cleveland’s Plain Dealer reports that “Japanese visit for ideas on elder care: Social workers want to avoid senior abuse.” California Bay Area newspaper reportage has included: ”Pastor convicted of murdering elderly rancher;” “Dementia patients mistreated, suit says; Elder abuse, fraud alleged at rest home near Lake Merritt;” “Murder, elder abuse charges for 2 in death of their client;” “Oakland man to stand trial for beating elderly people.” “Early involvement critical to curbing elder scams.” “Elder Protection Court crucial to halting abuse.” “Elder abuse a hidden national epidemic.” “$500,000 bail remains for Foster City man accused of hitting father in head.” “Not guilty plea in attack on Holocaust survivor.” “Real estate broker pleads no contest to cheating seniors.” “Senior-abuse agencies short on funds.” “Elder facility accused of abuse.”
Because the crime of elder abuse is notoriously under-reported, no statistic comes close to telling the whole story. The most recent nationwide analysis of elder abuse estimated that reported cases increased thirty percent from 1997 to 2007. In California, half of all residents over age 65 and living alone do not have enough money to cover their housing, food, health care and other basic expenses, according to a 2009 UCLA Center for Health Policy Research study. In Florida—the state with the second-highest 65-plus population—reports of elder abuse have increased thirteen percent in the last two years, according to the state’s Adult Protective Services. The California Legislature voted to eliminate the Attorney General’s Crime and Violence Prevention Center from the State’s 2008/09 budget, and it was closed on Oct., 15, 2008. Each state has its own elder abuse laws, so definitions of abuse and prosecution for such acts vary across the country. State adult protective service programs, which handle elder abuse, are severely underfunded, a problem exacerbated by recession-era cuts in state budgets. Passing the federal Older Justice Act tops advocates’ lists of what must be done to combat this problem.
When I approached a senior center director about the possibility of an elder abuse current-awareness program, she was skeptical but agreed to let me use the lounge. I provided the program, handouts, and publicity. It was well attended by people from several communities. Most described themselves as neighbors and relatives. They asked “Is such’n such ‘elder abuse’?,” and they wondered “What can I do when we see/hear him doing that?” I moved on and up. But elder abuse did not merit consideration, responded the Commission on Aging’s chair.
Senior housing, senior centers, nursing homes—approximately twenty-five percent of elder abuse occurs in nursing homes and other retirement facilities—and rehabilitation facilities, ombudsmen, certain college and university classes, caregivers, and related commissions and agencies have responsibility for communicating the facts of life related to elder abuse: what it is and where to go for help. The San Diego District Attorney’s office defines elder abuse as the physical or psychological mistreatment of a senior. It can include taking financial advantage or neglecting the care of a senior. Elder abuse crimes fall into several categories:
Physical abuse, including assaults, batteries, sexual assaults, false imprisonment and endangerment;
Physical neglect by a caregiver, including withholding medical services or hygiene that exposes the elderly person to the risk of serious harm;
Psychological mental abuse, including making threats or the infliction of emotional harm;
Financial abuse, including theft of personal items such as cash, investments, real property and jewelry and neglect.
The AARP March 2008 Bulletin published a Scam Alert titled “Harrowing Home Care.”
If you suspect elder abuse, neglect, or exploitation,call the National Domestic Violence Hotline 1-800-799 -7233. To connect with services by state, reach the U S Administration on Aging’s Eldercare Locator at 1-800-677-1116, or go to www.ncea.aoa.gov.
When I shared news of a nearby community’s elder abuse workshop with a physician whose specialization is geriatrics, she responded, “This is a much-needed presentation—should be every day on the street corner. Seldom a day goes by that I don’t hear of some injustice… .”
Dr. Wheeler is a Berkeley resident, a senior advocate who has served on the Berkeley Commission on Aging, Berkeley Housing Authority board, North Berkeley Senior Center Advisory Council, and the Alameda County Commission on Aging.