We hear about child abuse and wife beating more than we hear about senior abuse. They're all ugly concepts, but we are likely less aware of the elderly being mistreated since what we hear is generally limited to nursing home cases. This is a limitation that is being relaxed as both houses of Congress debate elder justice provisions in connection with health care reform.
Nursing homes provide the public face since, as Marsha Greenfield of the American Association of Homes & Services for the Aging recently said in an article written by Kaiser Health News, seniors are a more invisible population.
"Adult abuse is a lot harder (than abuse of other vulnerable populations) to get your arms around," she told Kaiser, an independent health news service. She added that this is because, while there are a growing number in community and group living arrangements, so many of the elderly are in their own homes.
The article added that other populations have become more visible as celebrities speak out on their problems. It noted that Nicole Kidman recently spoke at a congressional hearing on violence against women and that stars of "Law & Order: Special Victims Unit" appeared at a Washington rally about child abuse.
Meanwhile, a coalition of elder abuse groups could only muster ordinary seniors telling their painful stories of physical and emotional abuse and financial exploitation. It's too bad that fewer people - and publications - take time to listen when a celebrity isn't speaking.
The lack of support that comes with a lack of spotlight may be changing as federal lawmakers consider establishing federal law to support the fight against elder abuse.
The House's healthcare bill would provide for national background checks for people who care for the elderly. This would override a mixture of state laws that have let known offenders end up in positions of trust where they can do additional harm.
The Senate is considering a broader Elder Justice Act that would provide federal dollars to identify and investigate elder abuse locally, require long-term care providers to report possible crimes to federal authorities and create new oversight within the Department of Health and Human Services. These provisions have been approved by the Senate Finance Committee and are part of health legislation headed for floor debate.
These provisions would help, but only up to a point since studies show up to 90 percent of elder abuse cases involve family or trusted advisors and happen in private homes. And this will get harder to control as more elderly people are at home or in community and group living arrangements without the kinds of oversight mechanisms available when, for example, child abuse is suspected. There, professionals (teachers, doctors, etc.) outside the home are required to report suspected abuse to authorities.
We'll see how the legislation develops. After all, money, as with all things, remains an issue. The Senate Act has an estimated cost of $757 million over four years. Even though this is negligible compared to the cost of healthcare reform as a whole, and despite broad support that includes more than 500 advocacy groups, this could mean passage problems.
For more information on the legislation, click here or here.
Michael Kosner, President
The Kosner Firm Chtd.
