25 July 2008

Third in a series: The Tragedy of Elder Abuse

This is the third in a series of reports pertinent to seniors and families. Today; Elder Abuse - Our Secret Tragedy. Monday; Healthcare. Be sure to refer your friends!

Three years ago, I was honored to be selected as an At-Large (Texas) delegate to the 2005 White House Conference on Aging. This conference, called by the president, happens only once very ten years. What is now known as Medicare and the Older Americans Act grew out of citizen input at previous year’s conferences. I was excited at the notion of joining with others in the shaping of America's future for its older citizens. That hope led to disappointment.

There were a number of disappointments in this conference; Bush did not even bother to appear before his own conference—he instead held a photo-op extolling the Medicare Rx bait-and-switch program at a suburban, gated-community of wealthy Virginia “retirees”, and the conference itself was constructed so that meaningful grassroots citizen input was prevented or ignored. Delegates were asked to rubber stamp administration provided options to administration selected issues which were then to be ignored and hidden in a basement storeroom in the Old Executive Office Building.

One particularly frightening horror, which has a great deal of bearing on our topic of the day, oozed forth from the fetid and reeking sludge of the official Republican party line. Conference organizers were very clear in touting the Bush/Republican line that resources will not be available to provide any meaningful level of long-term care to the “baby-boom bubble”, and that this generation of Americans will be required to “age-in-place” and be provided care by their families. No, not trained caregivers or para-medic people--their families.

To prepare for this, the Republicans offer a national long-term care program which says the "boomers" should eat right, quit smoking and exercise more, so that they enter their old age in better shape.

Let’s put aside all the other issues related to this dismissive, cruel and cynical view of our future and focus on its implications for exacerbating the already chronic tragedy of elder abuse. Imagine a very near future in which financially hard-strapped working families, fighting to pay their mortgage, help their kids through college, and save and prepare for their own old age, also assume the role as primary caregivers to two sets of aging parents who must age “in-place” regardless their mental or physical limitations and/or impairments. Remember, Bush/Republicans tell us there will be no money for resources to assist or support our families—we are on their own!

It is not difficult to imagine scenarios of stress, fatigue, and impatience contributing to, and compounding, the various types of elder abuse. These are; passive and active neglect, physical abuse, material/financial abuse or misappropriation of property or funds, psychological abuse, violation of basic rights, the over looking or allowance of self-neglect, and yes, even sexual abuse.
Dr. Linda Woolf, of Webster University, writes that caregiver stress is already believed the leading contributory factor in the extremely complex problem of elder abuse. As the aging person’s dependency and impairment increases, so too does the likelihood of abuse. Other correlating contributing factors include external stresses such as job or financial pressures, substance abuse, and family or marital discord, along with social isolation, intergeneration transmission of violence, and emotional disorders.

What is already a tragic problem in our society threatens to become a catastrophe.

The National Center on Elder Abuse reported, in 2005, that between 1 and 2 million older Americans have been injured, exploited or otherwise mistreated by someone they depended on for care or protection. They also estimate that for every one case of elder abuse, neglect, exploitation or self-neglect coming to light, there are five more that go unreported or unnoticed.
In Texas alone, the state’s Adult Protective Services Agency reported that during 2004 it completed 61,342 investigations of abuse, neglect, or exploitation involving vulnerable adults. Of these, 44,694 were confirmed. Using the one for five ratio given us by the NCEA, this would project to slightly more than 230,000 annual cases of elder abuse in Texas alone.

There are currently bills working their way through the Senate and House (Elder Justice Act) which would, “Amend the Social Security Act to enhance the social security of the Nation by ensuring adequate public-private infrastructure and to resolve to prevent, detect, treat, intervene in, and prosecute elder abuse, neglect, and exploitation, and for other purposes”.

Specifically, the bipartisan, bicameral effort aims to coordinate the efforts of the federal government with states, senior centers, law enforcement organizations, community groups and social services to prevent and respond to instances of physical, emotional or financial abuse of seniors—whether committed by family members, strangers or caregivers.

We applaud this as a realistic and healthy initial step away from the current Bush/Republican national long-term care policy of, “You’re on your own; eat right, quit smoking and try to get some exercise!”

First steps are good. But, they should be toward a goal. We believe that goal should be a national system, tax and private enterprise supported, along the lines of the Veteran’s Administration or Medicare, providing long-term care for the country’s aged population and assistance and support for their caregivers.

A good starting point for funding such a program would be to offset and claim a percentage of the profits from oil companies, HMOs, pharmaceuticals, and health and life insurance companies, along with all for-profit companies employing 200 or more full, or part-time employees, and contractors.

Frankly, I'm under-whelmed with well-meaning, first-step incrementalism. Let us set the goal and educate, organize and mobilize toward its achievement.

Here’re a few sites for addition information:

National Committee For The Prevention of Elder Abuse:
http://www.ncea.aoa.gov/NCEAroot/Main_Site/Index.aspx

Texas State Adult Protective Services Agency:
http://www.dfps.state.tx.us/Adult_Protection/About_Adult_Protective_Services/

Elder Abuse and Neglect. Linda M. Woolf, Ph.D., Webster University
http://www.webster.edu/~woolflm/abuse.html#pot

Track the Elder Justice Act in Congress
http://www.govtrack.us/congress/bill.xpd?bill=h110-1783

Coming Monday: Healthcare, be sure to refer your friends.

1 comment:

Katharine said...

Your suggestion is just not fair to the poor and the working class.

The problem with having a “federal long term care program” is that the federal and state governments ALREADY pay for long term care services for the poor and for most of the middle class.

A new federal program covering long term care would benefit the rich and the upper middle class who can’t qualify for government-funded long term care.

Why should a new tax (because that's what you're really proposing) take more money from working Americans in order to primarily benefit the richest Americans? It’s just not fair to working Americans.

Certainly, Medicaid needs to be streamlined and improved. Some states are working on expanding home healthcare benefits under Medicaid. That's a good thing.

To suggest that "a portion of the profits of HMO's, oil companies, and insurance companies" shows that you have no idea how much money is spent on formal and informal long term care costs. The entire profits of all the oil companies (in these years of record profits) would not even cover all the costs of care. Your wonderful program would then force Congress to tax the poor to continue to fund a program for the rich.