Thursday, March 10, 2011

Mickey Rooney's Tale of Elder Abuse

From the

"If elder abuse happened to me, Mickey Rooney, it can happen to anyone."

With this statement last week before the Senate Special Committee on Aging, 90-year old entertainment legend Mickey Rooney focused the nation’s attention on a growing problem that long has remained invisible.

We’ve spent countless billions to extend how long we live, but many fewer resources to ensure safety and well-being in the time we’ve gained. Our failure to address the problem means that millions of our parents and grandparents are paying the price in the form of physical, sexual and psychological abuse, neglect, abandonment, and financial exploitation.

Elder abuse occurs in nursing homes, assisted living facilities, other care settings, and, most often, at home. And it’s deadly, leading to a 300% increase in premature death.

Rooney alleges that his step-son and wife withheld food and medication, isolated and verbally abused him, and controlled his life and assets. Neither fame nor fortune protected him from a fate that befalls untold millions of others.

“I tell my residents,” said Mark Lachs, MD, co-chief of geriatrics at Weill Cornell Medical College, “that of every thirteen older patients they see, odds are, one of them is a victim of elder abuse.”

A just-released New York phone survey conducted by Weill Cornell and colleagues found that 7.6% of people 60+ experienced elder abuse, neglect or financial exploitation in the past year. (A similar nationwide survey found even higher rates.) And these phone surveys can’t capture the elders at greatest risk: those who live in facilities; who can’t answer or don’t have a phone; who are too scared to speak because an abuser is close by, or those with dementia.

Abuse rates among those with Alzheimer’s disease are higher still. A staggering 47% of people with dementia who live at home were abused or neglected by caregivers, according to a 2010 University of California, Irvine study.

Few people in Rooney’s position ever come forward which made his Senate appearance all the more significant. The New York study found that only one of every 23 cases of elder abuse ever comes to the attention of a responsible entity.

Rooney explained it this way: I felt trapped, scared, used, and frustrated. But above all, I felt helpless. For years I suffered silently. I couldn’t muster the courage to seek the help I knew I needed. Even when I tried to speak up, I was told to be quiet. It seemed like no one believed me.

The human suffering exacted by elder abuse is matched only by its immense fiscal burdens. Given its estimated price tag of countless billions/year, we can’t afford not to do something about elder abuse:

Elder abuse increases the likelihood of nursing home admission four-fold, depleting Medicare and Medicaid. Health care providers that bill for care they don’t provide (and neglect frail elders) defraud those programs. Financial exploitation pushes victims whose life savings are stolen to lose homes and rely on public programs for housing and health care. And abusive guardianships squander court resources.

A new Government Accountability Office report released last week found a dearth of resources going to address the problem and a federal leadership vacuum. Our response to elder abuse lags some 40 years behind child abuse and 20 years behind domestic violence, in part because there is no Office of Elder Justice, comparable to federal offices that have for years provided leadership, resources, and sustained attention on child abuse and domestic violence issues. Nor have private funders or not-for-profits stepped forward. The consequences of this systemic neglect are everywhere evident.

The safety net to prevent and address elder abuse is in tatters. In some jurisdictions, Adult Protective Services workers begin fieldwork with less training than a Starbucks employee receives before making her first latte. We don’t know why elder abuse occurs, how much it costs, what practices and programs are effective in addressing it, or how to detect and prevent it. We desperately need more research. Yet, according to the GAO, the National Institute on Aging spent just 1/1000th of its annual budget on elder abuse research. And the situation is similar among other federal or state agencies.

Which takes us back to Mickey Rooney. His testimony has trained a very public spotlight on elder abuse for the first time ever. The question is, will we use this sudden burst of attention to do something lasting? Will Congress and the Administration exert federal leadership, provide resources, and take the necessary smart steps to tackle the problem and build capacity among the fragmented scattershot systems? If Rooney’s dramatic testimony catalyzes such change, it will have been his finest performance yet.

Mickey Rooney's greatest performance - The Hill's Congress Blog

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