I’m happy to report that the NYC Elder Abuse Center has posted my interview on their blog, just in time for World Elder Abuse Awareness Day on June 15. It was fun to record, and got me thinking about the connections between ageism and abuse, some obvious and some less so.
Start with the money, right? Only 2% of federal abuse prevention dollars goes towards protecting the elderly. Ninety-one percent is spent on child abuse and 7% on domestic abuse. (The point is that we should spend more on olders, not less on children.) That is because at some fundamental level Americans don’t value older people. In the proverbial “boat is sinking and you can only save your parent or your child” scenario, some societies would pick Mom, because you only get one. Americans would save the kid, because we prioritize our futures over our pasts.
Most victims are women and the very old. Most abuse takes place in the home. Two-thirds of the perpetrators are adult children or spouses. It crosses all social and economic lines. “Even if the abuse is going on at home and family members are involved—whether it’s physical or financial or involves neglect—it can be a criminal case,” says Elizabeth Loewy, Chief of the New York County District Attorney’s Office Elder Abuse Unit, who successfully prosecuted the Brooke Astor case.
Authorities estimate that at least 5 out of 6 (84%) incidents of elder abuse go unreported. “It’s underreported because I don’t think people know that it’s treated the same way as if stranger steals from strangers,” says Loewy. “It’s a crime.” She finds people more likely to excuse exploitation or neglect by flesh and blood, especially by a child, especially an only child, and especially if the victim has dementia. “You have all these cases. Do you really think it’s so bad if a kid take money from a parent who doesn’t know what’s going on?” she recalls being asked by a hedge fund manager not long ago. Uh, perhaps a thousand times worse? Yet he insisted that if he didn’t know, it wouldn’t bother him. I bet he changes his mind.
Many victims understandably fear antagonizing a caregiver or family member on whom they depend for important things. Mary Anne Corasaniti, who ran New York State’s Onondaga County Elder Abuse Program, recalls the case of a woman who’d been beaten for decades, “from the day she walked down the aisle with this guy. But every time we got to the house she didn’t want to let him go. It took the caseworker about three moths to figure out that he was the one who drove her to see her sister in a nursing home about 60 miles away and he made her think there was no one else who could take her.” The caseworker arranged a ride and the woman threw out her batterer.
Others are reluctant to report abuse, or even a decline in their ability to care for themselves, for fear of being “shipped off” to a nursing home. In fact adult protective caseworkers prioritize the least restrictive intervention: a system that will allow the older person to live in their chosen surroundings for as long as possible—often to the dismay of neighbors or family members. “They may not like the way they live and think they should be forced to move to someplace ‘safe.’ But whose definition of ‘safe?’ Not the seniors’,” says Tim Murphy, case supervisor in protective services for adults at the Orange County Department of Social Services. Murphy points out the need to look at the whole person, start with their abilities, not their deficiencies, and “tell me what they can do for themselves.” Or as geriatricians put it, “if you’ve seen one 80-year-old, you’ve seen one 80-year-old.”
Loewy makes the same point when training new Assistant District Attorneys. “First of all, don’t act like these cases are completely different,” she says. “I just get annoyed when I hear, ‘Oh my God, I have an elder abuse case, what do I do?!?’ I’ve had clients over a hundred years old who were perfectly good cases. Expect that victim is fine unless you hear otherwise.” Even if a client of Loewy’s has a serious cognitive impairment, “I still want to meet them, find out what they can talk to me about or not. And afford them respect.”
“You can’t work with seniors, even if you’re doing something lofty like trying to resolve elder abuse, without being aware of ageism and being careful that you’re not part of the problem,” says Loewy ruefully. “I explain that I don’t want to see attorneys standing up next to someone in a wheelchair, or screaming when they’re not hearing impaired, or talking to the person accompanying them, or touching their back or knee. Do not treat the older victim in a childlike manner because he or she is older. A lot of training needs to be done.”
Interviewing these professionals has been part of my research for an upcoming talk at a conference for elder abuse caseworkers. It’s been an eye-opening pleasure. It also dovetails beautifully and disturbingly with my other reading these days, about the quest for identity and agency on the part of people with disabilities.