The Elderly Are Not Children
So how come abuse laws treat them that way?
Elder abuse did not exist in the public mind until 1979. That year, a group of Boston researchers used a federal grant to test their hypothesis that something akin to child abuse was prevalent among the elderly. Their study argued that the problem did exist, and it set off alarms about mistreated elders, bruised and battered by stressed-out or uncaring children--a view driven home by shock-value congressional hearings run by the late Rep. Claude Pepper in 1981.
All this led to the creation of an extensive legal system of reporting, investigation and even sometimes the involuntary institutionalization of a threatened aged person. Today, more than 140,000 cases of suspected abuse are reported yearly. Yet there are now troubling questions: Was it counterproductive to start from the child-abuse model? Did that reinforce unhelpful stereotypes about the elderly, setting back, rather than aiding, efforts to wipe out abuse? Among the myths:
Older people--like children--are highly vulnerable to abuse: Perhaps nothing has hurt anti-abuse efforts more than this almost automatic assumption. To write elder-abuse laws, states simply copied existing child-abuse statutes. Today, 43 states require doctors and other social-service professionals to report to state authorities a bruise, a fracture or anything else that suggests abuse. This may make sense with children who cannot speak up for themselves. But it strips the elderly of the confidentiality between doctor and patient--not to mention the ability to make their own decisions--that is afforded all other adults. States have spent millions of dollars to investigate such reports, regardless of the subject's wishes. Sometimes abuse is caught. More often, critics complain, the result is little more than perfunctory paperwork. Far more efficient, says Hofstra University law Prof. John Regan, would be spending money on solid preventive programs, such as helping family members with in-home care or even psychological counseling.
Unlike children, most elderly Americans are independent (40 percent live on their own), financially secure (they have a median household net worth of $60,300, nearly twice the national average) and capable of taking care of themselves. Cornell gerontologist Karl Pillemer argues that elder abuse has more in common with spousal abuse than with child abuse.
Elder abuse is rising at alarming rates. Those driving the elder-abuse issue regularly contend there are some 2 million reportable cases of abuse each year, up from 1 million a decade ago. The figure comes from a distortion of the research by Pillemer, who concluded that no more than 1.1 million older Americans have been abused--ever. In fact, even Pillemer himself says there are no sure numbers--which suggests that it makes more sense to be cautious rather than alarmist when examining the problem. Although it is logical that abuse will become a more urgent problem in a rapidly graying America, it is not clear that abuse is occurring with greater frequency. More likely, with rising awareness by health-care workers and the public, is that more cases are being reported.
Physical abuse is most common. Most elder-abuse laws--following the child-abuse model--focus on physical, psychological and sexual abuse, as well as neglect. But new research suggests the elderly are more probably victims of financial exploitation. Pillemer found financial abuse was the primary problem in 50 percent of cases in Canada, although it is much tougher to detect: A forged check is far harder to spot than a black eye. Contrary to popular perception that the elderly are victimized most often by door-to-door con men and get-rich-quick schemers, the typical abuser is frequently a somewhat distant relative or an acquaintance. Spouses are rarely involved, since most money and property are jointly held.
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