Last week, the Elder Justice Coordinating Council (EJCC) held its spring meeting on Capitol Hill, hosted by the Senate Special Committee on Aging. We heard from experts from across the country about milestones in three key areas—research, financial services, and spreading knowledge through training—and where the gaps remain.
As I listened to these dedicated, talented people presenting what they have learned and how they are tackling the thorny issues that elder abuse presents, it struck me that we have accomplished a great deal since the EJCC was established in 2012. We—and by ‘we’ I mean all of us who work on the issues of elder justice from our own spheres of influence—have infused new energy into the field by seeking new partners and joining together to see the work more comprehensively than ever. Law enforcement, health care, community organizations, governments, the aging network, the financial services sector, and philanthropy are all involved in doing this important work.
For the past five years, I’ve carried around a report I call my “calling card”—I’ve used it to ask for help from my colleagues at every level of government and in the private sector. In that 2011 report, titled Stronger Federal Leadership Could Enhance the National Response to Elder Abuse (PDF), the Government Accountability Office reported that, “[f]ederal elder justice activities have been scattered across agencies and as a whole have had a limited impact on the elder justice field; a clear indication that federal leadership in this area has been lacking.”
And it was true. But not anymore. We have worked hard to connect the dots with people, with policy and with practice, and we are seeing that approach bear fruit.
One of the main recommendations called out in the GAO report was to set up an Adult Protective Services (APS) system. We have built a federal home for APS as well as a national database so we can better understand what is happening in abuse of adults, including elders, from the perspective of the states.
In a follow-up report (PDF) in 2012, the GAO called for a national strategy to combat financial exploitation. This is also in progress. Many of their recommendations are happening, with work being done among multiple federal agencies: the Department of Justice has a comprehensive website for prosecutors and other criminal justice officials; the Consumer Financial Protection Bureau has taken steps to encourage banks and other financial institutions to identify and report suspected elder financial fraud; and financial services professionals are more aware of what suspicious activity looks like than ever before.
Bottom line: we really are doing what was needed in this nation. I may need a new calling card going forward.
My Short List: Data, Research, and Screening
If I were asked for a short list of priorities to hand to federal officials, advocates, and to the new administration, there are three areas that I believe require the most significant focus:
Data—We need data everywhere. We need data so we can start analyzing and doing predictive modeling, and to figure out where to find aberrant behavior and abuse. There is data out there, but we have not yet harnessed our ability to pull together the datasets in the federal government to see what is actually happening and how to use that data most effectively. Predictive modeling is a great example of where we can use data not just for prevention, but to see what the data tells us in terms of behavior of older people and their abusers.
Research—We need research in every field. For example, we need research on the normal aging brain, as well as Alzheimer’s and other dementias. Not everyone who is a victim has dementia, but dementia definitely increases the risk for abuse. We need research of a variety of types to help us get better at both prevention and response. And we must identify the factors that support the resilience of older adults who are victims so we can ensure they are also survivors.
Assessment Tools and Screening—We are not yet where we need to be in screening: every professional who works with older adults in any capacity should be screening, and we need better tools. Some of the tools that have been evaluated may work, but they are too long to use in a brief doctor’s visit. We need to develop an easy-to-use tool to help us find abuse, like the mini mental state exam (PDF) used by professionals to quickly identify possible cognitive impairment.
I have a vision of recruiting pharmacists to screen for and respond to abuse—they are often trusted resources for seniors. Banks should proactively screen older customers—not just respond when they see a suspicious transaction. Aging service providers need to catch up, too. Everyone who interacts regularly with older adults—drivers who deliver meals, bankers, doctors, physical therapists, exercise class leaders—anyone who provides services to older people needs to screen for abuse.
Keep Asking People to Help: They Always Say “Yes”
Finally, I want everyone to keep asking for help. Everyone I have asked to help in these efforts says yes. Everyone wants to help.
Even the President. President Obama was our first president to speak out about elder abuse, and his administration was the first to include elder justice as a major focus of the White House Conference on Aging in 2015.
We have to continue to bring new people into the conversation. Let’s keep up the momentum—keep asking people to help.
Sometimes, when we try to tackle a problem this big and this important, it can seem impossible. It feels like pushing a boulder up a hill.
But I can tell you that we have moved this one. Progress is slow but certain. Both now and in the future we must keep pushing. At every level, in every way, we must continue to move forward and upward. Older adults deserve the dignity, independence, and security we all seek, and they are more than worth our effort.