The goal of elder justice dangles within reach

By Barbara Peters Smith 

"I know she steals my silverware, but at least she comes every day."

Terry Fulmer, president of the John A. Hartford Foundation, quoted these words of her former patient in a Grantmakers in Aging webinar this week, "Making Elder Justice a Reality." The poignant mix of vulnerability and pragmatism at work here is no doubt familiar to a lot of elders and their caregivers, and it illustrates the difficulty of finally doing something meaningful about the complex problem of elder abuse.

Kathy Greenlee

Joining her in the talk was Kathy Greenlee, U.S. assistant secretary for aging and a passionate advocate for raising the profile of elder abuse. The fact that abuse can be physical, emotional and financial complicates the work to combat it, Greenlee said.

"When we talk about an estimated 10 percent of older adults having abuse every year, the number is so large that it becomes a bit numbing," she said. "We are decades behind other fields, such as domestic violence and child abuse, and we really need research in every direction to help us form a response."

Since the passage of the 2010 Elder Justice Act, in concert with the Affordable Care Act, the ball started rolling slowly but is picking up speed. Greenlee is working with a coalition of some 12 federal departments and agencies to put together the first federal "home" for adult protective services.

"It's significant," she said. "At a federal level we've had an office for child protective services for decades." But for adults, "we have 50 different approaches. It creates a patchwork across the country and gives us no real sense of what the national picture looks like, in terms of data and quality."

Even with better research, it won't be easy. Greenlee cited a new report by the Frameworks Institute that was designed to answer her question of "why not everybody in the world is as enraged as I am about elder abuse." The provocative report highlights the thin line between protection and paternalism:

"When thinking about elder abuse, people assume that it is up to younger people to make decisions for older people. When this mode of thinking is active, the public understands older people as objects to be cared for and protected, rather than as actors with voices and minds of their own. These understandings not only fuel ageism but also make it hard for the public to understand how older people’s integration and participation in the community can help to prevent elder abuse."

Hospital price check

The march to greater transparency in health care costs continues: The Florida Hospital Association has unveiled a new section of its “Mission to Care” website, with information on hospital prices and quality. The website also provides context for the cost data and emphasizes that patients should contact their hospitals, physicians and health plans for accurate out-of-pocket estimates.

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The goal of elder justice dangles within reach