Sunday, April 22, 2012

A Prosecutor Becomes a Champion for the Elderly

By Elizabeth Olson of the New York Times.

MARIE-THERESE CONNOLLY is using the prosecutorial skill she honed fighting nursing home fraud to add dimensions to the public’s awareness of the widespread problem of elder abuse, including highlighting the costs to society of financial, physical and psychological mistreatment of older adults.

“Elder abuse is ubiquitous,” Ms. Connolly, 54, a former Justice Department prosecutor, said. “But we are not connecting the dots and realizing that the economic costs are high. Few people realize the huge implications for Medicare, Medicaid and family programs.”

She has been working — writing federal legislation, testifying and prosecuting cases — for years, but a grant last fall from the MacArthur Foundation recognized her efforts in the area and gave her the financial freedom to reframe the issue on her own terms.

Despite the occasional highly publicized case like the one involving the actor Mickey Rooney, who told Congress he had been mistreated by relatives, or the conviction of the heiress Brooke Astor’s son on charges of defrauding her and stealing millions of dollars from her, the biggest challenge is that aging is something that everyone wants to ignore, Ms. Connolly said.

“We need to talk about this,” she said.

She decided to write a book, but not about the many examples of how older people are exploited or mistreated.

“The engine of the book is going to be the people on the ground who are doing amazing things to help older people who are suffering from all these different kinds of abuses,” Ms. Connolly said of the book, which she said would be published in spring 2013. With no coordinated national approach, “the social workers and others who are trying to help are forced to invent the wheel over and over,” she said.

Protecting the elderly is not a top national concern, she said, although 5.4 million Americans have Alzheimer’s disease, and large numbers of baby boomers are in or approaching their 60s, a period when they become more vulnerable.

Ms. Connolly, an energetic mother of three, did not set out to become a champion of rights for the elderly. As a newly minted lawyer out of Northeastern University School of Law, an early assignment was prosecuting civil fraud cases at the Justice Department.

Several years later, an investigation by the Government Accountability Office, the Congressional watchdog agency, uncovered widespread nursing home abuses. That prompted the Justice Department to set up the Elder Justice and Nursing Home Initiative to, among other things, pursue fraud against older adults. She was named to lead it in 1999.

She left the post in 2007, becoming a fellow at the Woodrow Wilson International Center for Scholars, a Washington research organization, and founding the nonprofit group Life Long Justice to help detect abuse of the elderly and find solutions. In 2010, Congress passed the first federal legislation, the Elder Justice Act, which she helped write, to address such abuse and exploitation.

Despite the law and efforts to shed light on the problem, the toll on victims remains vast and grim, she said.

Just making sure that the people who come into contact with older adults, including doctors and social workers, are trained to distinguish between accidental bruises, which are common among older adults, and marks that are inflicted by someone else would be an important step, she said.

Ms. Connolly also wants people to understand the economic toll of abuse, noting that studies show that abused elderly people “are more likely to be admitted to a nursing home, for example, and far more likely to suffer from increased mortality and morbidity.”

When financial, physical or other abuse means that an older person cannot live independently, taxpayers pick up the bill for costly acute, intensive or long-term care via Medicare or Medicaid, she said.

Financial exploitation alone costs victims $2.9 billion annually, according to a 2011 MetLife Mature Market Institute study. Ms. Connolly said that the actual cost of abuse could be much greater, but no comprehensive study had been done.

A major drawback to public awareness, she said, is the lack of research, especially in the areas of intervention and prevention. It is difficult to pinpoint the precise number of cases of mistreatment and abuse of older people, she said, because abuse takes many forms, can be hard to detect and can occur at home or in nursing homes and other institutions.

Citing surveys and studies over the last decade, Ms. Connolly estimated that several million older Americans suffered abuse each year. But she said, “It’s very hard to put a finger on the prevalence.”

To arrive at more precise figures, she is working with some other specialists on the elderly to research the various aspects of abuse and to find financing to support the effort.

Her no-strings $500,000 MacArthur award helps make up for the fact that she has not drawn a salary since she left her federal job — something her family has taken in stride although her older two children are in college. Her husband, Daniel Kohrman, is a lawyer with the AARP Foundation and works on issues involving older adults as well.

But Ms. Connolly says she knows focusing public attention on abuse of the elderly is not going to be easy.

“Despite the tide of aging baby boomers, people are still far more aware of child abuse and domestic violence than they are of what happens to an older neighbor or relative,” she said. “Elder abuse is still a national blind spot.”

Link to story.

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